St John D J, Young G P, McHutchison J G, Deacon M C, Alexeyeff M A
Royal Melbourne Hospital, University of Melbourne, Victoria, Australia.
Ann Intern Med. 1992 Sep 1;117(5):376-82. doi: 10.7326/0003-4819-117-5-376.
To compare the Hemoccult II and HemoQuant tests regarding their specificity and sensitivity in screening for colorectal neoplasia.
Cross-sectional study in which subjects underwent the two tests in parallel, after excluding dietary hemes and peroxidase-rich foods. HemoQuant results were analyzed for three different upper limits of normality (1.5, 2.0, 3.0 mg/g feces).
A university hospital and the surrounding community.
A total of 150 healthy volunteers, 124 patients with colorectal cancer, and 86 patients with adenoma.
Blinded comparison of the specificity and the sensitivity of the two tests for colorectal cancer and adenoma.
Test specificity was 99.3% with Hemoccult and was 92.7%, 94.7%, and 97.3% with HemoQuant, depending on the cutoff point; differences between Hemoccult and HemoQuant were significant when cutoffs of 1.5 and 2.0 mg/g were used in HemoQuant testing (6.6% [95% CI, 2.3 to 11.1] and 4.7% [CI, 0.8 to 8.5], respectively). Test sensitivity for colorectal cancer at all sites was 89.5% with Hemoccult and was 83.1%, 74.2% and 62.9% with HemoQuant, for the 1.5, 2.0, and 3.0 mg/g cutoffs, respectively; differences were significant with the 2.0 and 3.0 mg/g cutoff points (6.4% [CI, 6.7 to 24.0] and 26.6% [CI, 17.4 to 35.9%], respectively). The two tests had similar levels of sensitivity for cancers proximal to the splenic flexure, but sensitivity was substantially lower with HemoQuant for the more distal cancers. For all adenomas, test sensitivity was 30.2% with Hemoccult and ranged from 45.4% to 22.1% with HemoQuant.
Although HemoQuant provides a precise measurement of fecal heme and its porphyrin degradation products, the test's performance characteristics in the detection of colorectal neoplasia are less satisfactory than those of Hemoccult II, a qualitative test for the presence of heme.
比较Hemoccult II和HemoQuant检测在筛查结直肠肿瘤方面的特异性和敏感性。
横断面研究，受试者在排除膳食血红素和富含过氧化物酶的食物后同时接受这两种检测。对HemoQuant结果分析了三种不同的正常上限（1.5、2.0、3.0毫克/克粪便）。
一家大学医院及其周边社区。
共150名健康志愿者、124例结直肠癌患者和86例腺瘤患者。
对两种检测结直肠癌和腺瘤的特异性和敏感性进行盲法比较。
Hemoccult检测的特异性为99.3%，HemoQuant检测的特异性分别为92.7%、94.7%和97.3%，取决于截断点；当HemoQuant检测使用1.5和2.0毫克/克的截断点时，Hemoccult和HemoQuant之间的差异具有显著性（分别为6.6%[95%CI，2.3至11.1]和4.7%[CI，0.8至8.5]）。Hemoccult检测所有部位结直肠癌的敏感性为89.5%，HemoQuant检测在1.5、2.0和3.0毫克/克截断点时的敏感性分别为83.1%、74.2%和62.9%；在2.0和3.0毫克/克截断点时差异具有显著性（分别为6.4%[CI，6.7至24.0]和26.6%[CI，17.4至35.9%]）。两种检测对脾曲近端癌症的敏感性水平相似，但对于更远端的癌症，HemoQuant的敏感性显著较低。对于所有腺瘤，Hemoccult检测的敏感性为30.2%，HemoQuant检测的敏感性范围为45.4%至22.1%。
尽管HemoQuant能精确测量粪便血红素及其卟啉降解产物，但在检测结直肠肿瘤方面，该检测的性能特征不如Hemoccult II（一种检测血红素存在的定性检测）。
