半定量粪隐血试验在社区结肠癌筛查中的应用  

Application of half-quantitative fecal occult blood test in a community for colon cancer screening

作　　者：吕会增[1] 张实[1] 苏雁甜 陈新岐[1] 周如健[1] 

机构地区：[1]广州医学院第五附属医院普通外科,广州510700

出　　处：《消化肿瘤杂志（电子版）》2012年第1期44-46,共3页Journal of Digestive Oncology(Electronic Version)

基　　金：广州市黄浦区科技局科技计划资助项目(编号:1043)

摘　　要：目的通过半定量粪隐血试验了解广州市黄埔区结肠癌患病率,并对该方案进行分析。方法采用随机整群分层抽样法,选取广州市黄埔区重点社区年龄≥40岁当地常住居民作为筛查目标人群,采用半定量粪隐血试验进行初筛,对阳性者进行免疫粪隐血检测,仍阳性者进行肠镜检查,收集数据进行统计分析。收集广州医学院第五附属医院年龄≥40岁当地常住居民、经内镜及病理确诊为结肠肿瘤及正常者的半定量粪隐血试验结果列入非筛查组进行统计分析。结果筛查组人群粪隐血试验应答率为26.76%(2408/9000)。半定量粪隐血试验阳性(≥+)率为15.66%(377/2408);序贯免疫粪隐血试验阳性率为11.25%(271/2408)。接受肠镜检查应答率为73.43%(199/271),阳性率65.83%(131/199)。本次筛查检出结肠癌2例,由此计算出结肠癌粗发病率为83.1/10万。半定量隐血试验阳性阈值为1+时,结肠出血性疾病检出比例最高(P<0.05)。非筛查组半定量隐血试验以1+为阳性阈值时,结肠癌检出敏感性最佳(P<0.05);结肠癌检出特异性与其他阈值比较,无统计学差异(P>0.05)。结论本次采用半定量粪隐血试验进行的结肠癌筛查效果基本满意,通过确定其最佳阳性阈值可提高筛检结果的敏感性和特异性,适合大规模社区人群筛检。Objective To investigate the prevalence of colon cancer in Huangpu District , Guangzhou City through half-quantitative fecal occult blood test (HFOBT), and analyze the application of HFOBT for bleeding diseases and colon caner. Methods HFOBT screening was applied for the residents over age 40 in Huangpu District by randomized stratified cluster sampling ways , and a further immune fecal occult blood test (IFOBT) was used for the positive cases to exclude the false-positive cases. Endoscopy was chosen for the IFOBT positive cases. In addition , consecutive 21 colorectal cancer patients and 30 normal volunteers over age 40 from the same district , confirmed by endoscopy in our hospital, were collected into a non-screening group to investigate the sensitivity and specificity of HFOBT for colon cancer. Results The target population of this screening program was 9 ,000, the HFOBT response rate was 26.76% (2,408 / 9,000). The positive rate (≥1+) of HFOBT was 15.66% (377 / 2, 408), and positive sequential IFOBT rate was 11.25% (271 / 2,408). The received endoscopy response rate was 73.43% (199 / 271) and positive rate of endoscopy results was 65.83% (131 / 199). Two cases with colon cancer were found by screening with a crude colon cancer incidence of the residents 831 per million. The best positive threshold was 1+ for the residents in colon cancer screening to detect bleeding diseases (P<0.05). The sensitivity of HFOBT for colon cancer in the non-screening group was highest with 1 + as positive threshold. Conclusions The results of HFOBT for colon cancer screening in Huangpu District are satisfactory and the optimal positive threshold of HFOBT is important to increase the sensitivity and specificity. More larger samples are necessary to be collected for such colon cancer screening.

关 键 词：结肠肿瘤 隐血试验 人群监测 社区 

分 类 号：R735.35[医药卫生—肿瘤]