免疫法粪便隐血试验和血癌胚抗原检测对大肠癌早期诊断的意义

目的探讨以免疫法粪便隐血试验与血癌胚抗原（CEA）检测为主要方法提高早期大肠癌的诊断率。方法应用问卷调查,按易感因素将研究对象分组,进行免疫法粪便隐血试验（iFOBT）、CEA、肠镜及病理检查。结果依据问卷调查将6997例研究对象分为大肠癌低度危险组（n=4551）、可疑组（n=2085）、高度危险组（n=361）。3组iFOBT阳性率依次升高,差异具有统计学意义（P〈0.05,P〈0.01）。共检出早期大肠癌6例,其中高度危险组5例,可疑组1例。根据结肠镜检查结果分为结肠癌、结肠息肉、结肠炎、正常组,结肠癌组iFOBT、CEA结果明显高于其他组,差异有统计学意义（P〈0.05）。结论 iFOBT可以作为早期大肠癌筛查的主要方法,iFOBT和CEA联合检测可以提高早期结肠癌的检出率。     

粪便隐血试验对早期大肠癌的诊断价值

大肠癌早期症状多不明显,很容易被忽略,粪便隐血试验敏感性高,且标本留取方便,操作方法简单,患者无痛苦,对大肠癌早期诊断有重要作用。现将结果报告如下。1材料和方法1．1研究对象     

早期大肠癌的粪便诊断筛选

<正>大肠癌是常见的恶性肿瘤之一。我国大肠癌在恶性肿瘤病死率中,男性居第5位,女性居第6位,且呈逐年上升趋势。目前病因尚未十分明了。减少大肠癌发病率难以取得实质性进展前,早期诊断、改善预后仍为大肠癌防治研究工作的重点。由于早期大肠癌往往无症状,且大肠癌症状与进展和预后并无必然联系,因此开     

免疫法在粪便隐血中的应用评价

为了解免疫法在粪便隐血测试中的可靠性。通过化学法中的联苯胺法和免疫法中的单克隆抗体法对120例患者的粪便和人们常食用的猪、牛、羊、鸡、鱼的血进行隐血测试，并对其特异性、灵敏度、抗干扰进行了实验。结果免疫法中单克隆抗体法的特异性强、灵敏度高、干扰小。认为免疫法使用简便、诊断准确，是项新的技术，应在广大基层医院推广使用。     

连续粪便隐血试验(胶体金法)在结直肠癌筛查中的临床研究

目的 评价连续粪便隐血试验（Sequential Fecal Occult Blood Test,SFOBT）（胶体金法）结合电子结肠镜和病理学诊断在结直肠癌早期筛查中的应用价值.方法 2006-10-01～2006-12-03,消化内科门诊就诊的60例40岁以上便秘或腹泻6个月以上患者,自愿接受胶体金法粪便隐血试验,连续3 d.阳性者行电子结肠镜检查,对可疑结肠组织进行病理标本采集.结果 22例SFOBT阳性（22/60）,阳性率为36.67%.其中,器质性病变者20例（20/22）,结直肠癌2例（2/20）,为全部筛查人群的3.33%,1例为Ducks A期,1例为Ducks B期,未见Ducks C期和D期.结论 SFOBT是检出有手术切除机会结直肠癌的一种经济实用、相对可靠的筛查手段,适于在我国进行大范围的普查工作.     

粪便隐血试纸法与联邻甲苯胺法的比较

迅速、准确地测定人体粪便隐血，对诊断和治疗胃肠道出血有着重要意义。现介绍粪便隐血试纸法（简称试纸法）与联邻甲苯胶法响称联苯胺法）比较，为隐血试验方法研究提供参考。1材料及方法1．1试剂试纸法是单克隆隐血试纸。联苯胶法是：①1％联邻甲苯胺冰醋酸溶液。②3％过氧化     

胶体金单克隆抗体法与邻联甲苯胺法联合检测粪便隐血的临床意义

目的探讨胶体金单克隆抗体法与邻联甲苯胺法联合检测粪便隐血的临床意义。方法同时采用胶体金单克隆抗体法与邻联甲苯胺法检测33例下消化道出血患者血便、36例上消化道出血患者柏油样便、38例正常对照粪便,分析对比两种方法检测粪便隐血结果的差异。结果胶体金单克隆抗体法在33例血便中的阳性率为84.8%（28/33）,低于邻联甲苯胺法的阳性率[100%（33/33）];胶体金单克隆抗体法在36例柏油样便和38例正常对照粪便中的阳性率分别为61.1%（22/36）、0%（0/38）,均明显低于邻联甲苯胺法的阳性率[100%（36/36）、23.7%（9/38）]（P〈0.01）。结论邻联甲苯胺法检测粪便隐血敏感性高,但存在较高的假阳性;胶体金单克隆抗体法检测粪便隐血不受饮食限制,特异性高,但在敏感性上不如邻联甲苯胺法,两种方法联合使用,可有效保证临床粪便隐血检测结果的准确性和敏感性。     

粪便隐血试验三种方法的比较

目的：对粪便隐血（OB）试验进行方法学上的筛选，帮助临床医生正确评价OB试验结果。方法：分别用免疫胶体金法，隐血试纸法及联苯胺法对120例门诊怀疑有消化道出血的患者粪使及40例确诊消化道出血的柏油样便进行检测。结果：120例门诊忠者胶体金法阳性79例，联苯胺法87例阳性，隐血试纸法53例阳性，胶体金法79例阳性中联苯胺法77例阳性，隐血试纸法74例阳性，40例确诊消化道出血患者，联苯胺法阳性40例，隐血试纸法阳性40例，胶体金法阳性39倒，其中标本未稀释的阳性26例，标本稀释后测得阳性13例。结论：免疫胶体金法敏感性好，可靠性高，但易出现假阴性，联苯胺法敏感性较好，但易受饮食存物影响而出现假阳性，隐血试纸法敏感性稍差，也易受饮食、药物影响而出现假阳性。     

Two-phase test of fecal occult blood screening for colorectal cancer

The detection of colorectal cancer in an early curable stage has become the focus of considerable interest recently. A two-phase test using both guaiac test and Hemolex latex immuno-agglutination test was applied for fecal occult blood screening of colorectal cancer. A total of 4,725 veterans aging 60 to 69 years were registered, and 2,176 persons (average age 66 years) completed the test giving a compliance rate of 46%. The positive rates of both tests were accounted 20.5% and 6.7% respectively. Five hundred and forty five persons had positive reaction for at least one of the tests. Of these, 90 had a follow up diagnosis with colonoscopy or combined with barium enema. Three rectal adenocarcinomas were detected, of which only one was positive by guaiac test, but two by Hemolex test. A rectal carcinoid was found by rectodigital examination. It was negative by both tests. Nineteen cases were detected to have one or more polyps in colon or rectum, of which only 6 were positive by guaiac test, but 18 by Hemolex test. Hemolex test using antibody against human hemoglobin is based on latex agglutination reaction. It is more sensitive and specific than guaiac test. Moreover, no dietary restriction is required. In the view point of cost-effectiveness, mass screening for colorectal cancer in general public is not recommended, but hospital-based screening for high risk group is still worthwhile to study.     

结直肠癌患者血液肿瘤标记物和粪便隐血结果的临床价值及相关性分析

探讨结直肠癌(CRC)血清标志物［细胞游离DNA (cfDNA)、癌胚抗原(CEA)、碳水化合物抗原19-9 (CA19-9)］以及粪便隐血检测(FOBT)在CRC患者中的临床价值以及这些生物标记物之间的关系。方法 收集来自南京医科大学附属肿瘤医院2001年1月—2021年12月共7537例患者的粪便和血液标志物检测结果,回顾性分析检测结果,研究标记物的诊断价值以及这些标记物与临床病理特征的关系。结果 结肠癌患者血浆cfDNA、血清CEA和CA19-9中位水平分别为17.32 ng/mL、3.59 ng/mL和15.63 U/mL。这3个标志物在直肠癌患者中的中位水平分别为15.61 ng/mL、3.15 ng/mL和12.9 U/mL。结肠癌患者血浆cfDNA和血清CEA、CA19-9水平明显高于直肠癌患者。cfDNA、FOBT、CEA和CA19-9的阳性率分别为67.90%、39.37%、48.67%、23.35%。FOBT和CEA阳性与CRC患者的性别、年龄、肿瘤部位相关。血清cfDNA和CA19-9阳性与年龄、肿瘤部位显著相关。联合检测可显著提高阳性检出率。cfDNA、FOBT、CEA和CA19-9诊断CRC的敏感性分别为56.5%、84.6%、49.9%和59.9%,特异性分别为58.6%、32.3%、84.0%和95.5%。粪便标志物FOBT与血清标志物CEA、CA19-9和cfDNA间没有显著相关性。结论 cfDNA 在CRC中存在较高的阳性率,联合检测cfDNA、CEA、CA19-9及FOBT可提高结直肠癌的检出率。同时血液和粪便来源的标志物在不同临床病理资料间存在差异     

潜血试验对人群大肠病变的普查意义

为验证潜血试验对人群大肠癌普查的筛检效果,在对4337例年龄在35岁以上的人群进行潜血试验的同时,作了全乙状结肠镜和部分全结肠镜检查。结果表明,肠镜病变检出率在非筛选人群为10.1％,在筛选人群中方13.3％,共查出大肠癌10例(含早期大肠癌5例),腺瘤167例,非腺瘤息肉131例,慢性肠炎171例。1％联苯胺试验阳性率为6.0％,检出60％大肠癌及3.9％腺瘤;免疫双扩试验阳性率为3.4％,检出40％大肠癌及2.0％腺瘤;SPA免疫潜血试验阳性率为14.7％,检出80％大肠癌(包括3例早期癌)及42.2％腺瘤。结果提示,潜血试验确能检出一些包括早期大肠癌在内的肠道肿瘤病变,尤以SPA免疫潜血试验敏感性最强。虽然潜血试验存在一定的漏检率(1％联苯胺为40％,免疫双扩为60％,SPA法为20％),但鉴于该法简易、经济,作为大规模大肠癌普查筛检.仍不失为一种值得推广的积极措施。     

Small adenomas detected during fecal occult blood test screening for colorectal cancer. The impact of serendipity

Yearly fecal occult blood testing (FOBT) has been recommended for men and women over age 50 years as part of a screening regimen intended to reduce colorectal cancer mortality. The primary targets of screening are early, surgically curable colon cancers and large adenomatous colon polyps; however, screening may sometimes reveal only small adenomas (ie, less than 1 cm in diameter). To assess the rates and mechanisms of FOBT detection of small adenomas, we performed quantitative analyses utilizing estimates of adenoma bleeding rates and FOBT sensitivity and specificity. The analysis suggests that the mechanisms of detection of small adenomas is often chance or serendipity. This occurs when an FOBT result is "falsely" positive because of diet or non-neoplastic gastrointestinal bleeding and leads to colonoscopic discovery of a nonbleeding small adenoma. Nevertheless, small adenomas remain undetected in most persons who have them, even if repeated yearly FOBT screening is done. The identification of persons with small adenomas should not be assumed to be an important beneficial outcome of FOBT screening, because the clinical significance of small adenomas is not clear, the mechanism of detection is serendipity, and only a minority of persons with small adenomas are identified. The current recommendations to perform periodic surveillance colonoscopy following removal of small adenomas detected during FOBT screening should be reexamined.     

结直肠癌患者血清、粪便中M2-PK表达的临床意义

目的探讨结直肠癌患者血清和粪便中肿瘤M2型丙酮酸激酶(M2-PK)表达的临床意义。方法收集44例结直肠癌患者和22名健康人血液和粪便标本,采用ELISA方法检测tumor M2-PK表达水平。结果血清M2-PK和粪便M2-PK对结直肠癌的诊断的敏感性分别为59.1%、63.6%,特异性分别为86.4%、81.8%。血清M2-PK和粪便M2-PK的吻合度有统计学意义。结论血清和粪便tumor M2-PK的检测对结直肠癌的诊断有重要价值,值得进一步研究。     

消化科门诊应用粪便潜血筛检大肠肿瘤的研究

目的探究粪便潜血检查对于大肠肿瘤的筛检意义。方法纳入北京协和医院消化科门诊行粪便潜血和结肠镜检查并有病理学检查结果的512例患者,以结肠镜及病理检查结果为标准,评价粪便潜血结果的诊断价值。结果512例患者中,203例粪便潜血结果阳性,353例结肠镜检查正常,115例有各种息肉,病理检查结果示9例高度不典型增生、21例为大肠癌。粪便潜血检查对于大肠腺瘤性息肉检出的灵敏度、特异度、阳性似然比和阴性似然比分别是42．8％、60．9％、1．09和0．93;对大肠癌及高度不典型增生的灵敏度、特异度、阳性似然比和阴性似然比分别是76．6％、62．5％、2．05和0．37。结论在消化内科就诊的患者中,粪便潜血检查对于大肠癌有一定的诊断和筛查意义,有助于临床医生合理临床决策,但尚需前瞻性研究以建立更可靠的大肠癌筛查模型。     

粪便潜血检查在结直肠癌筛选中的评价(摘要)

1 背景在西方发达国家中,结、直肠癌的发病率与病死率一直位于前列。据统计,在澳大利亚、英国及美国,女性结、直肠癌的发病率仅次于乳腺癌[(22-33)/10万人]。而男性结、直肠癌的发病率排第3位,仅次于前列腺癌和肺癌[(31～47)/10万人]。     

便隐血联合癌胚抗原在体检筛查诊断结直肠癌的价值分析

目的 探讨便隐血联合癌胚抗原在体检筛查诊断结直肠癌的价值.方法 选取本院2015年1月至2020年12月收治的60例可疑结直肠癌患者,所有患者进行癌胚抗原、大便隐血检查,比较不同检查方式的检查效果.结果 病理检查诊断结直肠癌50例,而联合检查诊断结直肠癌48例,诊断准确性为96.00％;癌胚抗原诊断结直肠癌41例,诊断...     

不同稀释液对免疫层析法粪便隐血试验的影响

目的比较采用生理盐水、去离子水、自来水作为样本稀释液对免疫层析粪便隐血试验结果的影响,明确隐血试验最适稀释液,提高隐血试验的准确率。方法采集正常人抗凝全血,用3种稀释液对其倍比稀释后进行隐血检测。通过肉眼观测及Image J图像处理软件灰度分析,比较三者差异。连续2周收集临床粪便标本,潜血检测使用3种稀释液同时测定,计算阳性率差异。结果全血检测生理盐水组灰度明显高于其他2组,P<0.05;自来水组和去离子水组相比差异无统计学意义,P>0.05;生理盐水/去离子水灰度比为1.78±0.85;生理盐水/自来水灰度比为2.12±0.72;自来水/去离子水灰度比为0.80±0.05。结论生理盐水是粪便隐血试验的最适稀释液,相比其他稀释液,具有较高的阳性检出率。     

Effect of dietary restriction on participation in faecal occult blood test screening for colorectal cancer

OBJECTIVES: To determine if participation in colorectal cancer screening using faecal occult blood testing (FOBT) is affected by a restrictive diet and if it is associated with certain demographic variables. PARTICIPANTS AND SETTING: 1,203 residents of South Australia aged 50-69 years, with no "currently active bowel disease", randomly selected from a database of people willing to be contacted about unspecified health issues. DESIGN: Randomised controlled trial: participants were offered screening by immunochemical FOBT by mail in 1998. Half were randomly allocated to a group instructed to follow a low-peroxidase diet, as required for guaiac FOBT, while the other group was not so restricted. MAIN OUTCOME MEASURES: Effect of diet restriction on participation (return of correctly completed FOBT sample cards within 15 weeks); time taken to return cards; relationships between participation and demographic variables. RESULTS: Participation rates were 65.9% (no-diet group) and 53.3% (diet group) (difference, 12.6%; 95% CI, 7.1%-18.1%). In the first week, rates of return as a proportion of all tests returned were 13.1% (no-diet) and 1.6% (diet) (difference, 11.5%; 95% CI, 8.6%-14.4%), increasing to 54.3% and 44.5%, respectively, after five weeks (difference, 9.8%; 95% CI, 4.2%-15.4%). Participation was significantly associated with older age (odds ratio, 1.40; 95% CI, 1.10-1.78), but not sex, Index of Social Disadvantage or rural versus urban address. CONCLUSIONS: Dietary restrictions create a barrier to FOBT-based screening for colorectal cancer. The use of immunochemical rather than guaiac FOBT removes this barrier.