Nakama H, Zhang B
Department of Public Health, Shinshu University School of Medicine, Matsumoto, Nagano, Japan.
Dig Dis Sci. 2000 Nov;45(11):2195-8. doi: 10.1023/a:1026692620150.
The present study was carried out to investigate the diagnostic accuracy of the immunochemical fecal occult blood test in the screening for stomach cancer. In the hospital-based case-control study, the test was positive in 6 (14.3%) subjects with stomach cancer, in 32 (76.2%) subjects with colorectal cancer, and in 10 (7.9%) healthy subjects, respectively, showing a significant difference in detection rate between the subjects with stomach cancer and colorectal cancer (p < 0.01). In the population-based cross-sectional study, detection rate for stomach cancer was 0.13% and 0.15% for negative and positive groups decided by immunochemical fecal occult blood test, indicating no significant difference. These results reveal that the immunochemical fecal occult blood test is inadequate as the screening test for stomach cancer and suggest that examination of the upper digestive tract is unnecessary in cases where the result of fecal occult blood test is positive with no sign of colorectal diseases.
本研究旨在探讨免疫化学法粪便潜血试验在胃癌筛查中的诊断准确性。在一项基于医院的病例对照研究中，该试验在6例（14.3%）胃癌患者、32例（76.2%）结直肠癌患者和10例（7.9%）健康受试者中分别呈阳性，胃癌患者和结直肠癌患者的检测率存在显著差异（p < 0.01）。在一项基于人群的横断面研究中，根据免疫化学法粪便潜血试验判定的阴性和阳性组中，胃癌的检测率分别为0.13%和0.15%，无显著差异。这些结果表明，免疫化学法粪便潜血试验作为胃癌筛查试验并不充分，提示在粪便潜血试验结果为阳性且无结直肠疾病迹象的情况下，无需进行上消化道检查。
