Tesis

Peran Pemeriksaan M2 Piruvat Kinase (M2PK) Tumor pada Tinja untuk Deteksi Lesi Neoplastik Kolorektal = The Role of Tumor M2 Pyruvate Kinase (M2PK) in Stools for the Detection of Colorectal Neoplastic Lesions.

Kanker kolorektal menempati urutan ketiga terbanyak dari kasus kanker pada laki-laki dan menempati urutan kedua pada wanita di seluruh dunia. Karakteristik enzimatik kanker kolorektal menunjukkan adanya peningkatan enzim M2PK tumor. Penelitian ini bertujuan untuk mengevaluasi pemeriksaan M2PK tumor pada feses pasien tersangka keganasan kolorektal dibandingkan dengan pemeriksaan histopatologi sebagai baku emas, menggunakan nilai titik potong baru dan nilai titik potong berdasarkan manufaktur. Desain penelitian adalah desain potong lintang dengan penyajian data secara deskriptif analitik. Subjek penelitian terdiri dari 86 pasien dewasa yang menjalankan kolonoskopi. Pemeriksaan M2PK tumor pada feses dilakukan menggunakan kit ScheBo ® Tumor M2- PK™ Stool Test dengan metode ELISA. Proporsi M2PK tumor pada feses pasien tersangka kanker kolorektal pada penelitian ini didapatkan sebesar 72,09%. Nilai titik potong baru untuk pemeriksaan M2PK tumor didapatkan sebesar 14,18 U/ml dengan sensitivitas 59,26%, spesifisitas 59,32%, NPP 40,00% dan NPN 76,09%. Hasil uji diagnostik menggunakan nilai titik potong M2PK berdasarkan manufaktur (≥4 U/ml) didapatkan sensitivitas 92,59%, spesifisitas 37,29%, NPP 40,32%, dan NPN 91,67%. Berdasarkan hasil tersebut, maka pemeriksaan M2PK tumor pada feses dengan nilai titik potong 4 U/ml dapat digunakan, terutama sebagai uji penapisan (screening) kanker kolorektal, sedangkan pemeriksaan M2PK sebagai uji diagnostik kanker kolorektal masih membutuhkan penelitian lebih lanjut.
Kata kunci: M2PK tumor, feses, kanker kolorektal, uji diagnostik


Colorectal cancer is the third most commonly occurring cancer in men and the second most commonly occurring cancer in women worldwide. Furrthermore, an increase on enzymatic characteristics of colorectal cancer was found in the Tumor M2PK biomarker. Hence, the aim of this study is to compare Tumor M2PK examination and histopathological examination –as a gold standard- on patients who are suspected colorectal malignancy in their feces by using a new cut-off value and manufacturer’s cutoff value. A cross sectional study design used in the current study by providing analitical descriptive data accordingly. There were 86 adult patients who underwent colonoscopy selected as the subject of this study; Tumor M2PK examination on their feces was performed using ScheBo ® Tumor M2-PK™ Stool Test kit with ELISA method. This research found that the proportion of tumor M2PK on subjects’ feces suspected colorectal cancer is 72.09%. The acquired new cut-off value for tumor M2PK is 14.18 U/ml with 59.26% of its sensitivity, 59.32% of its specificity, 40.00% and 76.09% for PPV and NPV respectively. As compared to the first value, diagnostic test result using the Manufacturer M2PK cut-off value, based on manufacturer (≥4 U/ml), shown sensitivity by 92.59%, specificity by 37.29%, PPV by 40.32%, and NPV by 91.67%. According to the result of this study, Tumor M2PK examination (cut-off value 4 U/ml) on stools is considerably able to be utilized especially as a screening test for the colorectal cancer. Nonetheless, still, the use of this examination as a diagnostic test for colorectal cancer requires further research.
Key words: Tumor M2PK, stools, colorectal cancer, diagnostic test