Che Alhadi Shahidah, Wan Zain Wan Zainira, Zahari Zalina, Md Hashim Mohd Nizam, Syed Abd Aziz Syed Hassan, Zakaria Zaidi, Wong Michael Pak-Kai, Zakaria Andee Dzulkarnaen
Department of Surgery, Kulliyyah of Medicine, International Islamic University Malaysia, Kuantan, Malaysia.
Department of Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.
Ann Coloproctol. 2020 Dec;36(6):409-414. doi: 10.3393/ac.2020.08.27. Epub 2020 Sep 18.
Guaiac fecal occult blood test (gFOBT) has been the standard for colorectal screening but it has low sensitivity and specificity. This study evaluated the use of fecal tumor M2-pyruvate kinase (M2-PK) for detection of colorectal cancer and to compare with the current surveillance tool; gFOBT in symptomatic adult subjects underwent colonoscopy.
Stool samples were collected prospectively from symptomatic adults who had elective colonoscopy from September 2014 to January 2016 and were analyzed with the ScheBo M2-PK Quick test and laboratory detection of fecal hemoglobin.
The results were correlated to the colonoscopy findings and/or histopathology report. Eighty-five subjects (age of 56.8 ± 15.3 years [mean ± standard deviation]) were recruited with a total of 17 colorectal cancer (20.0%) and 10 colorectal adenoma patients (11.8%). The sensitivity of M2-PK test in colorectal cancer detection was higher than gFOBT (100% vs. 64.7%). M2-PK test had a lower specificity when compared to gFOBT (72.5% vs. 88.2%) in colorectal cancer detection. The positive and negative predictive values were 47.2% and 100% for M2-PK test and 57.9% and 90.9% for gFOBT.
Fecal M2-PK Quick test has a high sensitivity for detection of colorectal cancer when compared to gFOBT, making it the potential choice for colorectal tumor screening biomarker in the future.
愈创木脂粪便潜血试验(gFOBT)一直是结直肠癌筛查的标准方法,但它的敏感性和特异性较低。本研究评估了粪便肿瘤M2-丙酮酸激酶(M2-PK)用于检测结直肠癌的情况,并与当前的监测工具——gFOBT进行比较,研究对象为有症状的成年受试者,他们均接受了结肠镜检查。
前瞻性收集了2014年9月至2016年1月期间因择期结肠镜检查而有症状的成年受试者的粪便样本,并用ScheBo M2-PK快速检测法和粪便血红蛋白实验室检测法进行分析。
结果与结肠镜检查结果和/或组织病理学报告相关。招募了85名受试者(年龄56.8±15.3岁[平均值±标准差]),其中共有17例结直肠癌患者(20.0%)和10例结直肠腺瘤患者(11.8%)。M2-PK检测在结直肠癌检测中的敏感性高于gFOBT(100%对64.7%)。在结直肠癌检测中,M2-PK检测的特异性低于gFOBT(72.5%对88.2%)。M2-PK检测的阳性和阴性预测值分别为47.2%和100%,gFOBT的阳性和阴性预测值分别为57.9%和90.9%。
与gFOBT相比,粪便M2-PK快速检测法在检测结直肠癌方面具有较高的敏感性,使其成为未来结直肠肿瘤筛查生物标志物的潜在选择。