Background: Colonoscopy is the gold standard forcolon cancer screening; it isalso associated with a high costand complication. Proliferating cells, in particular tumorcells,expressa dimericisoenzyme of pyruvate kinase, termed M2 pyruvate kinase(M2-PK). Theaimofthis studywas to determinethe diagnosticaccuracy offecalM2-PK forcolon cancer. Materials andMethods: Forty-nine patients with colon cancersand 49 healthy controls wereselected consecutively among individuals undergoing screening colonoscopy for various indications. The diagnosis was confirmed by histology. M2-PK measurements were done by enzyme-linked immunosorbentassay offecal occult blood test (FOBT)and immunologicalFOBT (IFOBT)according to the manufacturer's instructions. Results: M2-PK 9 (U/mL) was the bestcutoff point in the detection ofcolon cancers. In thiscutoff point, sensitivity and specificitywere 87.8%and 91.8%, respectively,and accuracywas 89.8%. The sensitivity and specificity ofIFOBTwere 93.9%and 100%, respectively,and accuracywas 96.9%. Thesensitivity and specificity ofFOBTwere 65.3%and 100%, respectively,and accuracywas 82.6%. Conclusion: IFOBTwith high sensitivity and specificity and accuracy and lowcost is the best fecalscreening test. Thecurrentstudy suggests that fecalM2-PK can be used for high-risk colon cancer patientsand negativeIFOBT that refused colonoscopy asa precolonoscopy screening test.
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