摘要
目的:比较免疫法粪便隐血试验(immune fecal occult blood test,IFOBT)和化学法粪便隐血试验(chemical fecal occult blood test,CFOBT)在上消化道出血性疾病中的阳性率,以验证IFOBT筛查上消化道出血不具特异性.方法:2006-07/2007-03间连续选择我院内镜中心进行胃镜检查的上消化道出血性疾病患者206例,利用邻甲苯胺CFOBT和IFOBT同时比较两种粪便隐血试验的阳性率,并结合临床资料分析其相应结果.结果:IFOBT和CFOBT结果均与食管癌、胃癌的解剖部位及食管癌浸润深度无关,两者均与胃癌浸润深度有关,与胃癌的最大长径呈正相关(IFOBT:r=0.30,P=0.02:CFOBT:r=0.20,P=0.04);IFOBT与食管癌的最大长径呈正相关(r=0.38,P=0.01);CFOBT在食管癌患者中的阳性率高于食管磷状细胞癌抗原(SCC)的阳性率(47.43% vs 20.45%,P<0.05);两者在胃癌患者中的阳性率均高于CA125,CEA和CA199的阳性率.CFOBT检测胃癌、食管癌、返流性食管炎和消化性溃疡的阳性率均高于IFOBT(50.88% vs 35.09%,47.73% vs 29.55%,18.00% vs 6.00%,60.OO% vs 41.82%,均P<0.05).IFOBT在上消化道出血性疾病中的总阳性率低于CFOBT.结论:IFOBT粪便隐血试验不适合上消化道出血性疾病的筛查,可能对下消化道出血性疾病的筛查具有相对特异性.
AIM: To compare the positive rates of immune fecal occult blood test (IFOBT) and chemical fecal occult blood test (CFOBT) in screening upper digestive tract bleeding.
METHODS: A total of 206 consecutive patients who suffered upper digestive tract bleeding and underwent endoscopic examination in our hospital were chosen from July 2006 to March 2007. CFOBT (using o-toluidine) and IFOBT were used to detect fecal occult blood positive rate in the same fecal specimen, and comparison was made between the two methods. The positive rates were also analyzed combined with the clinical data.
RESULTS: The results of IFOBT and CFOBT were not associated with anatomic sites in esophageal and gastric cancer, but associated with the invasion depth in gastric cancer, and they were positively correlated with the largest diameter of gastric cancer (IFOBT: r = 0.30, P = 0.02; CFOBT: r = 0.20, P = 0.04). Meanwhile, IFOBT result showed a positive correlation with the largest diameter of esophageal cancer (r = 0.38, P = 0.01). The positive rate of CFOBT was superior to that of squamous cell carcinoma (SCC) antigen detection in esophageal cancer patients (47.43% vs 20.45%, P 〈 0.05), and the positive rates of both methods were higher than those of CA125, CEA and CA199 detection. CFOBT was superior to IFOBT in detecting gastric cancer, esophageal cancer, reflux esophagitis and peptic ulcer (50.88% vs 35.09%; 47.73% vs 29.55%; 18.00% vs 6.00%; 60.00% vs 41.82%; all P 〈 0.05). The total positive rate of IFOBT was lower than that of CFOBT in detecting upper digestive tract bleeding.
CONCLUSION: The IFOBT is not suitable for screening upper digestive tract diseases, but relatively specific for lower digestive tract bleeding.
出处
《世界华人消化杂志》
CAS
北大核心
2008年第9期946-950,共5页
World Chinese Journal of Digestology
基金
上海市重点学科建设资助项目
No Y0205~~
关键词
化学法粪便隐血试验
免疫法粪便隐血试验
上消化道出血
阳性率
Chemical fecal occult blood test
Immune fecal occult blood test
Upper digestive tract bleeding
Positive rate