Shani A, Rozen P, Fink A, Bass D, Levy E, Fireman Z, Gottesfeld F, Baker S, Fraizer D, Bentwich Z
Oncology Unit, Kaplan Hospital, Rehovot.
Harefuah. 1990 Jan 15;118(2):66-70.
We screened groups at high risk for colorectal neoplasms, determining the efficacy of the leukocyte adherence inhibition test (LAI) for early detection, in comparison with that of the fecal occult blood (Hemoccult) test and sigmoidoscopy or colonoscopy. Those screened included 549 first-degree relatives of patients with colorectal cancer, 190 patients with a past history of colorectal adenoma or carcinoma and 67 with a past history of breast or gynecological cancer or inflammatory bowel disease. 146 normal volunteers served as controls. In 782 of those fully screened during a 3-year period, 121 had adenomas (15.5%) and 5 had invasive cancer (0.6%). The LAI test was positive in 21% of those at high risk and in 7.5% of the controls. The hemoccult test was positive in only 4.8%, but in 1/3 of them neoplasms were found. This predictive value of 33% compares with only 16% for the LAI test. That most of the neoplasms found were adenomas and not invasive cancer may be due to the relative youth of most of those screened. We conclude that the groups studied were indeed at high risk. The LAI test is not sensitive enough to identify benign adenomas but might serve as another risk-market for colorectal neoplasms. Long-term follow-up of those at high-risk with positive LAI tests may prove that we have identified a subgroup truly at risk.
我们对患结肠直肠肿瘤高风险人群进行了筛查，与粪便潜血（Hemoccult）检测及乙状结肠镜或结肠镜检查相比较，确定白细胞黏附抑制试验（LAI）用于早期检测的效果。接受筛查的人群包括549名结肠直肠癌患者的一级亲属、190名有结肠直肠腺瘤或癌病史的患者以及67名有乳腺癌、妇科癌症或炎症性肠病病史的患者。146名正常志愿者作为对照。在3年期间接受全面筛查的782人中，121人患有腺瘤（15.5%），5人患有浸润性癌（0.6%）。LAI检测在高风险人群中的阳性率为21%，在对照组中的阳性率为7.5%。潜血检测的阳性率仅为4.8%，但其中1/3的人发现有肿瘤。其33%的预测价值与LAI检测的16%相比。所发现的大多数肿瘤为腺瘤而非浸润性癌，这可能是由于大多数接受筛查者相对年轻。我们得出结论，所研究的人群确实处于高风险状态。LAI检测不足以敏感地识别良性腺瘤，但可能作为结肠直肠肿瘤的另一个风险指标。对LAI检测呈阳性的高风险人群进行长期随访可能会证明我们已经识别出了一个真正处于风险中的亚组。
