Brief Article
Copyright ©2012 Baishideng. All rights reserved.
World J Gastrointest Oncol. Jun 15, 2012; 4(6): 145-151
Published online Jun 15, 2012. doi: 10.4251/wjgo.v4.i6.145
Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening
Wen Meng, Hong-Hong Zhu, Ze-Feng Xu, Shan-Rong Cai, Qi Dong, Qiang-Rong Pan, Shu Zheng, Su-Zhan Zhang
Wen Meng, Ze-Feng Xu, Shan-Rong Cai, Qi Dong, Qiang-Rong Pan, Shu Zheng, Su-Zhan Zhang, Zhejiang University Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, China National Ministry of Education, Key Laboratory of Molecular Biology in Medical Sciences), Hangzhou 310009, Zhejiang Province, China
Wen Meng, Ze-Feng Xu, Shan-Rong Cai, Qi Dong, Qiang-Rong Pan, Shu Zheng, Su-Zhan Zhang, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Wen Meng, Department of Cardiothoracic Surgery, Hangzhou First People’s Hospital, Hangzhou 310006, Zhejiang Province, China
Hong-Hong Zhu, Department of Health Administration, Public Health and Gerontology, School of Public Service Leadership, Capella University, Minneapolis, MN 55403, United States
Hong-Hong Zhu, Department of Community Health, Saint Louis University School of Public Health, Saint Louis, MO 63104, United States
Hong-Hong Zhu, Department of Public Health, College of Health and Human Services, Western Kentucky University, Bowling Green, KY 42101, United States
Author contributions: Meng W and Zhu HH contributed equally to this work; Meng W conducted the study, data collection, management and analysis, and drafted the manuscript; Zhu HH did data correction, designed the analysis strategy and did data interpretation, co-drafted and revised the manuscript, reviewed and edited the whole manuscript; Xu ZF performed quality control on ELISA work; Cai SR performed previous screening work and collection of serum samples; Dong Q performed helpful work in previous screening; Pan QR did part of ELISA work; Zheng S co-supervised the field activities and designed the study’s analytical strategy; Zhang SZ co-designed the study, co-supervised the field activities and did quality assurance and control.
Supported by The National 11th 5-Year Key Programs for Department of Science and Technology of China, No. 2006BAI02A08
Correspondence to: Dr. Su-Zhan Zhang, MD, PhD, Professor, Zhejiang University Cancer Institute, 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. zuci@zju.edu.cn
Telephone: +86-5718778-4501 Fax: +86-5718721-4404
Received: January 6, 2012
Revised: May 10, 2012
Accepted: May 18, 2012
Published online: June 15, 2012
Abstract

AIM: To explore the value of serum M2-pyruvate kinase (M2-PK) in colorectal cancer (CRC) mass screening.

METHODS: We conducted a molecular epidemiology study in Hangzhou, China, from year 2006 to year 2008. Serum samples were collected from 93 CRC, 41 advanced adenomas, 137 adenomas, 47 non-adenomatous polyps, and 158 normal participants in a community setting. Serum M2-PK and carcinoembryonic antigen (CEA) were measured using Enzyme-linked immunosorbent assay. SPSS 16.0 software was used to perform data analysis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificities were estimated for serum M2-PK in diagnosis of colorectal lesions and compared with CEA.

RESULTS: Average serum M2-PK value among 158 normal people was 2.96 U/mL and not affected by gender (P = 0.47) or age (P = 0.59). Average serum M2-PK (U/mL) was 14.75 among stage III and 13.10 among stage I and II CRC patients, about 4 times higher than that among normal people. Average serum M2-PK was 8.58, 6.70, 5.13 and 2.51 U/mL among advanced adenoma, adenomas, non-adenomatous polyps, and inflammatory bowel disease patients, respectively. AUC for serum M2-PK was greater than that for CEA among all colorectal lesions. AUC for serum M2-PK was 0.89 (0.84, 0.94) (95% confidence interval), higher than that for CEA [0.70 (0.62-0.79)] in CRC stage I and II, 0.89 (0.84-0.94) vs 0.73 (0.63-0.83) in CRC stage III, 0.81 (0.74-0.86) vs 0.63 (0.53 - 0.73) in advanced adenomas, 0.69 (0.64-0.76) vs 0.54 (0.47-0.60) in adenomas, and 0.69 (0.62-0.78) vs 0.58 (0.48-0.68) in non-adenomatous polyps. The diagnostic sensitivity for all colorectal lesions increased with decrease in the cut-off value of serum M2-PK. The diagnostic sensitivity (%) of serum M2-PK was 100.00 for CRC, 95.12 advanced adenoma, 82.48 adenoma, and 82.98 non-adenomatous polyp. There were no CRC cases missed and 40.51% of unnecessary colonoscopies were avoided when the cut-off value was 2.00 U/mL.

CONCLUSION: Serum M2-PK can be used as a primary screening test in CRC mass screening. It may be a promising non-invasive biomarker for CRC early detection.

Keywords: Serum M2-pyruvate kinase; Colorectal cancer screening; Serum biomarker; Carcinoembryonic antigen