Evaluation of plasma M2-Pyruvate Kinase as a novel biomarker in the differentiation between Functional and Organic Colonic Disorders

Abstract

Abstract Background Differentiating between functional bowel disorders and organic colonic disorders can often be difficult as they may be present with similar symptoms. Aim of the Work to evaluate the diagnostic value of plasma M2-pyruvate kinase level in differentiating functional colonic disorders (e.g: IBS) from organic colonic disorders (e.g: IBD, colorectal polyps and colorectal cancer) and to assess its use as screening tools for inflammatory bowel disease, premalignant and malignant colorectal lesions. Patients and Methods This study was conducted on 80 patients who divided into four groups: Group I included 20 patients, representing functional bowel disorders (as a control group). Group II included 20 patients with inflammatory bowel diseases; Group III included 20 patients with colorectal polyps; Group IV included 20 patients with colorectal cancer. Results The current study showed that plasma M2 - PK can be used to differentiate functional from organic colonic lesions at a cut-off point > 3 U/mL, with 93.33% sensitivity, 100% specificity, 100% PPV and 83.3% NPV. Also, plasma M2-PK can be used to discriminate between benign (colorectal polyp) and malignant colonic lesions (CRC) with a cut-off level of > 12 U/ml, with 100% sensitivity, 100% specificity, 100% PPV and 100% NPV. Also, In the present study there was a highly significant + ve correlations between Plasma M2 PK level and CEA as (r = 0.787, p value = 0.000) and their combination can give higher sensitivity and specificity. Conclusion Plasma M2-PK can differentiate between functional and organic colonic disorders as it is more elevated in organic than functional colonic disorders. Also, it is considered a promising rapid noninvasive biomarker for organic colonic disorders early detection and screening to reduce unnecessary endoscopic intervention.