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Faecal dimeric M2 pyruvate kinase in colorectal cancer and polyps correlates with tumour staging and surgical intervention
Author(s) -
Koss K.,
Maxton D.,
Jankowski J. A. Z.
Publication year - 2008
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/j.1463-1318.2007.01334.x
Subject(s) - medicine , colorectal cancer , gastroenterology , monoclonal antibody , pyruvate kinase , cancer , antibody , immunology , glycolysis , metabolism
Objective & Method A dimeric form of pyruvate kinase isoenzyme (tumour M2‐PK) is predominantly found in highly proliferating cells. Sandwich ELISA with monoclonal antibodies against dimeric (tumour) M2‐PK was used to measure faecal tumour M2‐PK in; 13 controls, 10 patients with colonic polyps and 32 patients with colorectal cancer. Results Levels of faecal tumour M2‐PK were higher in patients with colorectal cancer (median 11.72 U/ml; range 0.9–146.95 U/ml, P = 0.0001) and polyps greater than 10 mm (median 2.54 U/ml; range 0.9–29.46 U/ml, P = 0.041) when compared with controls (median 1.75 U/ml; range 0.9–3.41 U/ml). Furthermore, levels were higher in stages Duke's B ( P = 0.013) and Duke's C ( P = 0.43) than in Duke's A. Six months postsurgery faecal tumour M2‐PK levels fell significantly to 3.46 U/ml (range 1.03–9.05 U/ml, P = 0.001). The sensitivity of a positive faecal tumour M2‐PK test, defined as a level above 3.33 U/ml, was 91% for colorectal cancer, 60% for >10 mm and 20% for <10 mm polyps, with a specificity of 92%. Conclusion Faecal tumour M2‐PK is a highly sensitive marker for colorectal cancer and larger polyps. It also correlates with more advanced stages of colorectal cancer and its reduction is associated with successful surgical intervention.