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

ABSTRACT

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