无症状门诊患者（无肉眼可见直肠出血）结直肠癌的检测：粪便潜血试验的有效性。

Detection of colorectal cancer in symptomatic outpatients without visible rectal bleeding: Validity of the fecal occult blood test.

机构信息

Department of Surgery P, Aarhus Sygehus, Aarhus University Hospital, Tage-Hansens Gade 2, 8000 Aarhus C, Denmark;

出版信息

Clin Epidemiol. 2009 Aug 9;1:119-24. doi: 10.2147/clep.s7097.

DOI:10.2147/clep.s7097

PMID:20865093

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2943167/

Abstract

BACKGROUND

In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding.

AIMS

The aim was to assess the validity of the Hemoccult Sensa® test in detecting colorectal cancer in the above-mentioned outpatients.

PATIENTS

Symptomatic outpatients without known established colorectal cancer risk factors and without visible rectal bleeding.

METHODS

Hemoccult Sensa® was performed before endoscopic examination. Colorectal cancer was identified at histopathological examination. Patients completed a questionnaire about their symptoms before their first hospital appointment.

RESULTS

Eight of 256 patients were found to have colorectal cancer. Median patient age was 63 years. The positive predictive value, negative predictive value, sensitivity, and specificity of Hemoccult Sensa® for colorectal cancer were 10.5% (95% confidence interval [CI]: 6.8-14.3), 99.0% (95% CI: 97.8-100.0), 75.0% (95% CI: 69.7-80.3), and 79.4% (95% CI: 74.5-84.4).

CONCLUSIONS

Hemoccult Sensa® as the initial examination in symptomatic outpatients without known established colorectal cancer risk factors presenting without rectal bleeding has to be used with caution. We did not find Hemoccult Sensa® test to be an acceptable alternative to flexible sigmoidoscopy.

摘要

背景

2002 年，丹麦针对无已知结直肠癌高危因素且年龄在 40 岁及以上的有症状门诊患者实施了一种新的诊断策略。在无肉眼可见直肠出血的患者中，粪便隐血试验（Hemoccult Sensa®）是该策略的一部分。

目的

评估 Hemoccult Sensa®试验在上述门诊患者中检测结直肠癌的有效性。

患者

无已知结直肠癌高危因素且无肉眼可见直肠出血的有症状门诊患者。

方法

在进行内镜检查前进行 Hemoccult Sensa®检测。在组织病理学检查中发现结直肠癌。患者在首次就诊前完成了一份关于其症状的问卷。

结果

256 例患者中有 8 例被发现患有结直肠癌。患者中位年龄为 63 岁。Hemoccult Sensa®检测结直肠癌的阳性预测值、阴性预测值、敏感度和特异度分别为 10.5%（95%置信区间：6.8-14.3）、99.0%（95%置信区间：97.8-100.0）、75.0%（95%置信区间：69.7-80.3）和 79.4%（95%置信区间：74.5-84.4）。