Diagnostic Accuracy of Five Different Fecal Markers for the Detection of Precancerous and Cancerous Lesions of the Colorectum

Background.Colorectal cancer (CRC) is the second deadliest malignancy worldwide. This study aimed to compare the diagnostic accuracy of different fecal markers in the detection of colorectal adenomas and cancer.Methods.Stool samples of patients referred to colonoscopy were collected for the analysis of tumor M2pyruvate kinase (M2PK), human hemoglobin (Hb), hemoglobin/haptoglobin (Hb/Hp) complex, fecal calprotectin (FC), and matrix metalloproteinase-9 (MMP-9).Results.Sensitivity and specificity of M2PK for adenomas sized > 1 cm were 60% and 67.5% and for CRC were 94.7% and 67.5%. Sensitivity and specificity of iFOBT for adenomas sized ≥ 1 cm were 80% and 72.5% and for CRC were 94.7% and 72.5%. Sensitivity and specificity of Hb/Hp complex for adenomas sized ≥ 1 cm were 80% and 52.9% and for CRC were 100% and 52.9%. Sensitivity of FC and MMP-9 for CRC was 77.8% and 72.2%. Combined use of M2PK, iFOBT, and FC resulted in a sensitivity and specificity of 95% and 47.5% for the detection of adenomas sized ≥ 1 cm.Discussion.In CRC, sensitivity of M2PK, iFOBT, and Hb/Hp complex proved to be high. Combined use of M2PK, iFOBT, and FC may be valuable in the detection of large adenomas.

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Optimal Range of Fecal Calprotectin for Predicting Mucosal Healing in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Visceral Medicine ◽

10.1159/000514196 ◽

2021 ◽

pp. 1-11

Author(s):

Bing-Jie Xiang ◽

Min Jiang ◽

Ming-Jun Sun ◽

Cong Dai

Keyword(s):

Inflammatory Bowel Disease ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Sensitivity And Specificity ◽

Bowel Disease ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Fecal Calprotectin ◽

Mucosal Healing ◽

Inflammatory Bowel

Objective: Fecal calprotectin (FC) is a promising marker for assessment of inflammatory bowel disease (IBD) activity. However, the utility of FC for predicting mucosal healing (MH) of IBD patients has yet to be clearly demonstrated. The objective of our study was to perform a meta-analysis evaluating the diagnostic accuracy of FC in predicting MH of IBD patients. Methods: We systematically searched the databases for studies from inception to April 2020 that evaluated MH in IBD. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random-effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Results: Sixteen studies comprising 1,682 ulcerative colitis (UC) patients and 4 studies comprising 221 Crohn’s disease (CD) patients were included. The best performance of FC for predicting MH in UC was at cut-off range of 60–75 μg/g with area under the curve (AUC) of 0.88 and pooled sensitivity and specificity of 0.87 and 0.79, respectively. The pooled sensitivity and specificity values of cutoff range 180–250 μg/g for predicting MH in CD were 0.67 and 0.76, respectively. The AUC of 0.79 also revealed improved discrimination for identifying MH in CD with FC concentration. Conclusion: Our meta-analysis has found that FC is a simple, reliable noninvasive marker for predicting MH in IBD patients. FC cutoff range 60–75 μg/g appears to have the best overall accuracy in UC patients.

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Reply: Is serum matrix metalloproteinase 9 a useful biomarker in detection of colorectal cancer? Considering pre-analytical interference that may influence diagnostic accuracy

British Journal of Cancer ◽

10.1038/sj.bjc.6604492 ◽

2008 ◽

Vol 99 (3) ◽

pp. 555-555

Author(s):

N G Hurst

Keyword(s):

Colorectal Cancer ◽

Matrix Metalloproteinase ◽

Diagnostic Accuracy ◽

Matrix Metalloproteinase 9 ◽

Analytical Interference ◽

Metalloproteinase 9

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Expression of tumor pyruvate kinase M2 isoform in plasma and stool of patients with colorectal cancer or adenomatous polyps

10.21203/rs.2.16791/v1 ◽

2019 ◽

Author(s):

Farideh Rigi ◽

Aliakbar Jannatabad ◽

Azra Izanloo ◽

Reza Roshanravan ◽

Hamid Reza Hashemian ◽

...

Keyword(s):

Colorectal Cancer ◽

Pyruvate Kinase ◽

Sensitivity And Specificity ◽

Adenomatous Polyps ◽

Plasma Samples ◽

Proliferating Cells ◽

Pyruvate Kinase M2 ◽

Specificity And Sensitivity ◽

Tumor Group ◽

Stool Samples

Abstract Background: Tumor pyruvate kinase M2 isoform (tM2-PK), which is an isoform of PK-glycolytic enzyme and appears on the surface of cancerous proliferating cells, has been used as a diagnostic biomarker for colorectal cancer (CRC). The aim of this study was to evaluate the tM2-PK measurement test for the diagnosis of CRCs and adenomatous polyps in plasma and stool samples in an Iranian population. Methods: In this prospective study, a total of 226 stool and 178 plasma samples were received from patients referred to colonoscopy units. tM2-PK enzyme was measured using two separate ScheBo-Biotech-AG ELISA kits for stool and plasma samples. Results: At the cut-off value of 4 U/ml, in tumor group, the sensitivity of fecal tM2-PK test was 100% and the specificity was 68%, and in polyp group, the sensitivity and specificity were 87% and 68%, respectively. At the cut-off value of 15 U/ml in tumor group, the sensitivity of plasma tM2-PK test was 98% and specificity was 74% and in polyp group the sensitivity and specificity were 98% and 74%, respectively. Based on our results, a cut-off range of 4.8-8 U/ml and >8 U/ml could be used to detect polyp and tumor in stool samples, respectively. Similarly, a cut-off range of 19-25 U/ml and >25 U/ml is recommended in plasma samples for polyp and tumor detection, respectively. Conclusions: This study revealed a high specificity and sensitivity of tM2-PK test for stool and plasma samples in patients with CRC and polyps suggesting it as a non-invasive assay to diagnose CRC and adenomatous polyps.

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Expression of tumor pyruvate kinase M2 isoform in plasma and stool of patients with colorectal cancer or adenomatous polyps

10.21203/rs.2.16791/v2 ◽

2020 ◽

Author(s):

Farideh Rigi ◽

Aliakbar Jannatabad ◽

Azra Izanloo ◽

Reza Roshanravan ◽

Hamid Reza Hashemian ◽

...

Keyword(s):

Colorectal Cancer ◽

Pyruvate Kinase ◽

Sensitivity And Specificity ◽

Glycolytic Enzyme ◽

Adenomatous Polyps ◽

Plasma Samples ◽

Polyp Detection ◽

Proliferating Cells ◽

Pyruvate Kinase M2 ◽

Stool Samples

Abstract Background: Tumor pyruvate kinase M2 isoform (tM2-PK), which is an isoform of PK-glycolytic enzyme and appears on the surface of cancerous proliferating cells, has been used as a diagnostic biomarker for colorectal cancer (CRC). The aim of this study was to evaluate the tM2-PK measurement test for the diagnosis of CRCs and adenomatous polyps in plasma and stool samples in an Iranian population. Methods: In this prospective study, a total of 226 stool and 178 plasma samples were received from patients referred to colonoscopy units. tM2-PK enzyme was measured using two separate ScheBo-Biotech-AG ELISA kits for stool and plasma samples. Results: According to ROC curves, in the tumor group, at the cut-off value of 4 U/ml, the sensitivity of fecal tM2-PK test was 100% and the specificity was 68%, and in the polyp group, the sensitivity and specificity were 87% and 68%, respectively. For tumor detection in plasma specimens, a cut-off value >25 U/ml has a sensitivity and specificity of 90.9% and 91.3%, respectively. Similarly, for polyp detection, a cut-off value >19 U/ml has a sensitivity of 96.3% and the specificity of 85.5%. Conclusions: Based on our results, a cut-off range of 4.8-8 U/ml and >8 U/ml could be used to detect polyp and tumor in stool samples, respectively. Similarly, a cut-off range of 19-25 U/ml and >25 U/ml is recommended in plasma samples, suggesting tM2-PK test as a non-invasive assay to diagnose CRC and adenomatous polyps.

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Is serum matrix metalloproteinase 9 a useful biomarker in detection of colorectal cancer? Considering pre-analytical interference that may influence diagnostic accuracy

British Journal of Cancer ◽

10.1038/sj.bjc.6604491 ◽

2008 ◽

Vol 99 (3) ◽

pp. 553-554 ◽

Cited By ~ 9

Author(s):

K Jung

Keyword(s):

Colorectal Cancer ◽

Matrix Metalloproteinase ◽

Diagnostic Accuracy ◽

Matrix Metalloproteinase 9 ◽

Analytical Interference ◽

Metalloproteinase 9

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Diagnostic accuracy of fecal calprotectin for screening patients with colorectal cancer: A meta-analysis

The Turkish Journal of Gastroenterology ◽

10.5152/tjg.2018.17606 ◽

2018 ◽

Vol 29 (4) ◽

pp. 397-405 ◽

Cited By ~ 3

Author(s):

Xiaohua Ye ◽

◽

Jiaping Huai ◽

Jin Ding ◽

◽

...

Keyword(s):

Colorectal Cancer ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Fecal Calprotectin

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Combined use of clinical pre-test probability and D-dimer test in the diagnosis of preoperative deep venous thrombosis in colorectal cancer patients

Thrombosis and Haemostasis ◽

10.1160/th07-06-0397 ◽

2008 ◽

Vol 99 (02) ◽

pp. 396-400 ◽

Cited By ~ 8

Author(s):

Jens Frøkjær ◽

Tina Nielsen ◽

Torben Larsen ◽

Søren Lundbye-Christensen ◽

Henrik Elbrønd ◽

...

Keyword(s):

Colorectal Cancer ◽

Diagnostic Accuracy ◽

Venous Thrombosis ◽

Cancer Patients ◽

Predictive Value ◽

Combined Use ◽

Colorectal Cancer Patients ◽

Test Probability ◽

D Dimer ◽

Rule Out

SummaryThe preoperative prevalence of deep venous thrombosis (DVT) in patients with colorectal cancer may be as high as 8%. In order to minimize the risk of pulmonary embolism, it is important to rule out preoperative DVT. A large study has confirmed that a negative D-dimer test in combination with a low clinical pre-test probability (PTP) can be safely used to rule out the tentative diagnosis of DVT in cancer patients. However, the accuracy in colorectal cancer patients is uncertain. This study assessed the diagnostic accuracy of a quantitative D-dimer assay in combination with the PTP score in ruling out preoperative DVT in colorectal cancer patients admitted for surgery. Preoperative D-dimer test and compression ultrasonography for DVT were performed in 193 consecutive patients with newly diagnosed colorectal cancer. Diagnostic accuracy indices of the D-dimer test were assessed according to the PTP score. The negative predictive value, positive predictive value, sensitivity and specificity were 99% (95% confidence interval (CI), 95–100%), 17% (95% CI, 9–26), 93% (95% CI, 68–100%) and 61% (95% CI, 53–68%), respectively. In conclusion, the combined use of pre-test probability and D-dimer test may be useful in ruling out preoperative DVT in colorectal cancer patients admitted for surgery.

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