Feasibility of fecal occult‐blood testing for detection of colorectal neoplasia. Debits and credits
Feasibility of fecal occult‐blood testing for detection of colorectal neoplasia. Debits and credits
复制标题
粪便潜血检测检测结直肠肿瘤的可行性。
作者：
S. Winawer;Daniel G. Miller;D. Schottenfeld;S. D. Leidner;P. Sherlock;B. Befler;M. Stearns
对6，579名年龄在40岁及以上的无症状男性和女性进行了结肠直肠癌和腺瘤的筛查计划，使用粪便潜血试验，然后通过空气对比钡灌肠和结肠镜检查对载玻片阳性的患者进行调查。7,325例对照人群仅接受乙状结肠镜检查，未进行潜血试验。大约1%的患者有阳性切片;大多数患者只有一个或两个切片阳性。大约50%的载玻片阳性患者有明显的肿瘤性病变，包括23例大腺瘤患者和7例癌症患者。与对照组相比，筛查的无症状组的癌症病理分期更有利。在粪便潜血试验阴性的筛查患者中，乙状结肠镜检查发现的肿瘤性病变包括2例癌症和15例大腺瘤。假阴性的原因包括可能将最初的阳性玻片转化为阴性。粪便潜血试验筛查结直肠癌和腺瘤似乎是一种可行的方法，患者依从性良好，阳性载玻片的可管理率可产生高比例的肿瘤性病变。假阳性的数量似乎很低。已观察到假阴性，需要进一步研究。
A screening program for colorectal cancer and adenomas has been applied to 6,579 mostly asymptomatic men and women age 40 years and older utilizing fecal occult‐blood testing followed by investigation of patients with positive slides by air‐contrast barium enema and colonoscopy. A control population of 7,325 patients had sigmoidoscopy only and no occult‐blood testing. Approximately 1% of the patients had positive slides; most patients had only one or two slides positive. Approximately 50% of patients with positive slides had significant neoplastic lesions, including 23 patients with large adenomas and 7 patients with cancers. Pathological staging of cancers was more favorable in the screened asymptomatic group as compared with the control group. Neoplastic lesions seen on sigmoidoscopy in screened patients who had negative fecal occult‐blood tests included 2 cancers and 15 large adenomas. Reasons for false negativity include possible conversion of initially positive slides to negative. Screening for colorectal cancer and adenomas with fecal occult‐blood testing appears to be feasible approach with good patient compliance, and manageable rate of positive slides productive of a high percentage of neoplastic lesions. The number of false‐positives seems to be low. False negativity has been observed and will require further study.