Department of Gastroenterology, National Cancer Center Hospital East, Chiba, Japan.
Clin Chim Acta. 2010 Jun 3;411(11-12):802-5. doi: 10.1016/j.cca.2010.02.057. Epub 2010 Feb 23.
Colonoscopic examination is the common pathway for positive screening tests detecting colorectal lesions. We evaluated a specific, quantitative high-throughput automatic immunochemical fecal occult blood test (Auto iFOBT) method for colorectal cancer (CRC) screening and to determine its concordance with physician assessments informed by complete colonoscopy, the gold-standard technique for evaluation of the colonic mucosa.
1200 CRC symptomatic patients were recruited for a retrospective investigation. Colorectal neoplasia were localized by colonoscopy and cancer outcomes were enumerated according to severity. In addition, stool samples were collected and analyzed by Auto iFOBT to derive sensitivity, specificity, and positive predictive value. Qualitative colonoscopy and Auto iFOBT results were correlated, as were cancer severities and quantitative hemoglobin concentrations.
Ninety-one patients were found positive for CRC; 50 mucosal, 20 submucosal, and 21 advanced. At standard cutoff, sensitivity was 60%, 90%, and 95%, respectively. Specificity and positive predictive value for all neoplasia and cancers were 89.6% and 86.4%, and 60.9% and 33.7%, respectively. Cancer severities could be approximated roughly according to hemoglobin concentrations.
Specific qualitative 2-day Auto iFOBT is an accurate tool for the detection of colorectal cancer and therefore provides the basis for a large-scale screening program.
结肠镜检查是检测结直肠病变的常用筛查检测途径。我们评估了一种特定的、高通量的自动免疫化学粪便潜血检测（Auto iFOBT）方法，用于结直肠癌（CRC）筛查，并确定其与完整结肠镜检查的一致性，完整结肠镜检查是评估结肠黏膜的金标准技术。
1200 名 CRC 症状患者被招募进行回顾性研究。通过结肠镜检查定位结直肠肿瘤，根据严重程度计算癌症结局。此外，收集粪便样本并通过 Auto iFOBT 进行分析，以得出敏感性、特异性和阳性预测值。对定性结肠镜检查和 Auto iFOBT 结果进行了相关性分析，以及癌症严重程度和定量血红蛋白浓度的相关性分析。
91 名患者被发现患有 CRC；50 名黏膜、20 名黏膜下和 21 名晚期。在标准截点下，敏感性分别为 60%、90%和 95%。所有肿瘤和癌症的特异性和阳性预测值分别为 89.6%和 86.4%，60.9%和 33.7%。根据血红蛋白浓度可以大致估算癌症的严重程度。
特定的定性 2 天 Auto iFOBT 是一种用于检测结直肠癌的准确工具，因此为大规模筛查计划提供了基础。
