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Subject Area

Endemic and Tropical Medicine

Article Type

Original Study

Abstract

Objective To evaluate the value of fecal M2-pyruvate kinase (M2-PK) level in patients with colorectal cancer (CRC) and other organic colonic disorders. Background Cancer cells are characterized by a high glycolytic rate, which leads to energy regeneration and anabolic metabolism, producing an abnormal expression of M2-PK. Multiple studies have demonstrated that the expression levels of M2-PK are upregulated in numerous cancer types. Patients and methods This prospective study included 30 patients with inflammatory bowel diseases (IBD), 32 CR polyps, and 31 CRC, who were compared with 42 controls. The quantitative M2-PK level was measured in all patients using a highly sensitive enzyme-linked immunosorbent assay. Results Our study revealed a highly significant increase in fecal M2-PK in the patients with organic colonic disorders compared with the control group. At a cutoff value of 3.95 U/ml, M2-PK was 93% sensitive and 81% specific for detection of CRC. Furthermore, in our study, fecal M2-PK level were significantly increaes in advanced CRC stage according to the Amrican Joint Committee on Cancer TNM system and Dukes staging, where T3 and T4 had increased levels compared with Tis and T1, and N1 and N2 had increased levels compared with N0, also Dukes stages B and C had increased level compared with Dukes A. Moreover, the correlation between fecal calprotectin and M2-PK in patients with IBD is significantly positive. Conclusion In colonic disorders, fecal M2-PK is a good marker for discrimination between functional and organic colonic conditions, and also a good marker for detection of CRC, with a sensitivity and specificity of 93 and 81%, respectively, and has the potential to be an important noninvasive marker of activity in IBD.

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