Launoy G
Cancers & Populations, UFR médecine, CHU de Caen, 14000 Caen, France.
Pathol Biol (Paris). 2009 Sep;57(6):488-92. doi: 10.1016/j.patbio.2008.07.010. Epub 2008 Oct 1.
Faecal occult blood tests (FOBT) have been established as the most relevant procedure for colorectal cancer screening in the general average risk population. Immunochemical FOBT consists in monoclonal antibodies reacting with the globin of the haemoglobin. These tests provide higher performances than traditional guaiac tests. They do not need any diet restriction and their analytic sensitivity is higher. An increasing number of papers suggest that their acceptance and clinical performances in the general population are more satisfactory than the guaiac test. The use of automated reading allowed to cut the process price making it similar to the guaiac test. The providing of quantitative measure of haemoglobin allows to choose the positivity threshold associated with the best balance between sensitivity, specificity and positivity rate. Comparative studies conducted in France suggest the use of a positivity threshold allowing an increase in both sensitivity and specificity compared to the guaiac tests.
粪便潜血试验(FOBT)已被确立为一般平均风险人群中结直肠癌筛查最相关的程序。免疫化学FOBT是由单克隆抗体与血红蛋白的珠蛋白发生反应组成。这些检测比传统的愈创木脂检测具有更高的性能。它们不需要任何饮食限制,并且分析灵敏度更高。越来越多的论文表明,它们在普通人群中的接受度和临床性能比愈创木脂检测更令人满意。自动读数的使用降低了检测过程的成本,使其与愈创木脂检测相近。血红蛋白定量测量的提供使得能够选择与灵敏度、特异性和阳性率之间最佳平衡相关的阳性阈值。在法国进行的比较研究表明,使用一个阳性阈值可使灵敏度和特异性相较于愈创木脂检测均有所提高。