粪隐血检测次数与大肠疾病筛检效率的关系

Relationship between the Detection Times of FOBT and the Screening Efficiency of Colorectal Diseases

目的:分析不同次数粪隐血试验筛检大肠疾病的效率。方法:对323例大肠疾病患者在肠镜检查前分别进行3次化学法粪隐血试验和免疫法粪隐血试验,1次隐血试验结果以本次试验结果判定阳性或阴性;2次隐血试验结果判定方法是:前2次试验中只要有1次阳性即判定为阳性,余为阴性;3次隐血试验结果判定是3次试验中只要有1次阳性即判定为阳性,余为阴性。分别计算两种方法对大肠疾病筛检的效率、敏感性和特异性。结果:①化学法粪隐血试验对大肠癌的筛检效率1次和2次无显著差异(P>0.05),1次和3次,2次与3次比较差异显著(P<0.05)。对出血性肠病的筛检效率1次与2次、3次比较差异显著(P<0.05),2次与3次比较无显著差异(P>0.05);正常结肠假阳性率1次与2次比较无显著差异(P>0.05);②免疫法粪隐血试验对癌的筛检效率1次和2次、1次和3次比较,都有显著差异(P<0.05),2次和3次比较,无显著差异(P>0.05);对出血性肠病的筛检效率1次与2次、1次与3次比较差异显著(P<0.05),2次与3次比较无显著差异(P>0.05);正常结肠假阳性率1次和2次比较无显著差异(P>0.05);1次和3次、2次和3次比较,差异显著(P<0.05)。③无论做几次隐血试验,化学法和免疫法对癌检出的敏感性均无差异(P>0.05),但免疫法均具有较好的特异性(P<0.05)。结论:①粪隐血检测宜宣教先行,提高受检人的依从性,并且正确留取标本。②用化学法,连续做3次粪隐血试验筛检效率最佳;用免疫法,做2次粪隐血试验检测为好。③在经济条件许可的前提下,粪隐血试验宜选择特异性好的免疫法。

Objective：To investigate the efficiency of screening eoloreetal diseases by means of FOBT detection during different times. Methods ： Before eolonoseopy,323 eases of coloreetal diseases underwent 3 sample tests of CFOBT and IFOBT. The results of one time test were expressed as（ - ） or（ ＋ ）. If there was a positive result in the early two tests,the results were expressed as（ ＋ ） ,while the others were negative. If there was a positive in the early three tests,the results were expressed as（ ＋ ） ,while the others were negative. The detected rate of the two methods of FOBT and the sensitivity and the specificity of CFOBT and IFOBT in eoloreetal cancer screening were evaluated. Results：① Three times of CFOBT had the best detected rate in eoloreetal cancer screening（P 〈 0. 05）. ②Two times of IFOBT had the best detected rate in eoloreetal cancer sereening（P 〈0.05）. ③The specificity of IFOBT was significantly higher than that of CFOBT. Conclusion：①A nice compliance and correct samples are essential for FOBT. Three times or two times of IFOBT had the best detected rate. ②IFOBT was recommended because of its higher specificity .