三种粪便潜血试验在检测结直肠肿瘤中的比较。
Comparison of three faecal occult blood tests in the detection of colorectal neoplasia.
作者信息
Hope R L, Chu G, Hope A H, Newcombe R G, Gillespie P E, Williams S J
机构信息
Department of Gastroenterology, Westmead Hospital, Australia.
出版信息
Gut. 1996 Nov;39(5):722-5. doi: 10.1136/gut.39.5.722.
METHODS AND AIMS
For the detection of colorectal neoplasia, 192 consecutive patients had colonoscopy to evaluate the sensitivity and specificity of three faecal occult blood tests (FOBT). Of 160 evaluable patients (96 female, mean age 51.9), 21 patients (13.1%) had adenomas and three patients (1.9%) had colorectal carcinoma.
RESULTS
When comparing all three faecal occult blood tests for the detection of colorectal neoplasia, the sensitivity of Monohaem (43.8%) was superior to both Hemoccult II (25%) and to BM-Test colon albumin (25%). The specificity of Monohaem (94.6%) was greater than both Hemoccult II (88%) and BM-Test colon albumin (89%). Using McNemar's test, Monohaem was a more accurate FOBT than Hemoccult II and BM-Test albumin (p < 0.05). In the 21 patients with adenomatous polyps, FOBT sensitivity seemed to be dependent on polyp size, but not polyp site.
CONCLUSIONS
Monohaem, a feacal occult blood test that uses a monoclonal antibody that is specific for human haemoglobin, is a more accurate test in the detection of colorectal neoplasia and should possibly be used in colorectal cancer screening programmes.
方法与目的
为检测结直肠肿瘤，对192例连续患者进行结肠镜检查，以评估三种粪便潜血试验（FOBT）的敏感性和特异性。在160例可评估患者（96例女性，平均年龄51.9岁）中，21例患者（13.1%）患有腺瘤，3例患者（1.9%）患有结直肠癌。
结果
比较三种粪便潜血试验检测结直肠肿瘤的情况时，单克隆血红蛋白检测法（Monohaem）的敏感性（43.8%）高于隐血试验II（Hemoccult II，25%）和BM-Test结肠白蛋白检测法（25%）。单克隆血红蛋白检测法的特异性（94.6%）高于隐血试验II（88%）和BM-Test结肠白蛋白检测法（89%）。使用McNemar检验，单克隆血红蛋白检测法是比隐血试验II和BM-Test白蛋白检测法更准确的粪便潜血试验（p < 0.05）。在21例患有腺瘤性息肉的患者中，粪便潜血试验的敏感性似乎取决于息肉大小，而非息肉部位。
结论
单克隆血红蛋白检测法是一种使用对人血红蛋白具有特异性的单克隆抗体的粪便潜血试验，在检测结直肠肿瘤方面是一种更准确的试验，可能应在结直肠癌筛查项目中使用。
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