We recommend faecal M2-PK as a routine test prior to colonoscopy for CRC screening. Conclusions Faecal M2-PK narrows the gap in clinical practice because it detects bleeding and non bleeding tumors with high sensitivity and specificity. There was significant relation between diagnosis of adenocarcinaoma with age of 72±SD3.7 (p-value 0.048) and with altered bowel habits as a presenting symptom (p-value 0.001) in our study population. The calculated sensitivity and specificity for stool M2-PK was 100% and 92.9% respectively. Five patients (6.5%) had adenocarcinoma of the colon confirmed by colonoscopy and hsitopathological examination, while 70 (90.9%) had either normal or benign pathology and another two patients (2.6%) final diagnosis were not established till the time of analysis ten patients have had positive faecal M2-PK test, five of them were true positives, and the other five were false positives. Results A total of seventy seven patients, males (46.8%) and females (53.2%), with mean age 61.7☑1SD years, participated in the study. Independent t-test and chi-square tests were used to test the level of significance between scociodemographic and clinicopathological characteristics of our study population. Primary objective (specificity and sensitivity) of the test in comparison to colonoscopy was calculated. Colonoscopies were performed by experienced endoscopists who were unaware of fecal assay results.Patients’ demographics and clinical characteristics were obtained from patients records. Stool specimens were collected before purgation, processed appropriately and were tested for M2-PK. Seventy seven consecutive subjects from general surgery and gastroenterology clinics were included. Methods We evaluated fecal M2-PK as a screening biomarker for colorectal cancer comparing to colonoscopy. Aim To evaluate the efficacy of faecal M2-PK as a screening biomarker for colorectal cancer. The detection of tumor-specific pyruvate kinase (M2-PK) in stool is a promising tool for colorectal cancer (CRC) screening. Future study with larger patient cohort in a randomised prospective manner should be undertaken in order to derive any valuable association in our local population.īackground Proliferating cells, particularly the tumor cells, express a dimeric isoenzyme of pyruvate kinase, termed M2-PK. The results appear to be similar in both groups regardless whether they were on Aspirin. It appears that low dose aspirin in our cohort of patients did not prevent local or distant metastases in patients who have undergone curative resection for CRC. Conclusion Although several studies have looked at Aspirin as chemoprevention with positive results, these studies do not reflect the Asian population. Whereby 10 patients (30%) in GrB developed distant recurrence, 2 patients (6%) had local recurrence, of these 2 died of disease progression. Eight patients (20%) in GrA developed distant cancer recurrence and 1 patient (3%) developed local recurrence. In both groups, majority of the tumour location were either in the rectum, rectosigmoid or sigmoid colon (79%, 85%). GrA patients presented more with altered bowel habit (40%) whereas GrB presented more with per rectal bleed (41%), bear in mind that these patients were already on Aspirin low dose (75-150mg daily), which may explain this occurrence. Results There were similar demographic data between the two groups however there appears to be more male patients in GrA 68% vs 50% in GrB. We then analyse the demographic data, incidence of CRC recurrence and mortality. The total number of patients were 74, these were then divided into group A (GrA) 40 patients who did not take Aspirin and group B (GrB) 34 patients who were on Aspirin on a daily dosage. We excluded patients with incomplete data as well as those who defaulted the cancer surveillance protocol or who were lost to follow up. Of these we included patients who had underwent curative resections. Methodology We looked at all patients who were diagnosed with CRC from year 2000 to 2013. Hence the reason we performed a retrospective observational study on our cohort of CRC patients who have undergone curative resection looking into the role of Aspirin in preventing cancer recurrence and mortality. However these studies were largely displaying retrospective data from Europe and America and were not looking at prevention of CRC recurrence as a primary aim. Many literature published around the world have looked into Aspirin as a chemopreventive agent in the development of CRC and the results look promising. Since there is currently no formal screening program in the country, we should strive to prevent recurrence of CRC in patients who have undergone curative treatment. Introduction Colorectal cancer (CRC) in Malaysia poses a large burden to the healthcare system.
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