The Importance of Evaluating Serum Levels of Tumor Markers M2-PK and Inhibin A in Patients Undergoing Colonoscopy

Q: Why evaluate tumor markers instead of relying only on colonoscopy?

Colonoscopy, although effective for detection, faces limitations due to aggressiveness, high costs, and patient noncompliance. The study supports using accurate, sensitive laboratory tests for earlier screening and diagnosis.

Q: How were M2-PK and Inhibin A measured in the study?

Before colonoscopy, tumor marker M2-PK was evaluated in stool samples, and serum Inhibin A was measured in both patients and age- and sex-matched controls.

Q: What were the main findings for M2-PK and Inhibin A?

M2-PK levels were significantly higher in hyperplastic polyps and colon cancer compared with controls (P<.001). In contrast, Inhibin A levels did not differ significantly (P=.054).

Q: How do the results relate to iFOBT screening?

The hyperplastic polyps and colorectal cancer groups showed higher positive immunochemical fecal occult blood (IFOBT) results than the control group (P<.001). The study suggests that combining stool M2-PK with a three-time iFOBT approach may support quick, noninvasive screening and diagnosis.

Sep 24, 2026

Uploaded by Sarah

Colonoscopy is widely used to detect colon cancer, but cost, invasiveness, and patient noncompliance limit its screening value. This study evaluates whether laboratory tumor markers—tumor marker M2-PK and Inhibin A—can support early diagnosis and screening. Forty-six gastrointestinal-ward patients and 45 age- and sex-matched controls were assessed pre-colonoscopy using stool M2-PK and serum Inhibin A. M2-PK was significantly higher in hyperplastic polyps and colon cancer (P<.001), while Inhibin A showed no significant difference (P=.054).

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Introduction

The Importance of Evaluating Serum Levels of Tumor Markers M2-PK and Inhibin Ain Patients Undergoing Colonoscopy Mahmood Khosravi, MSc 1,2, Ali Arash Anoushirvani, MD3, Zahedin Kheiri, MD4, Ali Rahbari, MD5, and Ali Jadidi, PhD6 Technology in Cancer Research & Treatment Volume 22: 1-5 © The Author(s) 2023 Article reuse guidelines: [sagepub.com/journals-permissions](sagepub.com/journals-permissions)[ ](sagepub.com/journals-permissions)[DOI: 10.1177/15330338231194492](DOI: 10.1177/15330338231194492)[ ](DOI: 10.1177/15330338231194492)[journals.sagepub.com/home/tct](journals.sagepub.com/home/tct) Abstract Despite the use of colonoscopy to detect colon cancer due to its aggressiveness, high cost, and lack of patient compliance, the use of laboratory tests with high accuracy and sensitivity, such as tumor marker M2-PK and Inhibin A is recommended and can be effective for early diagnosis and screening of patients in the early stages. We studied 46 patients admitted it the gastrointestinal ward of Amir al Momenin Hospital and 45 normal (age and sex-matched) subjects as a control group (case-control and retrospective studies). Before the colonoscopy, the level of tumor marker M2-PK in the stool sample and the serum level of Inhibin A were evaluated in patients and the control group. The level of tumor marker M2-PK was signiﬁcantly higher in the group with hyperplastic polyps and colon cancer (P < .001) than in the control group. At the same time, there was no signiﬁcant difference in Inhibin A level (P = .054). In the hyperplastic polyps group 73% and in the colorectal cancer group 27% had a positive immunochemical fecal occult blood (IFOBT) result, signiﬁcantly higher than the control group (P < .001). Evaluation of the level of tumor marker M2-PK in the stool sample in association with the three-time iFOBT test method may be suggested as a quick and noninvasive method for screening and diagnosis of polyps and early stages of colon cancer. Keywords colorectal cancer, colon cancer, hyperplastic polyp, tumor markers M2-PK, inhibin A Abbreviations IFOBT, immunochemical fecal occult blood; M2-PK, M2-pyruvatkinase; IU/mL, international units per milliliter; pg/mL, picograms per milliliter; g/dL, grams per decilitre; IQR, interquartile range; STARD, standards for reporting diagnostic accuracy studies; U/mL, units per millilitre; CA, cancer antigen; CEA, carcinoembryonic antigen; LDH, lactate dehydrogenase; Hb, hemoglobin; TGF-β, transforming growth factor beta; SPSS, statistics is software for advanced statistical analysis Received: March 6, 2023; Revised: May 29, 2023; Accepted: July 19, 2023. Introduction Colon cancer is the third most common cancer worldwide, with 875,000 new cases each year.1 According to the condition of the disease and its history, early diagnosis, screening and prevention are essential and most colon cancers originate from benign polyps and turn into adenocarcinoma as the histology progresses step by step.2 Colon cancer is the third leading cause of death in Iran, with a prevalence of eight in every 10,000 people.3 High prevalence of the disease, it is necessary to use laboratory screening tests with high sensitivity and speciﬁcity to diagnose the condition in the early stages, and also consider the critical role of these 1 Department of Medical Laboratory Sciences, School of Allied Medical Sciences, Arak University of Medical Sciences, Arak, Iran 2 Department of Hematology and Medical Laboratory Sciences, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran 3 Department of Internal Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran 4 School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 5 School of Medicine, Arak University of Medical Sciences. Arak, Iran 6 School of Nursing, Arak University of Medical Sciences, Arak, Iran Corresponding Author: Ali Jadidi, School of Nursing, Basij Square, Arak Uni

FAQs

Why evaluate tumor markers instead of relying only on colonoscopy?

Colonoscopy, although effective for detection, faces limitations due to aggressiveness, high costs, and patient noncompliance. The study supports using accurate, sensitive laboratory tests for earlier screening and diagnosis.

How were M2-PK and Inhibin A measured in the study?

Before colonoscopy, tumor marker M2-PK was evaluated in stool samples, and serum Inhibin A was measured in both patients and age- and sex-matched controls.

What were the main findings for M2-PK and Inhibin A?

M2-PK levels were significantly higher in hyperplastic polyps and colon cancer compared with controls (P<.001). In contrast, Inhibin A levels did not differ significantly (P=.054).

How do the results relate to iFOBT screening?

The hyperplastic polyps and colorectal cancer groups showed higher positive immunochemical fecal occult blood (IFOBT) results than the control group (P<.001). The study suggests that combining stool M2-PK with a three-time iFOBT approach may support quick, noninvasive screening and diagnosis.

Sep 24, 2026

Uploaded by Sarah