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A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Pyruvate Kinase M2 Isoenzymatic Assay in Diagnosing Colorectal Cancer

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Review

A Systematic Review and Meta-Analysis of the Diagnostic Accuracy of Pyruvate Kinase M2 Isoenzymatic Assay in Diagnosing Colorectal Cancer

Mallikarjuna Uppara et al. World J Surg Oncol.

Abstract

Background: Screening programmes exist in many countries for colorectal cancer. In recent years, there has been a drive for a non-invasive screening marker of higher sensitivity and specificity. Stool-based pyruvate kinase isoenzyme M2 (M2-PK) is one such biomarker under investigation. The aim of this systematic review and meta-analysis is to determine the diagnostic accuracy, sensitivity and specificity of M2-PK as a screening tool in colorectal cancer.

Methods: A literature search of Ovid Medline, EMBASE and Google Scholar was carried out. The search strategy was restricted to human subjects and studies published in English. Data on sensitivity and specificity were extracted and pooled. Statistical analysis was conducted using summary receiver operating characteristic (SROC) curve methodology.

Results: A total of eight studies were suitable for data synthesis and analysis. Our analysis showed a pooled sensitivity and specificity for M2-PK to be 79% (CI 73%-83%) and 80% (CI 73%-86%), respectively. The accuracy of M2-PK was 0.85(0.82-0.88).

Conclusion: Faecal M2-PK assay has a relatively good sensitivity and specificity and high accuracy for screening colorectal cancer.

Figures

Figure 1
Figure 1
SROC curve of M2-PK isoenzymatic assay of faeces samples for following eight studies: Haug et al. [ 18 ], Shastri et al. [ 11 ], Tonus et al. [ 17 ], Koss et al. [ 16 ], Hardt et al. [ 15 ], Mulder et al. [ 10 ], Parente et al. [ 14 ] and Abdullah et al. [ 13 ].
Figure 2
Figure 2
A PRISMA diagram outlining the search strategy.
Figure 3
Figure 3
Forest plots showing the sensitivity and specificity for individual studies with their 95% confidence intervals, combined sensitivity and combined specificity from all the included studies.
Figure 4
Figure 4
Foreb plot.
Figure 5
Figure 5
Graphical depictions of residual-based goodness-of-fit, bivariate normality, influence and outlier detection analyses.
Figure 6
Figure 6
SROC curve of M2-PK isoenzymatic assay of faeces samples for the following four studies (excluding the outliers): Haug et al. [ 18 ], Shastri et al. [ 11 ], Hardt et al. [ 15 ] and Abdullah et al. [ 13 ].
Figure 7
Figure 7
Forest plots showing the sensitivity and specificity for individual studies with their 95% confidence intervals, combined sensitivity and combined specificity from four studies excluding the out liars.

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