大便隐血定量检测仪和胶体金试纸用于人群结直肠癌筛查的比较  

Comparison between application of fecal occult blood quantitive testing instrument and colloidal gold strip method in colorectal cancer screening

作　　者：黄彦钦[1] 张梦文[1] 沈永洲[2] 马浩清 蔡善荣[1] 张苏展[1] 郑树[1] 

机构地区：[1]浙江大学医学院附属第二医院浙江大学肿瘤研究所恶性肿瘤预警与干预教育部重点实验室浙江省医学分子生物学重点实验室,杭州310009 [2]海宁市中医院肿瘤防治研究所海宁市肿瘤防治研究所

出　　处：《中华预防医学杂志》2013年第8期747-751,共5页Chinese Journal of Preventive Medicine

基　　金：国家863课题（2012AA02A506）

摘　　要：目的比较大便隐血定量检测仪和胶体金试纸用于人群结直肠癌筛查的效果。方法于2011年以随机整群抽样方法在浙江省海宁市许巷镇取9000名40—74岁调查对象，分别用大便隐血定量检测仪和胶体金试纸两种方法，按产品说明，对调查对象同一次大便用不同的采便管采两个样本进行检测。以定量检测仪测得血红蛋白浓度≥100ng／ml，以及胶体金试纸条检测带显色为隐血阳性标准。对筛选出的阳性者行结肠镜检查，对病变患者行病理诊断。比较两种方法检测隐血阳性率及一致性，以及结直肠癌和腺瘤的阳性预测值和人群检出率。结果9000名对象中最终有6475（71．9％）名调查对象按要求同时送检了两份大便样品。定量检测仪和胶体金试纸阳性例数分别为319（4．9％）例和146（2．3％）例，其中双阳性患者45例（Kappa值=0．168，95％CI：0．119—0．217）；阳性者中分别有184（57．7％）例和89（61．0％）例完成结肠镜检查。自动定量检测仪对结直肠癌、进展期腺瘤、非进展期腺瘤的阳性预测值与胶体金试纸的差异无统计学意义（P〉0．05），但自动定量检测仪检出的结直肠癌和进展期腺瘤例数（26例，人群检出率为0．402％）大于胶体金试纸法检出例数（10例，人群检出率为0．154％），差异有统计学意义（x2=7．131，P〈0．01）。结论大便隐血定量检测仪用于筛检结直肠癌和进展期腺瘤的效果可能优于胶体金试纸，但尚需进一步证实。Objective To compare the performances of fecal occuh blood quantitive testing instrument and colloidal gold strip method in colorectal cancer screening. Methods A representative random population of 9000 subjects aging between 40 and 74 years old were selected from Xuxiang, Haining city, Zhejiang province, by random cluster sampling method in year 2011. The fecal samples from each subject were separately detected by the two methods, namely fecal occult blood quantitive testing instrument and colloidal gold strip method. The positive result was standardized by hemoglobin concentration （HGB） t〉 100 ng,/ml under the application of quantitive testing instrument, or color-developing by colloidal gold strip method. The positive subjects from either method would be provided a further eolonoscopy examination for pathological diagnosis. The positive rate and consistency of the two methods were compared, as well as the positive predictive value and population detecting rate of the colorectal cancer and adenoma. Results A total of 6475 （71.9%） subjects submitted their two fecal samples according to our requirement in 9000 subjects. There were separately 319 positive cases （4. 9% ） and 146 positive cases （2. 3% ） by the performances of fecal occult blood quantitive testing instnament and colloidal gold strip method, including 45 positive in both tests （Kappa = 0. 168, 95% CI：O. 119 - 0.217） . 184 out of the 319 positive cases （57. 7% ） in the test by quantitive testing instrument and 89 out of 146 positive cases （61.0%） in the test by colloidal gold strip method received the colonoscopy examination. There were no significant statistical differences between the two methods in the positive predictive value of colorectal cancer （ P 〉 0. 05 ） , developing adenoma and non-developing adenoma. However, the population detecting rate of the colorectal cancer and developing adenoma were higher in the test by quantitive testing instrument （26 cases, 0. 402% ） than it in the test by colloidal go

关 键 词：肿瘤 多相筛查 结直肠肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]