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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...

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Autores principales: 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
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
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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).
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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
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