隐血珠检测上消化道出血病变的价值

目的 评介隐血珠在检测上消化道出血性病变中的意义,为该法用于筛检胃癌及食管癌提供客观的数据资料。方法 对一组因有上消化道症状来医院就诊而需做胃镜检查的患者,在行胃镜检查前先做隐血珠检测,以胃镜和（或）病理学检查结果为金标准,对隐血珠检测的结果用敏感性,特异性,似然比及Ｙｏｕｄｅｎ指数（正确指数）等指标进行评价。结果 ５２１７例患者中,隐血珠阳性者２４０３例（４６．１％）,共发现上消化道恶性肿瘤２０

The value of "occult blood bead" in detection of upper digestive tract disorders with bleeding]

OBJECTIVE: To evaluate the usefulness of "occult blood bead" (OBB) test in the screening of gastric and esophageal cancers. METHODS: In the study, subjects with upper gastro-intestinal (GI) symptoms received gastric OBB test before gastroscopic examination. OBB test was scored as +(-)+++ according to the intensity of reactions. The sensitivity, specificity, and likelihood ratio of OBB test were evaluated according to results of gastroscopic and/or pathological examination. RESULTS: Among 5,217 subjects, 2,403 showed positive OBB test (46.1%). In this series, 202 cases of malignant disorders were detected (gastric cancer in 155 and esophageal cancer in 47). There were 69 cancer cases among 1847 subjects presenting "+" OBB test, with a cancer detection rate of 3.7%. In 393 subjects presenting "++" OBB test, 28 were cancer (7.1%); while in 163 subjects presenting "+++" OBB test, 34 were diagnosed as gastric or esophageal cancer with a detection rate of 20.9%. The sensitivity of OBB test in detection of gastric and esophageal cancer was 0.65, the specificity was 0.55, likelihood ratio was 1.43 and the Youden Index was 0.2. CONCLUSION: OBB test provides a new, simple and non-invasive method for detection of upper digestive tract bleeding. For detection of upper GI carcinomas it presents a reasonable sensitivity and specificity in a group of subjects with upper GI symptoms. OBB test can be used as a prelimnary screening tool for gastric and esophageal cancer in asymptomatic general population.