Faecal tumour M2 pyruvate kinase: a new, sensitive screening tool for colorectal cancer

Hardt, Philip D.; Mazurek, Sybille; Toepler, M; Schlierbach, P.; Bretzel, Reinhard G.; Eigenbrodt, Erich; Kloer, Hans-Ulrich

doi:10.1038/sj.bjc.6602033

Cited by 123 publications

(110 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These analyses showed that performance characteristics of the test only changed slightly when potential degradation during mailing of control samples was taken into account. The consistency of our findings with performance characteristics reported previously based on smaller sample sizes (Hardt et al, 2004;Shastri et al, 2006) further supports that the limitations of our study might not have distorted the results.…”

Section: Discussionsupporting

confidence: 91%

“…Given that previous studies on tumour M2-PK did not mention conditions of sample handling at all (Hardt et al, 2004;Shastri et al, 2006), the necessity of raising stability issues within our study is not only a limitation, but also a strength and allows further conclusion: Application of the test in a setting where a cold chain might be feasible would be expected to result in levels of specificity close to the corrected levels derived in this study and in levels of sensitivity close to those observed in this study. Conversely, application of the test in a setting where all stool samples are mailed without cooling would be expected to result in levels of specificity close to the uncorrected levels observed in this study and in levels of sensitivity that would be somewhat lower than observed in this study.…”

Section: Discussionsupporting

confidence: 58%

“…So far, specificity of the tumour M2-PK test has only been estimated based on selected high-risk controls (Hardt et al, 2004;Shastri et al, 2006). Our results suggest that specificity may be slightly higher in an asymptomatic screening population.…”

Section: Discussionmentioning

confidence: 71%

See 2 more Smart Citations

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

et al. 2007

View full text Add to dashboard Cite

Stool testing based on tumour-derived markers might offer a promising approach for non-invasive colorectal cancer (CRC) screening. The aim of this study was to estimate the potential of a new test for faecal tumour M2-PK to discriminate patients with CRC from a large sample of unselected older adults. Faecal tumour M2-PK concentrations were determined in 65 CRC patients and in a population-based sample of 917 older adults (median age: 65 and 62 years, respectively). Sensitivity and specificity of the test were calculated at different cutoff values, and receiver-operating characteristic curves (ROC) were constructed to visualise the discriminatory power of the test. The median (interquartile range) faecal tumour M2-PK concentration was 8.6 U ml À1 (2.8 -18.0) among CRC patients and o2 U ml À1 (o2 -3.2; Po0.0001) in the population sample. At a cutoff value of 4 U ml À1 , sensitivity (95% confidence interval) was 85% (65 -96%) for colon cancer and 56% (41 -74%) for rectum cancer. Specificity (95% confidence interval) was estimated to be 79% (76 -81%). Given the comparatively high sensitivity of the tumour M2-PK stool test (especially for colon cancer) and its simple analysis, the potential use of the test for early detection of CRC merits further investigation. Possibilities to enhance specificity of the test should be explored. Colorectal cancer (CRC) is one of the leading causes of cancerrelated morbidity and mortality worldwide (Ferlay et al, 2004). Even in countries where up-to-date therapeutic options are available, more than 40% of CRC patients still die from the disease within 5 years after diagnosis (Brenner, 2002;Brenner et al, 2005). As survival is considerably better for early, localised CRC than for later stages and CRC might be prevented altogether by detection and removal of precancerous lesions, enhanced screening will be of crucial importance for further progress in reducing the burden of the disease.Experience with faecal occult blood testing (FOBT) has shown the possibility of reducing both incidence and mortality owing to screening based on stool tests (Hardcastle et al, 1996;Mandel et al, 1999Mandel et al, , 2000 and the advantages of this screening modality regarding acceptability and practicality compared with invasive screening options. However, given the limitations of FOBT, mainly the inherently low sensitivity to detect precancerous or cancerous lesions, there is still need for improvement. Therefore, the development of stool tests with better performance characteristics has become a focus of current research, both in the field of DNAbased stool markers and in the field of protein-based stool markers. For some of the new tests, preliminary results regarding sensitivity and specificity are encouraging but evidence of the performance of the new methods is mostly restricted to small-scale investigations in the clinical setting (Haug and Brenner, 2005a).A novel approach based on the detection of proteins in stool derived from neoplastic colonocytes is the quantitative measurement of faecal tum...

show abstract

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 58%

See 1 more Smart Citation

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

et al. 2007

View full text Add to dashboard Cite

show abstract

“…Previous studies investigating this test reported a comparably high sensitivity for CRC ranging about 70 -80%, whereas specificity ranged about 70 -90% (Hardt et al, 2004;Vogel et al, 2005;Shastri et al, 2006;Tonus et al, 2006;Haug et al, 2007;Mulder et al, 2007;Koss et al, 2008). However, the potential of the tumour M2 PK test to detect colorectal adenomas, an issue that is highly relevant for estimating its use in reducing CRC incidence and mortality, has been investigated rarely and with rather limited sample size only (Vogel et al, 2005;Shastri et al, 2006;Mulder et al, 2007;Koss et al, 2008).…”

mentioning

confidence: 99%

Sensitivity and specificity of faecal tumour M2 pyruvate kinase for detection of colorectal adenomas in a large screening study

2008

View full text Add to dashboard Cite

The measurement of faecal tumour M2 pyruvate kinase (tumour M2 PK) has been proposed as a novel approach for early detection of colorectal cancer (CRC). However, as regards the potential of the test to detect precursors to CRC, an issue that is highly relevant to estimate its use in reducing CRC incidence and mortality, the available evidence is scant and controversial. The aim of our study was to determine the performance characteristics of the tumour M2 PK test with respect to colorectal adenomas in the target population of screening. Among 1082 participants of screening colonoscopy in Germany, of whom 30% had any adenoma and 10% had an advanced adenoma, the median (interquartile range) tumour M2 PK level in the whole study population was 1.3 U ml À1 (0.3 -3.3). At a cutoff value of 4 U ml À1 , sensitivity was 22 and 23% for detection of advanced and other adenomas, respectively, whereas specificity was 82%. The area under the receiver-operating characteristics curve (95% confidence interval) was 0.54 (0.51 -0.58) and 0.56 (0.52 -0.59) for advanced and other adenomas, respectively. In conclusion, the tumour M2 PK test has only very limited potential to distinguish between people bearing precursors to CRC and people with no finding at colonoscopy.

show abstract

“…Fecal pyruvate kinase: Fecal Pyruvate Kinase has been suggested as a potential new marker for intestinal inflammation in children with IBD [75], a new predictor for inflammation and severity of pouchitis [76], and as a new, sensitive screening tool for CRC [77].…”

Section: Biomarkers Of Outcomes/complicationsmentioning

confidence: 99%

Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

Bahgat¹

2017

Austin J Gastroenterol

View full text Add to dashboard Cite

Ulcerative colitis (UC) and Crohn's disease (CD) exemplify the two main arms of the spectrum of an idiopathic chronic disease known as inflammatory bowel disease (IBD). To date, this disease remained a puzzling dilemma in many aspects; including difficulties in its etiology/pathogenesis, diagnosis, severity assessment, treatment and outcomes/complications. Physicians usually get the diagnosis of IBD through a combination of clinical features, laboratory tests, radiology, as well as the invasive technique of endoscopy/biopsy. In spite of these efforts, the definite diagnosis can't be established in a significant cohort of cases. This paved the way to searching for laboratory biomarkers that are noninvasive, reproducible, rapid and relatively cheap than other modalities. Unfortunately, we're still far from these ideal biomarkers. Some biomarkers are already being used in daily practice including C-reactive protein (CRP) and fecal calprotectin while others are still in need for confirmation before being applied in clinical practice. In this review article, the authors are going to discuss the past, present, and future utility of biomarkers in IBD. This article aims at highlighting the uses and limitations of all possible current and novel biomarkers in every aspect of the disease from predisposition to prognosis.

show abstract

Faecal tumour M2 pyruvate kinase: a new, sensitive screening tool for colorectal cancer

Cited by 123 publications

References 33 publications

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients

Sensitivity and specificity of faecal tumour M2 pyruvate kinase for detection of colorectal adenomas in a large screening study

Bio-Markers of Inflammatory Bowel Disease: Past, Present, and Future

Contact Info

Product

Resources

About