- 期刊
Immunological Test of Induced Fecal Occult Blood in Colorectal Cancer Screening among High Risk Population: A Preliminary Study
灌腸後免疫法測糞潛血在大腸癌高危險群篩檢之角色：初期研究
摘要
Chemical fecal occult blood test(s) (FOBT) has been used to screen colorectal cancer, but the sensitivity and specificity are not satisfactory. Immunological FOBT was reported to be more sensitive and specific. In conjunction with a colonoscopic screening of colorectal cancer for high risk individuals, we evaluated the efficacy of a new immunological FOBT (OC-HEMODIA) for detecting colorectal cancer. Subjects considered to be at high risk for colorectal cancer were invited for colonoscopic screening. A total of 277 subjects accepted and completed both FOBT and total colonoscopy. A stool specimen was collected during bowel preparation. Overall, chemical FOBT were positive in 15.9% of subjects studied, and immunological FOBT in 25.2%. In subjects with normal colonoscopic examination, the positive rate of chemical and immunological FOBT were comparable (15.4% and 14.7%). However, in subjects with some abnormalities in their colon, immunological FOBT were positive more often than chemical FOBT (35.5% vs. 16.3%, P＜0.001). Colorectal cancer was diagnosed in 3 subjects (1.1%) and polyps in 63 (22.7%). The chemical and immunological FOBT detected bleeding in 1 and 3, respectively, of the 3 subjects with carcinoma, and 12 and 25 of the 63 with polyps. For cancer detection, the sensitivity of chemical and immunological FOBT was 33.3% and 100%, respectively. Bowel preparation before colonoscopy might induce bleeding from minor mucosal abnormalities and increase the sensitivity but decrease the specificity of FOBT.
並列摘要
Chemical fecal occult blood test(s) (FOBT) has been used to screen colorectal cancer, but the sensitivity and specificity are not satisfactory. Immunological FOBT was reported to be more sensitive and specific. In conjunction with a colonoscopic screening of colorectal cancer for high risk individuals, we evaluated the efficacy of a new immunological FOBT (OC-HEMODIA) for detecting colorectal cancer. Subjects considered to be at high risk for colorectal cancer were invited for colonoscopic screening. A total of 277 subjects accepted and completed both FOBT and total colonoscopy. A stool specimen was collected during bowel preparation. Overall, chemical FOBT were positive in 15.9% of subjects studied, and immunological FOBT in 25.2%. In subjects with normal colonoscopic examination, the positive rate of chemical and immunological FOBT were comparable (15.4% and 14.7%). However, in subjects with some abnormalities in their colon, immunological FOBT were positive more often than chemical FOBT (35.5% vs. 16.3%, P＜0.001). Colorectal cancer was diagnosed in 3 subjects (1.1%) and polyps in 63 (22.7%). The chemical and immunological FOBT detected bleeding in 1 and 3, respectively, of the 3 subjects with carcinoma, and 12 and 25 of the 63 with polyps. For cancer detection, the sensitivity of chemical and immunological FOBT was 33.3% and 100%, respectively. Bowel preparation before colonoscopy might induce bleeding from minor mucosal abnormalities and increase the sensitivity but decrease the specificity of FOBT.