Evaluating the Efficacy of Fecal Occult Blood Test and Tumor Marker Combined Screening for Colorectal Cancer

Objective:To analyze the screening effectiveness of combining the fecal occult blood test with tumor marker detection for colorectal cancer.Methods:A total of thirty patients with colorectal cancer and thirty patients with benign colon hyperplasia who received treatment from January 2020 to January 2023 were selected.These patients were assigned to the observation group and the control group,respectively.All patients in both groups underwent both fecal occult blood tests and tumor marker detection.The levels of tumor markers between the two groups were compared,the tumor marker levels in different stages were assessed within the observation group,and the positive detection rates for single detection and combined detection were compared.Results:The levels of various tumor markers in the observation group were significantly higher than those in the control group(P<0.05).Furthermore,as the Duke stage increased within the observation group,the levels of various tumor markers also increased(P<0.05).The positive detection rate of the combined test was notably higher than that of single detection(P<0.05).Conclusion:Combining the fecal occult blood test with tumor marker detection in colorectal cancer screening can significantly improve the overall detection rate.

To scope or not-the challenges of managing patients with positive fecal occult blood test after recent colonoscopy

BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent colonoscopy.AIM To determine the prevalence of advanced neoplasia in patients with a positive iFOBT after a recent colonoscopy, and clinical and endoscopic predictors for advanced neoplasia.METHODS The study recruited i FOBT positive patients who underwent colonoscopy between July 2015 to March 2020. Data collected included demographics, clinical characteristics, previous and current colonoscopy findings. Primary outcome was the prevalence of CRC and advanced neoplasia in a patient with positive iFOBT and previous colonoscopy. Secondary outcomes included identifying any clinical and endoscopic predictors for advanced neoplasia.RESULTS The study included 1051 patients(male 53.6%;median age 63). Forty-two(4.0%) patients were diagnosed with CRC, 513(48.8%) with adenoma/sessile serrated lesion(A-SSL) and 257(24.5%) with advanced A-SSL(AA-SSL). A previous colonoscopy had been performed in 319(30.3%). In this cohort, four(1.3%) were diagnosed with CRC, 146(45.8%) with A-SSL and 56(17.6%) with AA-SSL. Among those who had a colonoscopy within 4 years, none had CRC and 7 had AA-SSL. Of the 732 patients with no prior colonoscopy, there were 38 CRCs(5.2%). Independent predictors for advanced neoplasia were male [odds ratio(OR) = 1.80;95% confidence interval(CI): 1.35-2.40;P < 0.001), age(OR = 1.04;95%CI: 1.02-1.06;P < 0.001) and no previous colonoscopy(OR = 2.07;95%CI: 1.49-2.87;P < 0.001).CONCLUSION A previous colonoscopy, irrespective of its result, was associated with low prevalence of advanced neoplasia, and if performed within four years of a positive iFOBT result, was protective against CRC.

Colorectal cancer screening: Comparison of transferrin and immuno fecal occult blood test

AIM: To evaluate the sensitivity and specificity of transfesrrin dipstick test (Tf) in colorectal cancer (CRC) screening and precancerous lesions screening. METHODS: Eight hundreds and sixty-one individuals at high-risk for CRC were recruited. Six hundreds and eleven subsequently received the three fecal occult blood tests and colonoscopy with biopsy performed as needed. Fecal samples were obtained on the day before colonoscopy. Tf, immuno fecal occult blood test (IFOBT) and guaiac fecal occult blood test (g-FOBT) were performed simultaneously on the same stool. To minimize false-negative cases, all subjects with negative samples were asked to provide an additional stool specimen for a second test even a third test. If the results were all negative after testing three repeated samples, the subject was considered a true negative. The performance characteristics of Tf for detecting CRC and precancerous lesions were examined and compared to those of IFOBT and the combination of Tf, IFOBT and g-FOBT. RESULTS: A total of six hundreds and eleven subjects met the study criteria including 25 with CRC and 60 with precancerous lesions. Sensitivity for detecting CRC was 92% for Tf and 96% for IFOBT, specificities of Tf and IFOBT were both 72.0% (95% CI: 68.2%-75.5%; χ2 = 0.4, P > 0.05); positive likelihood ratios of those were 3.3 (95% CI: 2.8-3.9) and 3.4 (95% CI: 2.9-4.0), respectively. In precancerous lesions, sensitivities for Tf and IFOBT were 50% and 58%, respectively (χ 2 = 0.8, P > 0.05); specificities of Tf and IFOBT were 71.5% (95% CI: 67.6%-75.1%) and 72.2% (95% CI: 68.4%-75.8%); positive likelihood ratios of those were 1.8 (95% CI: 1.3-2.3) and 2.1 (95% CI: 1.6-2.7), respectively; compared to IFOBT, g-FOBT+ Tf+ IFOBT had a significantly higher positive rate for precancerous lesions (83% vs 58%, respectively; χ 2 = 9.1, P < 0.05). In patients with CRC and precancerous lesions, the sensitivities of Tf and IFOBT were 62% and 69% (χ 2 = 0.9, P > 0.05); specificities of those were 74.5% (95% CI: 70.6%-78.1%) and 75.5% (95% CI: 71.6%-79.0%); positive likelihood ratios of those were 2.5 (95% CI: 2.0-3.1) and 2.8 (95% CI: 2.3-3.5). Compared to IF-OBT alone, combining g-FOBT, IFOBT and Tf led to significantly increased sensitivity for detecting CRC and cancerous lesions (69% vs 88%, respectively; χ 2 = 9.0, P < 0.05). CONCLUSION: Tf dipstick test might be used as an ad- ditional tool for CRC and precancerous lesions screening in a high-risk cohort.

Impact of fecal occult blood on obscure gastrointestinal bleeding:Observational study

AIM: To elucidate the association between small bowel diseases(SBDs) and positive fecal occult blood test(FOBT) in patients with obscure gastrointestinal bleeding(OGIB).METHODS: Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy(CE) and FOBT were enrolled(mean age; 63.6 ± 14.0 years, 118 males, 96 previous overt bleeding, 106 with occult bleeding). All patients underwent immunochemical FOBTs twice prior to CE. Three experienced endoscopists independently reviewed CE videos. All reviews and consensus meeting were conducted without any information on FOBT results. The prevalence of SBDs was compared between patients with positive and negative FOBT.RESULTS: CE revealed SBDs in 72 patients(36%). FOBT was positive in 100 patients(50%) and negative in 102(50%). The prevalence of SBDs was significantly higher in patients with positive FOBT than those with negative FOBT(46% vs 25%, P = 0.002). In particular, among patients with occult OGIB, the prevalence of SBDs was higher in positive FOBT group than negative FOBT group(45% vs 18%, P = 0.002). On the other hand, among patients with previous overt OGIB, there was no significant difference in the prevalence of SBDs between positive and negative FOBT group(47% vs 33%, P = 0.18). In disease specific analysis among patients with occult OGIB, the prevalence of ulcer and tumor were higher in positive FOBT group than negative FOBT group. In multivariate analysis, only positive FOBT was a predictive factors of SBDs in patients with OGIB(OR = 2.5, 95%CI: 1.4-4.6, P = 0.003). Furthermore, the trend was evidentam on g patients with occult OGIB who underwent FOBT on the same day or a day before CE. The prevalence of SBDs in positive vs negative FOBT group were 54% vs 13% in patients with occult OGIB who underwent FOBT on the same day or the day before CE(P = 0.001), while there was no significant difference between positive and negative FOBT group in those who underwent FOBT two or more days before CE(43% vs 25%, P = 0.20).CONCLUSION: The present study suggests that positive FOBT may be useful for predicting SBDs in patients with occult OGIB. Positive FOBT indicates higher likelihood of ulcers or tumors in patients with occult OGIB. Undergoing CE within a day after FOBT achieved a higher diagnostic yield for patients with occult OGIB.

Prediction of flare-ups of ulcerative colitis using quantitative immunochemical fecal occult blood test

AIM:To examine the feasibility of predicting the flareup of ulcerative colitis (UC) before symptoms emerge using the immunochemical fecal occult blood test (IFOBT).METHODS:We prospectively measured fecal hemoglobin concentrations in 78 UC patients using the I-FOBT every 1 or 2 mo.RESULTS:During a 20 mo-period,823 fecal samples from 78 patients were submitted.The median concentration of fecal hemoglobin was 41 ng/mL (range:0-392 500 ng/mL).There were three types of patients with regard to the correlation between I-FOBT and patient symptoms;the synchronous transition type with symptoms (44 patients),the unrelated type withsymptoms (19 patients),and the flare-up predictive type (15 patients).In patients with the flare-up predictive type,the values of I-FOBT were generally low during the study period with stable symptoms.Two to four weeks before the flare-up of symptoms,the I-FOBT values were high.Thus,in these patients,I-FOBT could predict the flare-up before symptoms emerged.CONCLUSION:Flare-up could be predicted by I-FOBT in approximately 20% of UC patients.These results warrant periodical I-FOBT in UC patients.

CT colonography after incomplete colonoscopy in subjects with positive faecal occult blood test

<Abstract>AIM: To report our experience with computed tomog- raphy colonography (CTC) systematically performed in subjects with positive faecal occult blood test (FOBT) and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer (CRC). METHODS: From April 2006 to April 2007, 43 290 indi- viduals (age range 50-70) who adhered to the regional screening program for the prevention of CRC under-went immunochemical FOBT. FOBT was positive in 1882 subjects (4.3%). 1463 (77.7%) of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 (7.2%) were incom- plete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep (polyethyleneglycole) in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Per-lesion and per-segment positive predictive values (PPV) were calculated. RESULTS: Twenty-one (50%) of 42 CTCs showed pol-yps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwentsurgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC cor- rectly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION: In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonos-copy.

EVALUATION OF REVERSE PASSIVE HEMAGGLUTINATION （RPHA） FECAL OCCULT BLOOD TEST IN SCREENING OF COLORECTAL NEOPLASIA

A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994

Diagnostic accuracy of a single qualitative immunochemical fecal occult blood test coupled with physical measurements

Background We aimed to improve the sensitivity of immunochemical fecal occult blood test （I-FOBT） to screen colorectal neoplasm among average-risk adults. Methods This is a diagnostic cohort study. All health examination participants receiving a single qualitative I-FOBT and a screening colonoscopy from January 2010 to June 2011 were included. Stool specimens were collected for I-FOBT before colonoscopy. Using pathology as gold standard, significant colorectal neoplasm was defined as advanced adenoma or malignancy. Results A total of 1 007 health examinees were identified. Fifty-five （5.5%） had borderline positive （＋/-） I-FOBT, while 38 （3.8%） had positive I-FOBT. Twenty-four （2.4%） had advanced adenoma, and five （0.5%） had carcinoma. Using borderline positive I-FOBT as cutoff value, the sensitivity and specificity for significant colorectal neoplasm were 34.5% （95% confidence interval （CI） 19.9%-52.7%） and 91.5% （95% CI 89.6%-93.1%）, respectively. If combined with advanced age, high blood pressure （BP）, and abdominal obesity, a fulfillment of either two criteria further increased the sensitivity to 72.4% （95% CI 54.3%-85.3%） with a specificity of 68.8% （95% C165.8%-71.6%）. Conclusion The sensitivity of a single qualitative I-FOBT for the detection of significant colorectal neoplasm can be increased by coupling with age, BP, and abdominal obesity.

Diagnostic value of fecal occult blood testing for screening colorectal cancer

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Significant increase in HBV, HCV, HIV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection

AIM: To evaluate the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kolkata, Eastern India for two consecutive years and to conduct a pilot study to explore the presence of HBV DNA among hepatitis B surface antigen (HBsAg) negative but anti-HBc positive blood donors. METHODS: Seroprevalence of HBsAg, anti-HCV and anti-HIV was studied among 113 051 and 106 695 voluntary blood donors screened in 2004 and 2005, respectively. Moreover, a pilot study on 1027 HBsAg negative donors was carried out for evaluating the presence of HBV DNA by PCR on HBsAg negative/anti- HBc positive donors. RESULTS: A statistically significant increase in the prevalence of HBV (1448 vs 1768, P < 0.001), HIV (262 vs 374, P < 0.001), HCV (314 vs 372, P = 0.003) and syphilis (772 vs 853, P = 0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as compared to 2004. Moreover, the exploratory study on 1027 HBsAg negative donors revealed that 188 (18.3%)of them were anti-HBc positive out of which 21% were positive for HBV DNA. CONCLUSION: The findings of this study underscore the significantly increasing endemicity of hepatitis viruses, syphilis and HIV among the voluntary blood donors of our community. The pilot study indicates a high rate of prevalence of HBV DNA among HBsAg negative/anti-HBc positive donors and thus emphasizes the need for a more sensitive and stringent screening algorithm for blood donations.

Early colorectal cancer screening–no time to lose

In this editorial,we comment on the article entitled“Stage at diagnosis of colorectal cancer through diagnostic route:Who should be screened?”by Agatsuma et al.Colorectal cancer(CRC)is emerging as an important health issue as its incidence continues to rise globally,adversely affecting the quality of life.Although the public has become more aware of CRC prevention,most patients lack screening awareness.Some poor lifestyle practices can lead to CRC and symptoms can appear in the early stages of CRC.However,due to the lack of awareness of the disease,most of the CRC patients are diagnosed already at an advanced stage and have a poor prognosis.

自动粪便分析仪与人工复核法检测粪便结果的比较分析

目的比较自动粪便分析仪与人工复核法两种粪便检测方法的检验效果。方法收集2022年9月—2023年8月三明市第二医院就诊患者的9402份新鲜粪便标本,分别使用FA160自动粪便分析仪和人工复核法检测粪便有形成分(白细胞、红细胞、脂肪球、真菌)和隐血,记录两种方法的检测结果并进行统计学分析。结果自动粪便分析仪检测白细胞、红细胞、脂肪球、真菌和隐血的阳性检出率分别为4.90%、2.67%、6.31%、4.54%、25.34%,人工复核法阳性检出率分别为4.17%、2.22%、5.55%、5.29%、25.23%,自动粪便分析仪对粪便有形成分的阳性检出率除真菌略低于人工复核外,其他各项指标均高于人工复核,且差异均有统计学意义(均P<0.05),而粪便隐血试验的阳性检出率比较差异无统计学意义(P>0.05)。以人工复核法为标准,自动粪便分析仪检测白细胞、红细胞、脂肪球、真菌、隐血的阳性符合率分别为91.07%、96.17%、94.83%、78.07%、98.19%;阴性符合率分别为98.85%、99.46%、98.90%、99.56%、99.25%;阳性预测值分别为77.44%、80.08%、83.47%、90.87%、97.77%;阴性预测值分别为99.61%、99.91%、99.69%、98.79%、99.39%。结论自动粪便分析仪与人工复核法的检测结果虽然符合率较高,但还存在漏检和误检。因此对自动分析结果必须进行人工复核,提高检测结果的准确性,为临床提供可靠的参考依据。

人工半髋关节置换术后隐性失血的影响因素分析

目的研究人工半髋关节置换术后隐性失血的影响因素。方法回顾性分析120例于重庆市北培区中医院进行人工半髋关节置换术后隐性失血的患者作为研究对象,以术后隐性失血量480 mL为分界线,将其分为高隐性失血组(31例,失血量≥480 mL),低隐性失血组(89例,失血量<480 mL),收集两组患者的临床资料,采用多因素Logistic回归分析影响隐性失血的因素。结果两组间年龄、糖尿病、高脂血症、骨质疏松的差异有统计学意义(P<0.05),其余对比差异均无统计学意义(P>0.05);多因素Logistic回归分析认为年龄60岁及以上(OR:8.953,95%CI:2.905,27.593)、骨质疏松(OR:5.127,95%CI:1.318,19.950)是人工半髋关节置换术后高隐性失血的危险因素。结论年龄60岁及以上和骨质疏松是人工半髋关节置换术术后高隐性失血的危险因素。因此,在临床实践中,对于年龄较大和存在骨质疏松的患者,应特别注意预防和监测术后隐性失血的发生,采取必要的措施来减少失血风险,促进患者的早日康复。

Tumor-Specific Histo-Blood Group Antigens: Apropos of Two Cases

Cancer cells with immunogenic properties having altered protein glycosylation, modified blood group substances have been widely studied. Due to the genetic instability occurring during carcinogenesis the glycosyltransferases may suffer from posttranslation sequence modification. The author describes 2 autopsy cases, where in the background of the unusual metastatic tumor presentation, incompatible blood group antigenic determinants have been demonstrated using blood group specific lectins and monoclonal antibodies (mAb). In the first case, reported here, a 10-year-old girl developed an acute myeloid leukemia and died in a septic endotoxin shock after successful cytostatic treatment of a juvenile signet ring cell cancer of her colon. At autopsy there were no signs of tumor except bilateral apple-sized mucinous ovarian (Krukenberg) metastases. While she had erythrocyte phenotype of blood group A, the signet ring adenocarcinoma cells expressed blood group B incompatible antigenic determinants with lectin/mAb. In the second case, the autopsy of a 78-year-old female resulted in no macroscopic tumor sign except a moderately enlarged, ham hard spleen. Light microscopy revealed adenocarcinomatous infiltration in the splenic sinusoids. The patient had blood group O, while the metastatic cells in the spleen reacted with Breast Carcinoma Antigen (BioGenex) and incompatible anti-B Banderiaeasimplicifolia agglutinin I and anti-B mAb. It proved to be a case of an occult, completely regressed breast cancer. Based on these observations the expression of tumor specific incompatible blood group antigens might occur from time to time, mostly in adenocarcinomas. Accordingly, blood group-based specific immuno-oncotherapy could be considered in some cancer cases.

基于FIB、HB、FOBT、CEA构建的Logistic回归模型对结直肠癌的诊断价值

目的 评价纤维蛋白原(FIB)、血红蛋白(HB)、癌胚抗原(CEA)和粪便隐血试验(FOBT)联合检测在结直肠癌患者中的诊断价值,为结直肠癌诊断提供参考。方法 选取宁夏医科大学总医院2021年1月至2022年6月结直肠外科收治的110例结直肠癌患者作为癌症组,选取同期病房收治的43例良性结直肠疾病患者为非癌症组。回顾性分析并比较癌症组及非癌症组常规实验室指标(血常规、生化常规、肿瘤标志物、细胞因子、FOBT)结果,采用Logistic回归分析结直肠癌的影响因素并构建Logistic回归模型,采用受试者工作特征(ROC)曲线分析Logistic回归模型对结直肠癌的诊断价值;进一步构建诊断结直肠癌的列线图并绘制校准曲线图进行内部验证。结果 癌症组患者血FIB、CEA水平及FOBT阳性率高于非癌症组,A/G、HB水平低于非癌症组,差异均有统计学意义(P<0.05)。将FIB、HB、FOBT、CEA进行多因素Logistic回归分析,建立Logistic回归模型作为4项指标联合检测模型:P=1/[1+e^(-(13.792-0.144×X_(1)+1.057×X_(2)+0.560×X_(3)+3.029×X_(4)))],其中X_(1)为HB水平,X_(2)为FIB水平,X_(3)为CEA水平,X_(4)为FOBT检测结果(阳性=1,阴性=0)。ROC曲线分析结果显示,当最大约登指数为0.841时,Logistic回归模型诊断结直肠癌的灵敏度为86.4%,特异度为97.7%,曲线下面积(AUC)为0.961(95%CI:0.933~0.988)。建立Logistic回归模型的列线图,并绘制校准曲线图,结果提示该模型的预测概率与实际概率具有较好的一致性。结论 基于FIB、HB、CEA和FOBT 4项指标构建的Logistic回归模型,对结直肠癌有着较好的诊断价值,也为临床对结直肠癌的早期筛查和诊断提供了一定的方向。

危重症患者内镜引导下可视化鼻肠管置管方法及效果

目的探索内镜引导下可视化鼻肠管置管在危重症患者中的应用效果。方法将100例危重症患者按鼻肠管置管时间分为对照组和观察组各50例。对照组采用床旁盲插置入鼻肠管,观察组采用内镜引导下可视化置入鼻肠管。结果观察组首次置管成功率显著高于对照组,置管耗时显著短于对照组,置管过程中患者平均动脉压、心率、血氧饱和度波动显著小于对照组(均P<0.05),观察组患者大便潜血、鼻腔黏膜出血及渗血、误入气道发生率显著低于对照组(均P<0.05)。结论内镜引导下可视化鼻肠管置管可提高患者首次置管成功率,缩短置管时间,减少置管过程中患者血压、心率和血氧饱和度变化,降低置管并发症发生率。

粪便隐血试验在体检人群中对大肠癌早期筛查的价值

目的研究免疫化学法粪便隐血试验(FIT)在体检人群中大肠癌早期筛查的应用价值。方法选取2017年9月至2020年9月该院体检中心健康体检人群,收集行FIT患者的基本资料,根据内镜下有无新生物、FIT检测值、新生物直径及位置进行分组;采用单样本K-S检验、Kruskal-Wallis H检查、χ^(2)检验进行组间统计分析,Spearman法分析双变量关系,多重线性回归模型分析性别、年龄及新生物病理类型、位置、直径、个数对FIT的预测价值。结果315例患者满足FIT>100 ng/mL并完成肠镜检查,包括大肠癌(腺癌)19例,腺瘤性息肉94例,增生性息肉59例,正常及其他疾病143例,男性大肠癌发病比率高于女性(χ^(2)=15.74,P<0.01)。FIT检测值平均中位水平:肿瘤组>腺瘤性息肉组>无新生物组>增生性息肉组,除无新生物组与增生性息肉组之间差异无统计学意义(P=0.206),其余各组间差异均有统计学意义(P<0.05)。随着FIT检测值的增加,肠镜正常和增生性息肉的占比下降,腺瘤和腺癌的占比升高(P<0.01)。新生物直径中位水平:肿瘤组>腺瘤性息肉组>增生性息肉组(P<0.01)。随着新生物直径的增加,增生性息肉百分比下降,肿瘤所占比例增加(P<0.01)。左半结肠发病率显著高于结肠其他部位(P<0.01)。双变量相关分析显示,FIT检测值与新生物病理类型、直径、个数呈正相关(r=0.291、0.591、0.354,P<0.01)。多重线性回归分析显示新生物病理类型、直径、个数是影响FIT检测值的独立影响因素,线性方程式为Y=-584.875+319.315×1+264.241×2+109.942×3(×1、×2、×3分别代表新生物病理类型、直径、个数),P<0.01。结论FIT能够有效应用于大肠癌的早期筛查,其检测值高低与肠道新生物癌变程度、直径呈正相关,男性患者、左半结肠病变、大直径新生物易发生癌变。

优化器械清洗流程在降低眼科手术器械损耗中的应用

目的探讨优化器械清洗流程在降低眼科手术器械损耗中的应用,为提高器械清洗质量、保证临床用械安全提供依据。方法选取2019年7月至2020年8月医院所用300件眼科手术器械作为研究对象,采用随机数字表法分为两组,每组150件。对照组采用传统清洗方法,观察组优化器械清洗流程。比较两组器械清洗合格率(分别采取目测法和镜检法评价清洗合格情况)、器械损耗率、器械灵活度、隐血试验结果。结果目测法结果显示,两组器械清洗合格率差异无统计学意义(P>0.05);镜检法结果显示,观察组器械清洗合格率高于对照组(P<0.05)。观察组器械损耗率低于对照组(P<0.05),器械灵活度高于对照组(P<0.05),隐血试验阳性率低于对照组(P<0.05)。结论优化眼科手术器械清洗流程可提高清洗质量,提升器械清洗合格率,减少器械损耗,延长器械使用寿命。

尿液分析在尿液潜血诊断中的价值分析

目的探讨尿液分析诊断尿液潜血的价值。方法选取2022年10月—2023年5月巨野县人民医院的118例疑似尿液潜血患者为研究对象,所有患者均进行尿液潜血检验。检查方式分为尿液分析检验和显微镜红细胞计数,金标准为显微镜红细胞计数检验,分析尿液分析检查的诊断效能。结果尿液分析的检验敏感度、特异度、准确度为76.47%、95.24%、89.83%,Kappa值为0.743。结论尿液分析可以为尿液潜血提供一定的参考数据,方便临床对尿液潜血的诊断。

粪便隐血及肿瘤标志物联合检验在诊断结直肠癌中的作用及结果分析

目的 探讨粪便隐血及肿瘤标志物联合检验在诊断结直肠癌中的应用价值。方法 选取2020年1月-2022年12月广州市番禺区康复医院接诊的疑似结直肠癌患者100例,对所有就诊患者进行粪便隐血、肿瘤标志物检验及联合检验,对检验结果进行分析。结果 确诊者95例,确诊结直肠癌患者的CA24-2、CA19-9、CEA水平相比未确诊人群均明显更高(P<0.05);联合检测检出率、灵敏度、特异性分别为98.00%、98.41%、97.30%,联合检验的诊断效能明显高于单一检验方式(P<0.05)。结论 粪便隐血及肿瘤标志物联合检验方式相比单一检验,对结直肠癌的诊断效果更高,值得在临床中推广应用。