Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2015

Open Access 01-12-2015 | Review

A systematic review and meta-analysis of the diagnostic accuracy of pyruvate kinase M2 isoenzymatic assay in diagnosing colorectal cancer

Authors: Mallikarjuna Uppara, Franklin Adaba, Alan Askari, Susan Clark, George Hanna, Thanos Athanasiou, Omar Faiz

Published in: World Journal of Surgical Oncology | Issue 1/2015

Login to get access

Abstract

Background

Screening programmes exist in many countries for colorectal cancer. In recent years, there has been a drive for a non-invasive screening marker of higher sensitivity and specificity. Stool-based pyruvate kinase isoenzyme M2 (M2-PK) is one such biomarker under investigation. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy, sensitivity and specificity of M2-PK as a screening tool in colorectal cancer.

Methods

A literature search of Ovid Medline, EMBASE and Google Scholar was carried out. The search strategy was restricted to human subjects and studies published in English. Data on sensitivity and specificity were extracted and pooled. Statistical analysis was conducted using summary receiver operating characteristic (SROC) curve methodology.

Results

A total of eight studies were suitable for data synthesis and analysis. Our analysis showed a pooled sensitivity and specificity for M2-PK to be 79% (CI 73%–83%) and 80% (CI 73%–86%), respectively. The accuracy of M2-PK was 0.85(0.82–0.88).

Conclusion

Faecal M2-PK assay has a relatively good sensitivity and specificity and high accuracy for screening colorectal cancer.
Literature
2.
go back to reference Lamberti C, Sauerbruch T. Early diagnosis of colorectal tumors. Internist. 2005;46(4):401–10. doi:10.1007/s00108-005-1369-x.CrossRefPubMed Lamberti C, Sauerbruch T. Early diagnosis of colorectal tumors. Internist. 2005;46(4):401–10. doi:10.1007/s00108-005-1369-x.CrossRefPubMed
3.
go back to reference Wong CKW, Fedorak RN, Prosser CI, Stewart ME, van Zanten SV, Sadowski DC. The sensitivity and specificity of guaiac and immunochemical fecal occult blood tests for the detection of advanced colonic adenomas and cancer. Int J Color Dis. 2012;27(12):1657–64. doi:10.1007/s00384-012-1518-3.CrossRef Wong CKW, Fedorak RN, Prosser CI, Stewart ME, van Zanten SV, Sadowski DC. The sensitivity and specificity of guaiac and immunochemical fecal occult blood tests for the detection of advanced colonic adenomas and cancer. Int J Color Dis. 2012;27(12):1657–64. doi:10.1007/s00384-012-1518-3.CrossRef
4.
go back to reference Zhu MM, Xu XT, Nie F, Tong JL, Xiao SD, Ran ZH. Comparison of immunochemical and guaiac-based fecal occult blood test in screening and surveillance for advanced colorectal neoplasms: a meta-analysis. J Dig Dis. 2010;11(3):148–60. doi:j.1463-1318.2007.01334.x/j.1751-2980.2010.00430.x.CrossRefPubMed Zhu MM, Xu XT, Nie F, Tong JL, Xiao SD, Ran ZH. Comparison of immunochemical and guaiac-based fecal occult blood test in screening and surveillance for advanced colorectal neoplasms: a meta-analysis. J Dig Dis. 2010;11(3):148–60. doi:j.1463-1318.2007.01334.x/j.1751-2980.2010.00430.x.CrossRefPubMed
6.
go back to reference Christofk HR, Vander Heiden MG, Harris MH, Ramanathan A, Gerszten RE, Wei R, et al. The M2 splice isoform of pyruvate kinase is important for cancer metabolism and tumour growth. Nature. 2008;452(7184):230–3. doi:10.1038/nature06734.CrossRefPubMed Christofk HR, Vander Heiden MG, Harris MH, Ramanathan A, Gerszten RE, Wei R, et al. The M2 splice isoform of pyruvate kinase is important for cancer metabolism and tumour growth. Nature. 2008;452(7184):230–3. doi:10.1038/nature06734.CrossRefPubMed
7.
go back to reference Christofk HR, Vander Heiden MG, Wu N, Asara JM, Cantley LC. Pyruvate kinase M2 is a phosphotyrosine-binding protein. Nature. 2008;452(7184):181–6. doi:10.1038/nature06667.CrossRefPubMed Christofk HR, Vander Heiden MG, Wu N, Asara JM, Cantley LC. Pyruvate kinase M2 is a phosphotyrosine-binding protein. Nature. 2008;452(7184):181–6. doi:10.1038/nature06667.CrossRefPubMed
8.
go back to reference Meng W, Zhu H-H, Xu Z-F, Cai S-R, Dong Q, Pan Q-R, et al. Serum M2-pyruvate kinase: a promising non-invasive biomarker for colorectal cancer mass screening. World J Gastrointest Oncol. 2012;4(6):145–51. doi:10.4251/wjgo.v4.i6.145.CrossRefPubMedCentralPubMed Meng W, Zhu H-H, Xu Z-F, Cai S-R, Dong Q, Pan Q-R, et al. Serum M2-pyruvate kinase: a promising non-invasive biomarker for colorectal cancer mass screening. World J Gastrointest Oncol. 2012;4(6):145–51. doi:10.4251/wjgo.v4.i6.145.CrossRefPubMedCentralPubMed
9.
go back to reference Tonus C, Sellinger M, Koss K, Neupert G. Faecal pyruvate kinase isoenzyme type M2 for colorectal cancer screening: a meta-analysis. World J Gastrointest Oncol. 2012;18(30):4004–11. doi:10.3748/wjg.v18.i30.4004. Tonus C, Sellinger M, Koss K, Neupert G. Faecal pyruvate kinase isoenzyme type M2 for colorectal cancer screening: a meta-analysis. World J Gastrointest Oncol. 2012;18(30):4004–11. doi:10.3748/wjg.v18.i30.4004.
10.
go back to reference Mulder SA, van Leerdam ME, van Vuuren AJ, Francke J, van Toorenenbergen AW, Kuipers EJ, et al. Tumor pyruvate kinase isoenzyme type M2 and immunochemical fecal occult blood test: performance in screening for colorectal cancer. Eur J Gastroenterol Hepatol. 2007;19(10):878–82. doi:10.1097/MEG.0b013e3282cfa49c.CrossRefPubMed Mulder SA, van Leerdam ME, van Vuuren AJ, Francke J, van Toorenenbergen AW, Kuipers EJ, et al. Tumor pyruvate kinase isoenzyme type M2 and immunochemical fecal occult blood test: performance in screening for colorectal cancer. Eur J Gastroenterol Hepatol. 2007;19(10):878–82. doi:10.1097/MEG.0b013e3282cfa49c.CrossRefPubMed
11.
go back to reference Shastri YM, Loitsch S, Hoepffner N, Povse N, Hanisch E, Rösch W, et al. Comparison of an established simple office-based immunological FOBT with fecal tumor pyruvate kinase type M2 (M2-PK) for colorectal cancer screening: prospective multicenter study. Am J Gastroenterol. 2008;103(6):1496–504. doi:j.1463-1318.2007.01334.x/j.1572-0241.2008.01824.x.CrossRefPubMed Shastri YM, Loitsch S, Hoepffner N, Povse N, Hanisch E, Rösch W, et al. Comparison of an established simple office-based immunological FOBT with fecal tumor pyruvate kinase type M2 (M2-PK) for colorectal cancer screening: prospective multicenter study. Am J Gastroenterol. 2008;103(6):1496–504. doi:j.1463-1318.2007.01334.x/j.1572-0241.2008.01824.x.CrossRefPubMed
12.
go back to reference Shastri YM, Naumann M, Oremek GM, Hanisch E, Rösch W, Mössner J, et al. Prospective multicenter evaluation of fecal tumor pyruvate kinase type M2 (M2-PK) as a screening biomarker for colorectal neoplasia. Int J Cancer. 2006;119(11):2651–6. doi:10.1002/ijc.22243.CrossRefPubMed Shastri YM, Naumann M, Oremek GM, Hanisch E, Rösch W, Mössner J, et al. Prospective multicenter evaluation of fecal tumor pyruvate kinase type M2 (M2-PK) as a screening biomarker for colorectal neoplasia. Int J Cancer. 2006;119(11):2651–6. doi:10.1002/ijc.22243.CrossRefPubMed
14.
go back to reference Parente F, Marino B, Ilardo A, Fracasso P, Zullo A, Hassan C, et al. A combination of faecal tests for the detection of colon cancer: a new strategy for an appropriate selection of referrals to colonoscopy? A prospective multicentre Italian study. Eur J Gastroenterol Hepatol. 2012;24(10):1145–52. doi:10.1097/MEG.0b013e328355cc79.CrossRefPubMed Parente F, Marino B, Ilardo A, Fracasso P, Zullo A, Hassan C, et al. A combination of faecal tests for the detection of colon cancer: a new strategy for an appropriate selection of referrals to colonoscopy? A prospective multicentre Italian study. Eur J Gastroenterol Hepatol. 2012;24(10):1145–52. doi:10.1097/MEG.0b013e328355cc79.CrossRefPubMed
15.
go back to reference Hardt PD, Mazurek S, Toepler M, Schlierbach P, Bretzel RG, Eigenbrodt E, et al. Faecal tumour M2 pyruvate kinase: a new, sensitive screening tool for colorectal cancer. Br J Cancer. 2004;91(5):980–4. doi:10.1038/sj.bjc.6602033.PubMedCentralPubMed Hardt PD, Mazurek S, Toepler M, Schlierbach P, Bretzel RG, Eigenbrodt E, et al. Faecal tumour M2 pyruvate kinase: a new, sensitive screening tool for colorectal cancer. Br J Cancer. 2004;91(5):980–4. doi:10.1038/sj.bjc.6602033.PubMedCentralPubMed
16.
go back to reference Koss K, Maxton D, Jankowski JAZ. Faecal dimeric M2 pyruvate kinase in colorectal cancer and polyps correlates with tumour stagingand surgical intervention. Colorectal Dis. 2007;10(3):244–8. doi:j.1463-1318.2007.01334.x/j.1463-1318.2007.01334.x. Koss K, Maxton D, Jankowski JAZ. Faecal dimeric M2 pyruvate kinase in colorectal cancer and polyps correlates with tumour stagingand surgical intervention. Colorectal Dis. 2007;10(3):244–8. doi:j.1463-1318.2007.01334.x/j.1463-1318.2007.01334.x.
18.
go back to reference Haug U, Rothenbacher D, Wente MN, Seiler CM, Stegmaier C, Brenner H. Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients. Br J Cancer. 2007;96(9):1329–34. doi:10.1038/sj.bjc.6603712.PubMedCentralPubMed Haug U, Rothenbacher D, Wente MN, Seiler CM, Stegmaier C, Brenner H. Tumour M2-PK as a stool marker for colorectal cancer: comparative analysis in a large sample of unselected older adults vs colorectal cancer patients. Br J Cancer. 2007;96(9):1329–34. doi:10.1038/sj.bjc.6603712.PubMedCentralPubMed
Metadata
Title
A systematic review and meta-analysis of the diagnostic accuracy of pyruvate kinase M2 isoenzymatic assay in diagnosing colorectal cancer
Authors
Mallikarjuna Uppara
Franklin Adaba
Alan Askari
Susan Clark
George Hanna
Thanos Athanasiou
Omar Faiz
Publication date
01-12-2015
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-015-0446-4

Other articles of this Issue 1/2015

World Journal of Surgical Oncology 1/2015 Go to the issue