Reproducibility and diagnostic value of Hemoccult-II test. A colonoscopic evaluation in asymptomatic patients.
Reproducibility and diagnostic value of Hemoccult-II test. A colonoscopic evaluation in asymptomatic patients.
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Hemocult-II 测试的重现性和诊断价值。
DOI：
10.3109/00365528509088874
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发表时间：
1985
影响因子：
1.9
通讯作者：
C. Fenger
中科院分区：
文献类型：
--
作者：
S. Adamsen;O. Kronborg;E. Hage;C. Fenger
观察者间的符合率为0.88(Kappa分析)，在246个血隐II试验的双倍读数中。幻灯片没有再加水。在之前的息肉切除术或根治性癌症手术后，在748名无症状的患者接受全结肠镜检查之前，立即进行了血隐-II测试，以评估该测试在大规模筛查中的诊断价值，接受研究组中肿瘤的较高患病率，但意识到结肠镜检查只能在高危组中进行。另一个目的是研究在既往的腺瘤或癌症后监测中用血隐血II代替结肠镜检查的可能性。阳性后的79例结肠镜检查发现癌3例，腺瘤13例，其他肠道病变34例。669例阴性的结肠镜检查中，癌1例，腺瘤67例，其他病变141例。总而言之，这项检测不能作为结肠镜检查的指南，因为它漏掉了本系列中84%的新病例。这项检测并不排除结直肠癌的存在，但检测阴性的患者(669人中有1人)患癌症的风险可能比检测阳性的患者(79人中有3人)低好几倍，这可能证明在无症状人群中使用hemoccult-II测试进行大规模筛查是合理的。
Inter-observer agreement rate in double readings of 246 Hemoccult-II tests was 0.88 (Kappa analysis). The slides were not rehydrated. The Hemoccult-II test was performed immediately before 748 total colonoscopies in asymptomatic patients after previous polypectomy or radical surgery for cancer to estimate the diagnostic value of the test in mass screening, accepting a higher prevalence of neoplasia in the study group but realizing that colonoscopy can only be performed in high-risk groups. Another purpose was to investigate the possibility of replacing colonoscopy with Hemoccult-II in surveillance after previous adenoma or cancer. The 79 colonoscopies after a positive test showed cancer in 3, adenomas in 13, and other intestinal pathology in 34 cases. The 669 colonoscopies after negative tests showed cancer in 1, adenomas in 67, and other pathology in 141 cases. In conclusion, the test cannot be used as a guideline for colonoscopy in follow-up programs for patients who have had adenomas, since it missed 84% of the new cases in the present series. The test does not exclude the presence of colorectal carcinoma, but the risk of cancer is probably several times less in patients with negative tests (1 of 669) than in patients with positive tests (3 of 79), which may justify the use of the Hemoccult-II test for mass screening in asymptomatic populations.