粪便序贯隐血与微量白蛋白互补对提高大肠肿瘤筛检率的价值

EVALUATION OF COMBINED TEST OF SEQUENCIAL FECAL OCCULT BLOOD AND ALBUMIN IN THE SCREENING OF COLORECTA NEOPLASMA

为进一步提高序贯粪隐血大肠肿瘤筛检方案（Ｓ方案）的敏感性，我们建立了免疫粪微量白蛋白与序贯粪隐血互补的大肠肿瘤筛检方案（ＳＡ方案）。同时采用两个方案检测３６５例已知患者，并对８８３例无症状人群进行盲法普查论证。在已知患者中，大肠癌检出的敏感性，Ｓ方案为５０．７％（３７／７３），ＳＡ方案为８７．７％（６４／７３），Ｐ＜０．００１；大肠腺瘤检出的敏感性，Ｓ方案为８．１％（６／７４），ＳＡ方案为３６．５％（２７／７４），Ｐ＜０．００１。无症状人群中，检出大肠癌的敏感性，Ｓ方案为２／３，ＳＡ方案为３／３；大肠腺瘤检出的敏感性，Ｓ方案为４．７％（４／８５），ＳＡ方案为４２．４％（３６／８５），Ｐ＜０．００１。结果提示，ＳＡ方案检出大肠肿瘤的敏感性显著高于Ｓ方案，减少了漏诊率。

Abstract Fecal albumin test was developed and the combined use of sequential occult blood test and al-bumin test(SA)was evaluated and compared with sequential fecal occult blood test(S)in 365cases diagnosed clinically and pathologically and in 883 asymptomatic individuals. In the formergroup,the sensitivity of detection of colorectal cancer was:50.7%(37/73) with S and 87.7%(64/73)with SA(P<0.001),and that of the adenoma was:8.1%(6/74)with S and 36.5%(27/74)with SA(P<0.001).In the latter group 2 of 3 cancer patients were detected with S while allwith SA)and the detection rate of adenoma was:4.7%(4/85)with S and 42.4%(36/85)withSA(P<0.001)it is suggested that the additional use of fecal albumin test is of help in detectingprecancerous inflammatory bowel lesions without bleeding.