Tate J J, Northway J, Royle G T, Taylor I
University Surgical Unit, Southampton General Hospital, UK.
Br J Surg. 1990 May;77(5):523-6. doi: 10.1002/bjs.1800770516.
This study examines three faecal occult blood tests, Haemoccult, Fecatwin and E-Z Detect, each with different sensitivities, to determine which is best suited for use in symptomatic patients--both for the detection of cancer and of non-malignant mucosal disease of the large bowel. A test was completed by 1025 patients before double-contrast barium enema and the performance of each test was determined from the result of this investigation. The study was completed by 969 patients. There were 49 patients with colorectal cancer, 92 patients with a cancer or a polyp greater than 5 mm, and 130 with some mucosal abnormality. The test most sensitive for blood, Fecatwin, detected 14 of 15 (93 per cent) cancers and 29 (69 per cent) of 42 patients with mucosal disease (including inflammatory bowel disease) but gave three times as many false positive results as the Haemoccult test, which is less sensitive for blood. The chance of a patient with a positive Haemoccult result having mucosal disease on barium enema was 24 of 47 patients (51 per cent) (two-thirds of these having colorectal cancer). A negative Haemoccult result, however, was unreliable and should not influence patient management. A test less sensitive for blood than Haemoccult was found to be of little value in symptomatic patients.
本研究对三种粪便潜血试验（隐血试验、粪潜血双抗夹心法检测试剂和简易便潜血检测试剂）进行了检测，每种试剂的灵敏度各不相同，目的是确定哪一种最适合用于有症状的患者，以检测大肠癌和大肠非恶性黏膜疾病。1025名患者在进行双重对比钡灌肠前完成了一项检测，并根据该调查结果确定了每种检测的性能。该研究由969名患者完成。其中有49例结直肠癌患者，92例患有大于5毫米的癌症或息肉患者，以及130例有黏膜异常的患者。对血液最敏感的检测试剂粪潜血双抗夹心法检测试剂，检测出了15例癌症患者中的14例（93%）以及42例黏膜疾病患者（包括炎症性肠病）中的29例（69%），但其假阳性结果是对血液不太敏感的隐血试验的三倍。隐血试验结果呈阳性的患者在钡灌肠检查中患有黏膜疾病的几率为47例患者中的24例（51%）（其中三分之二患有结直肠癌）。然而，隐血试验结果呈阴性并不可靠，不应影响对患者的治疗管理。一种对血液的敏感度低于隐血试验的检测试剂被发现对有症状的患者价值不大。
