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Evaluation of Quantitative Immunochemical Fecal Occult Blood Test for the Diagnosis of Colorectal Cancer and Other Gastrointestinal Diseases

Author: WuDeHai
Tutor: YangYunSheng
School: PLA Postgraduate Medical School
Course: Internal Medicine
Keywords: Numerical fecal occult blood test Immuno-gold method fecal occult blood test Colorectal Cancer Colorectal polyps
CLC: R735.3
Type: Master's thesis
Year: 2010
Downloads: 33
Quote: 1
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Abstract


[Objective] To explore the value of fecal occult blood test (quantitative immunochemical fecal occult blood test, QIFOBT) colorectal cancer (colorectal cancer, CRC) and other gastrointestinal diseases diagnostic value. Numerical fecal occult blood test (QIFOBT) and method (1) November 2008 to February 2010 in our hospital outpatient endoscopy center accepts gastroscopy examination of patients and the School of General Surgery, hospitalization CRC patients colloidal gold immunoassay method fecal occult blood test (colloidal gold immunochromatographic, CGIFOBT) detection; were detected in specimens of 502 cases, including 420 cases of outpatients and inpatients 82 cases; 101 patients with a final diagnosis of CRC (the hospitalization 82 cases 19 cases, outpatient) ; comparative analysis of the two methods of the diagnostic value of the CRC and other gastrointestinal diseases; (2) compared QIFOBT abdominal CT, double contrast barium (double-contrast barium enema, DCBE) and serum tumor marker CEA the diagnosis of colorectal cancer (carcinoembryonic antigen) coincidence rate; (3) analysis of the correlation QIFOBT CRC Dukes stage and tumor size; (4) preliminary observation QIFOBT different positive threshold on the positive rate of diagnosis of CRC. [Results] (1) 502 cases of this group of patients examined, QIFOBT and CGIFOBT the total positive rate was 35% and 21% (P lt; 0.05), false positive rates were 1.9% and 3.7% (P gt; 0.05 ); two methods of all 101 cases of CRC positive rate were 93.4% and 63.2% (P lt; 0.05); two methods the outpatient total positive rate of 420 patients, respectively, 16.1% and 7.2% (P lt; 0.05 ), the the respective positive rate of the two methods detected disease (polyps, inflammatory bowel disease, etc.) There was no significant difference (P gt; 0.05). QIFOBT total positive rate of CRC and non-CRC disease were 92.1% and 15.4% (P <0.05); QIFOBT outpatient upper and lower gastrointestinal disease positive rate were 13.1% and 26.8% (P lt; 0.05 ); QIFOBT of ≥ 1cm lt; 1cm positive rate of colorectal polyps were 29.4% and 5.3% (P lt; 0.05). (2) QIFOBT and abdominal CT of the CRC positive rate were 97.3% and 97.3% (P gt; 0.05); QIFOBT and DCBE CRC positive rates were 84.6% and 100% (P gt; 0.05 ); QIFOBT and serum tumor marker CEA positive rates were 93.8% and 73.4% (P lt; 0.05) of the CRC. (3) QIFOBT CRC Dukes stages related to sex (P gt; 0.05);, while QIFOBT with CRC tumor size was positively correlated (P lt; 0.05). (4) with the experimental set QIFOBT positive threshold 100ng/mL comparison, when the positive threshold down to 50 ng / mL of CRC QIFOBT positive rate increased by 2%, at this time, normal colonoscopy the group QIFOBT positive detection rate also doubled (4.6%); the CRC's QIFOBT positive rate decreased by 3% when the threshold is raised to 150ng/mL colonoscopy normal group, the positive rate decreased by 0.9%; When the threshold is raised to 200 ng / mL the CRC's QIFOBT positive rate decreased by 5%, colonoscopy normal set of positive detection rate also decreased by 0.9%. [Conclusion] (1) the value of fecal occult blood test for colorectal cancer have a high positive rate of diagnosis, up to 90% or more; and abdominal CT and barium double contrast have similar diagnosis rate; diagnostic sensitivity was significantly higher fecal occult blood test and serum tumor marker CEA detection; immune colloidal gold (2) the value of the fecal occult blood test positive rate of diagnosis of lower gastrointestinal disease was significantly higher than the upper gastrointestinal disease; detection of colorectal polyps diagnosis of colorectal cancer have an optimum rate of polyp size; (3) the value will occult blood test was positive threshold positive rate of diagnosis of colorectal cancer, the positive threshold is set to 100 ng / mL positive samples out rate and false positive rate; (4) the value of fecal occult blood test with colorectal cancer size (the maximum diameter of the tumor mucosal surface) is positively correlated, but with Dukes pathological staging needs to be validated.

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