Huddy Jeremy R, Ni Melody Z, Markar Sheraz R, Hanna George B
Jeremy R Huddy, Melody Z Ni, Sheraz R Markar, George B Hanna, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, W2 1NY London, United Kingdom.
World J Gastroenterol. 2015 Apr 14;21(14):4111-20. doi: 10.3748/wjg.v21.i14.4111.
Point-of-care (POC) tests enable rapid results and are well established in medical practice. Recent advances in analytical techniques have led to a new generation of POC devices that will alter gastrointestinal diagnostic pathways. This review aims to identify current and new technologies for the POC diagnosis of gastrointestinal cancer. A structured search of the Embase and Medline databases was performed. Papers reporting diagnostic tests for gastrointestinal cancer available as a POC device or containing a description of feasibility for POC application were included. Studies recovered were heterogeneous and therefore results are presented as a narrative review. Six diagnostic methods were identified (fecal occult blood, fecal proteins, volatile organic compounds, pyruvate kinase isoenzyme type M2, tumour markers and DNA analysis). Fecal occult blood testing has a reported sensitivity of 66%-85% and specificity greater than 95%. The others are at a range of development and clinical application. POC devices have a proven role in the diagnosis of gastrointestinal cancer. Barriers to their implementation exist and the transition from experimental to clinical medicine is currently slow. New technologies demonstrate potential to provide accurate POC tests and an ability to diagnose gastrointestinal cancer at an early stage with improved clinical outcome and survival.
即时检验（POC）能够快速得出结果，在医学实践中已得到广泛应用。分析技术的最新进展催生了新一代即时检验设备，这些设备将改变胃肠道疾病的诊断途径。本综述旨在确定用于胃肠道癌即时诊断的现有技术和新技术。我们对Embase和Medline数据库进行了结构化检索。纳入了报告可作为即时检验设备用于胃肠道癌诊断的测试，或包含即时检验应用可行性描述的论文。检索到的研究具有异质性，因此结果以叙述性综述的形式呈现。我们确定了六种诊断方法（粪便潜血、粪便蛋白质、挥发性有机化合物、丙酮酸激酶同工酶M2型、肿瘤标志物和DNA分析）。据报道，粪便潜血检测的灵敏度为66%-85%，特异性大于95%。其他方法则处于不同的研发和临床应用阶段。即时检验设备在胃肠道癌诊断中已被证明具有重要作用。其实施存在障碍，从实验医学向临床医学的转变目前较为缓慢。新技术显示出提供准确即时检验的潜力，以及在早期诊断胃肠道癌从而改善临床结局和生存率的能力。
