The Value of Fecal M2PK in Colorectal Cancer

Abstract

olorectal cancer is the third most common cancer in men and the second in women. With age is a major risk factor for sporadic CRC. The incidence begins to increase significantly between the ages of 40 and 50. CRC is the second leading cause of cancer related deaths in U.S. In Egypt, according to (NCI) statistics, CRC ranks the sixth most common cancer in males, while in females it ranks the fifth common cancer. The median age of CRC cases in Egypt is 48 years for both males and females. Approximately 30% of individuals harbor risk factors for CRC (high risk), the other 70% of individuals are considered (average risk). Flexible Sigmoidoscopy, Colonoscopy, Double-contrast barium enema, CT colonography, Fecal occult blood test, Fecal M2PK, Stool DNA test are the screening modalities for average risk, while colonoscopy for high risk groups. Early detection and accurate classification of different polyposis syndromes are essential, in order to initiate a surveillance program for the early detection of cancer. Tumor M2-PK is released into the blood, and in the case of adenomas and tumors in the lower gastrointestinal tract also into the stool of patients. An increase in tumor M2-PK in EDTA plasma samples is found in gastrointestinal cancers, as well as a wide range of other tumors such as lung, renal, breast and cervical cancer. The EDTA plasma test is highly suitable for patient monitoring. Faecal M2-PK has the advantage that it detects both bleeding as well as non-bleeding tumors and adenoma and will close a gap in clinical practice. Conversely, Faecal M2-PK does not have false positive results due to various non-cancerous sources of bleeding, e.g., hemorrhoids and fissures. To fulfill the aim of the work, this study was designed to evaluate the sensitivity of fecal tumor M2 pyruvate kinase (M2PK) as a diagnostic biomarker for colorectal cancer (CRC) and adenomatous polyps screening in symptomatic populations. This study was conducted in co-operation between Tropical Medicine Department, Ain-Shams University and the Gastroenterology and Hepatology Department, Theodor Bilharz Research Institute between November 2014 to November 2015.It included 60 adult Egyptian patients presented with recent change in bowel habits or bleeding per rectum with or without weight loss and anemia that are fulfilling the eligibility criteria.