Abdullah Murdhani, Rani Abdul A, Simadibrata Marcellus, Fauzi Ahmad, Syam Ari F
Department of Internal Medicine, Faculty of Medicine, University of Indonesia - Cipto Mangunkusumo Hospital. Jl. Diponegoro no. 71, Jakarta 10430, Indonesia.
Acta Med Indones. 2012 Apr;44(2):94-9.
to evaluate the performance of fecal tumor M2 pyruvate kinase (M2PK) as a diagnostic biomarker for colorectal cancer (CRC) screening in high-risk or symptomatic populations.
consecutive patients (N=328) who were referred for elective colonoscopy were prospectively enrolled. One walnut-sized stool sample was collected from each patient for analysis of tumor M2PK content using an ELISA kit. No dietary restrictions were applied. The clinical pathologists who conducted the M2PK analyses were blinded to the patients' confirmed diagnoses. Levels of fecal tumor M2PK were compared with histopathological results from colorectal biopsies.
of the 328 patients who underwent colonoscopy examinations, 197 (60.1%) were men and 131 (39.9%) were women. Based on histopathological examination, 83 (25.3%) patients had normal bowel histology, 42 (12.8%) patients had CRC, 67 (20.4%) patients had adenoma, 19 (5.8%) patients had inflammatory bowel disease, three (0.9%) patients had amoebic colitis, and 114 (34.8%) patients had infective colitis. The cutoff level for tumor M2PK concentration was defined as 4.00 U/mL. The sensitivity, specificity, positive predictive value, and negative predictive value of the M2PK test were 71.4%, 71.0%, 73.5%, and 94.4%, respectively. There was a significant association between CRC and fecal tumor M2PK level (P<0.001). The M2PK test detected 16 tumors among 67 (23.9%) cases of adenoma, eight tumors among 19 (42.1%) cases of inflammatory bowel disease, 35 tumors among 114 (30.7%) cases of infective colitis, and two tumors among three (66.7%) cases of amoebic colitis.
the fecal tumor M2PK test has good sensitivity and specificity for CRC detection, especially in high-risk or symptomatic populations.
评估粪便肿瘤M2丙酮酸激酶（M2PK）作为高危或有症状人群结直肠癌（CRC）筛查诊断生物标志物的性能。
前瞻性纳入连续328例因择期结肠镜检查而转诊的患者。从每位患者收集一份核桃大小的粪便样本，使用酶联免疫吸附测定试剂盒分析肿瘤M2PK含量。未施加饮食限制。进行M2PK分析的临床病理学家对患者的确诊诊断不知情。将粪便肿瘤M2PK水平与结直肠活检的组织病理学结果进行比较。
在328例接受结肠镜检查的患者中，197例（60.1%）为男性，131例（39.9%）为女性。根据组织病理学检查，83例（25.3%）患者肠道组织学正常，42例（12.8%）患者患有CRC，67例（20.4%）患者患有腺瘤，19例（5.8%）患者患有炎症性肠病，3例（0.9%）患者患有阿米巴结肠炎，114例（34.8%）患者患有感染性结肠炎。肿瘤M2PK浓度的截断水平定义为4.00 U/mL。M2PK检测的敏感性、特异性、阳性预测值和阴性预测值分别为71.4%、71.0%、73.5%和94.4%。CRC与粪便肿瘤M2PK水平之间存在显著关联（P<0.001）。M2PK检测在67例（23.9%）腺瘤病例中检测到16个肿瘤，在19例（42.1%）炎症性肠病病例中检测到8个肿瘤，在114例（30.7%）感染性结肠炎病例中检测到35个肿瘤，在3例（66.7%）阿米巴结肠炎病例中检测到2个肿瘤。
粪便肿瘤M2PK检测对CRC检测具有良好的敏感性和特异性，尤其是在高危或有症状人群中。
