Cargando…
Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions
OBJECTIVE: Highly sensitive guaiac-based faecal occult blood (Hemoccult SENSA) and Helicobacter pylori stool antigen testing might help detect upper gastrointestinal lesions when appended to a colorectal cancer screening programme with faecal immunochemical testing. We evaluated the diagnostic accur...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2013
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816242/ https://www.ncbi.nlm.nih.gov/pubmed/24176798 http://dx.doi.org/10.1136/bmjopen-2013-003989 |
_version_ | 1782477937802477568 |
---|---|
author | Lee, Yi-Chia Chiu, Han-Mo Chiang, Tsung-Hsien Yen, Amy Ming-Fang Chiu, Sherry Yueh-Hsia Chen, Sam Li-Sheng Fann, Jean Ching-Yuan Yeh, Yen-Po Liao, Chao-Sheng Hu, Tsung-Hui Tu, Chia-Hung Tseng, Ping-Huei Chen, Chien-Chuan Chen, Mei-Jyh Liou, Jyh-Ming Liao, Wei-Chih Lai, Yo-Ping Wang, Chen-Ping Ko, Jenq-Yuh Wang, Hsiu-Po Chiang, Hung Lin, Jaw-Town Chen, Hsiu-Hsi Wu, Ming-Shiang |
author_facet | Lee, Yi-Chia Chiu, Han-Mo Chiang, Tsung-Hsien Yen, Amy Ming-Fang Chiu, Sherry Yueh-Hsia Chen, Sam Li-Sheng Fann, Jean Ching-Yuan Yeh, Yen-Po Liao, Chao-Sheng Hu, Tsung-Hui Tu, Chia-Hung Tseng, Ping-Huei Chen, Chien-Chuan Chen, Mei-Jyh Liou, Jyh-Ming Liao, Wei-Chih Lai, Yo-Ping Wang, Chen-Ping Ko, Jenq-Yuh Wang, Hsiu-Po Chiang, Hung Lin, Jaw-Town Chen, Hsiu-Hsi Wu, Ming-Shiang |
author_sort | Lee, Yi-Chia |
collection | PubMed |
description | OBJECTIVE: Highly sensitive guaiac-based faecal occult blood (Hemoccult SENSA) and Helicobacter pylori stool antigen testing might help detect upper gastrointestinal lesions when appended to a colorectal cancer screening programme with faecal immunochemical testing. We evaluated the diagnostic accuracies of two stool tests in detecting upper gastrointestinal lesions. DESIGN: Cross-sectional design. SETTING: Hospital-based and community-based screening settings. PARTICIPANTS: A hospital-based deviation cohort of 3172 participants to evaluate test performance and a community-based validation cohort of 3621 to verify the findings. INTERVENTIONS: Three types of stool tests with bidirectional endoscopy as the reference standard. OUTCOMES: Sensitivity, specificity and positive and negative likelihood ratios. RESULTS: For detecting upper gastrointestinal lesions in cases with negative immunochemical tests, the sensitivity, specificity, and positive and negative likelihood ratios of the guaiac-based and H pylori antigen tests were 16.3% (95% CI 13.3% to 19.8%), 90.1% (88.9% to 91.2%), 1.64 (1.31 to 2.07), and 0.93 (0.89 to 0.97), respectively, and 52.5% (48.1% to 56.9%), 80.6% (79.0% to 82.1%), 2.71 (2.41 to 3.04) and 0.59 (0.54 to 0.65), respectively. For detecting upper gastrointestinal lesions in cases with normal colonoscopy, the results of the guaiac-based and H pylori antigen tests were 17.9% (14.8% to 21.5%), 90.1% (88.9% to 91.2%), 1.81 (1.45 to 2.26) and 0.91 (0.87 to 0.95), respectively, and 53.1% (48.6% to 57.4%), 80.7% (79.1% to 82.2%), 2.75 (2.45 to 3.08) and 0.58 (0.53 to 0.64), respectively. Within the community, positive predictive values of the immunochemical and H pylori antigen tests were 36.0% (26.0% to 46.0%) and 31.9% (28.3% to 35.5%), respectively, for detecting lower and upper gastrointestinal lesions, which were similar to expected values. CONCLUSIONS: The H pylori stool antigen test is more accurate than the guaiac-based test in the screening of upper gastrointestinal lesions in a population with high prevalence of H pylori infection and upper gastrointestinal lesions. It is applicable to add the H pylori antigen test to the immunochemical test for pan detection. TRIAL REGISTRATION: NCT01341197 (ClinicalTrial.gov). |
format | Online Article Text |
id | pubmed-3816242 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-38162422013-11-04 Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions Lee, Yi-Chia Chiu, Han-Mo Chiang, Tsung-Hsien Yen, Amy Ming-Fang Chiu, Sherry Yueh-Hsia Chen, Sam Li-Sheng Fann, Jean Ching-Yuan Yeh, Yen-Po Liao, Chao-Sheng Hu, Tsung-Hui Tu, Chia-Hung Tseng, Ping-Huei Chen, Chien-Chuan Chen, Mei-Jyh Liou, Jyh-Ming Liao, Wei-Chih Lai, Yo-Ping Wang, Chen-Ping Ko, Jenq-Yuh Wang, Hsiu-Po Chiang, Hung Lin, Jaw-Town Chen, Hsiu-Hsi Wu, Ming-Shiang BMJ Open Gastroenterology and Hepatology OBJECTIVE: Highly sensitive guaiac-based faecal occult blood (Hemoccult SENSA) and Helicobacter pylori stool antigen testing might help detect upper gastrointestinal lesions when appended to a colorectal cancer screening programme with faecal immunochemical testing. We evaluated the diagnostic accuracies of two stool tests in detecting upper gastrointestinal lesions. DESIGN: Cross-sectional design. SETTING: Hospital-based and community-based screening settings. PARTICIPANTS: A hospital-based deviation cohort of 3172 participants to evaluate test performance and a community-based validation cohort of 3621 to verify the findings. INTERVENTIONS: Three types of stool tests with bidirectional endoscopy as the reference standard. OUTCOMES: Sensitivity, specificity and positive and negative likelihood ratios. RESULTS: For detecting upper gastrointestinal lesions in cases with negative immunochemical tests, the sensitivity, specificity, and positive and negative likelihood ratios of the guaiac-based and H pylori antigen tests were 16.3% (95% CI 13.3% to 19.8%), 90.1% (88.9% to 91.2%), 1.64 (1.31 to 2.07), and 0.93 (0.89 to 0.97), respectively, and 52.5% (48.1% to 56.9%), 80.6% (79.0% to 82.1%), 2.71 (2.41 to 3.04) and 0.59 (0.54 to 0.65), respectively. For detecting upper gastrointestinal lesions in cases with normal colonoscopy, the results of the guaiac-based and H pylori antigen tests were 17.9% (14.8% to 21.5%), 90.1% (88.9% to 91.2%), 1.81 (1.45 to 2.26) and 0.91 (0.87 to 0.95), respectively, and 53.1% (48.6% to 57.4%), 80.7% (79.1% to 82.2%), 2.75 (2.45 to 3.08) and 0.58 (0.53 to 0.64), respectively. Within the community, positive predictive values of the immunochemical and H pylori antigen tests were 36.0% (26.0% to 46.0%) and 31.9% (28.3% to 35.5%), respectively, for detecting lower and upper gastrointestinal lesions, which were similar to expected values. CONCLUSIONS: The H pylori stool antigen test is more accurate than the guaiac-based test in the screening of upper gastrointestinal lesions in a population with high prevalence of H pylori infection and upper gastrointestinal lesions. It is applicable to add the H pylori antigen test to the immunochemical test for pan detection. TRIAL REGISTRATION: NCT01341197 (ClinicalTrial.gov). BMJ Publishing Group 2013-10-30 /pmc/articles/PMC3816242/ /pubmed/24176798 http://dx.doi.org/10.1136/bmjopen-2013-003989 Text en Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/ |
spellingShingle | Gastroenterology and Hepatology Lee, Yi-Chia Chiu, Han-Mo Chiang, Tsung-Hsien Yen, Amy Ming-Fang Chiu, Sherry Yueh-Hsia Chen, Sam Li-Sheng Fann, Jean Ching-Yuan Yeh, Yen-Po Liao, Chao-Sheng Hu, Tsung-Hui Tu, Chia-Hung Tseng, Ping-Huei Chen, Chien-Chuan Chen, Mei-Jyh Liou, Jyh-Ming Liao, Wei-Chih Lai, Yo-Ping Wang, Chen-Ping Ko, Jenq-Yuh Wang, Hsiu-Po Chiang, Hung Lin, Jaw-Town Chen, Hsiu-Hsi Wu, Ming-Shiang Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title | Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title_full | Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title_fullStr | Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title_full_unstemmed | Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title_short | Accuracy of faecal occult blood test and Helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
title_sort | accuracy of faecal occult blood test and helicobacter pylori stool antigen test for detection of upper gastrointestinal lesions |
topic | Gastroenterology and Hepatology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3816242/ https://www.ncbi.nlm.nih.gov/pubmed/24176798 http://dx.doi.org/10.1136/bmjopen-2013-003989 |
work_keys_str_mv | AT leeyichia accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chiuhanmo accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chiangtsunghsien accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT yenamymingfang accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chiusherryyuehhsia accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chensamlisheng accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT fannjeanchingyuan accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT yehyenpo accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT liaochaosheng accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT hutsunghui accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT tuchiahung accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT tsengpinghuei accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chenchienchuan accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chenmeijyh accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT lioujyhming accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT liaoweichih accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT laiyoping accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT wangchenping accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT kojenqyuh accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT wanghsiupo accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chianghung accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT linjawtown accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT chenhsiuhsi accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions AT wumingshiang accuracyoffaecaloccultbloodtestandhelicobacterpyloristoolantigentestfordetectionofuppergastrointestinallesions |