Colorectal cancer screening b non-invasive faecal biomarkers M2 -PK and faecal calprotectin

Colorectal cancer [CRC] is a disease with major impact on public health. Colonoscopy is a gold standard test for screening. However, the acceptance by the general population is very poor. Therefore evaluation of additional screening tools is of great interest. The use of M2-PK measurement in the feaces as well as the faecal calprotectin [FC] in persons undergoing routine health care check-up will provide a better screening tool for early discovery of colorectal cancer. In our study we measured these tests in patients with CRC, group of benign lesions esp IBD and controls. Comparison of faecal M2PK results between all studied groups demonstrated a significant difference between CRC and benign group, also with a significant difference between benign group and controls .The sensitivity, specificity, and positive and negative predictive values of the faecal M2PK assay in distinguishing between CRC and benign group at cutoff [3 U/ ml] showed a positive predictive value of 93.8 and negative predictive value 100 and sensitivity 93.8 and specificity of 96% with an accuracy of 97.5%. Comparison of faecal calprotectin results between all studied groups demonstrated a significant difference between CRC and benign group, also with a significant difference between benign group and controls .The sensitivity, specificity, and positive and negative predictive values of the fecal calprotectin assay in distinguishing between CRC and benign group at cutoff [200 microg/g] showed a positive predictive value of 100.0 and negative predictive value 92.6 and sensitivity 86.7 and specificity of 100.0 with an accuracy of 97%. Measurement of tumor M2-PK in faeces seems to be the most promising tool for CRC screening at the present time. In combination with colonoscopy, this test should hence be recommended for CRC screening programs

Study the changes of the levels of some trace elements and minerals in patients with ulcerative colitis and Crohn's disease

Inflammatory bowel disease [IBD] is a chronic inflammatory process that involves the colon in Ulcerative colitis [UC] and may involve any part of the entire gastrointestinal tract in Crohn's disease [CD]. The aetiology and pathogenesis of IBD are still unclear. Nutrition plays an important role in pathogenesis and treatment. The aim of the present study was to study the level of some minerals and trace elements in inflammatory bowel disease and correlate their levels with the disease activity. The study was carried out on patients of previously diagnosed IBD [included 10 CD patients and 10 UC patients] as a patient group and ten healthy volunteers as a control group. The disease activity in all patients were assessed according to Crohn's disease activity index [CDAI], and Truelove and Witts criteria for ulcerative colitis. Sample collection of some minerals and trace elements were done on fasting serum samples including:- Calcium [Ca], Phosphorus [Ph], Magnesium, Chromium, Copper, Selenium, and Zinc. The results of plasma concentrations of some minerals and trace elements in ulcerative colitis, Crohn's disease patients and controls showed a significant reduction of serum calcium [P=0.000], serum phosphate [P=0.01], serum magnesium [P=0.000], serum copper [P=0.000], serum selenium [P=0.004],and serum zinc [P=0.000] in patients with UC and CD than controls. However, chromium was significantly elevated in UC and CD patients than controls [P=0.03, P=0.000 respectively]. Using inter-groups comparison; only serum calcium level showed a statistically significant difference in CD patients than UC patients. we found that the assessment of patient with IBD should include a focus on nutritional aspects even minerals and trace elements. Plasma or serum concentration of antioxidants including trace elements could be used as a biomarker of oxidative stress which has been established in IBD