Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based ...Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detect...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.展开更多
AIM To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related complications.METHODS Charts of all patients undergoing elective laparoscopic cholecyst...AIM To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related complications.METHODS Charts of all patients undergoing elective laparoscopic cholecystectomy from January 2013 through December2014 were reviewed retrospectively for demographics,indication for surgery,operative course and outcome.In our institution the decision to perform postoperative blood analysis is left for the discretion of the surgeon,therefore we had the possibility to compare the results of those who had blood analyses results to those who did not.Analysis was performed to identify variables associated with the decision to perform postoperative blood tests.Subsequently a univariate and multivariate analyses was performed comparing the two cohorts.Secondary subgroup analysis was performed to identify factors associated with procedure related complications.RESULTS Five hundred and thirty-two elective laparoscopic cholecystectomies for symptomatic gallstones were performed during the study period.Sixty-four percent of the patients(n=340)had blood tests taken post operatively.Patients that had laboratory tests taken were older(P=0.006,OR=1.01),had longer surgery(P<0.001,OR=3.22)had more drains placed(P<0.001,OR=3.2)and stayed longer in the hospital(P<0.001,OR=1.2).A subgroup analysis of the patients who experienced complications revealed longer stay in the hospital(P<0.001),higher body mass index(BMI)(P=0.04,OR=1.08),increased rates of drain placement(P=0.006,OR=3.1)and higher conversion rates(P=0.01,OR=14.6).Postoperative blood tests withdrawals were not associated with complications(P=0.44).On Multivariate analysis BMI and drain placement were independently associated with complications.CONCLUSION The current study indicate that routine postoperative blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones does not predict complications and may have an added benefit in diagnosis and management of cases were the surgeon encountered true technical difficulty during surgery.展开更多
BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hosp...BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.展开更多
AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a popul...AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.展开更多
AIM: To evaluate the sensitivity and specificity of transfesrrin dipstick test (Tf) in colorectal cancer (CRC) screening and precancerous lesions screening. METHODS: Eight hundreds and sixty-one individuals at high-ri...AIM: To evaluate the sensitivity and specificity of transfesrrin dipstick test (Tf) in colorectal cancer (CRC) screening and precancerous lesions screening. METHODS: Eight hundreds and sixty-one individuals at high-risk for CRC were recruited. Six hundreds and eleven subsequently received the three fecal occult blood tests and colonoscopy with biopsy performed as needed. Fecal samples were obtained on the day before colonoscopy. Tf, immuno fecal occult blood test (IFOBT) and guaiac fecal occult blood test (g-FOBT) were performed simultaneously on the same stool. To minimize false-negative cases, all subjects with negative samples were asked to provide an additional stool specimen for a second test even a third test. If the results were all negative after testing three repeated samples, the subject was considered a true negative. The performance characteristics of Tf for detecting CRC and precancerous lesions were examined and compared to those of IFOBT and the combination of Tf, IFOBT and g-FOBT. RESULTS: A total of six hundreds and eleven subjects met the study criteria including 25 with CRC and 60 with precancerous lesions. Sensitivity for detecting CRC was 92% for Tf and 96% for IFOBT, specificities of Tf and IFOBT were both 72.0% (95% CI: 68.2%-75.5%; χ2 = 0.4, P > 0.05); positive likelihood ratios of those were 3.3 (95% CI: 2.8-3.9) and 3.4 (95% CI: 2.9-4.0), respectively. In precancerous lesions, sensitivities for Tf and IFOBT were 50% and 58%, respectively (χ 2 = 0.8, P > 0.05); specificities of Tf and IFOBT were 71.5% (95% CI: 67.6%-75.1%) and 72.2% (95% CI: 68.4%-75.8%); positive likelihood ratios of those were 1.8 (95% CI: 1.3-2.3) and 2.1 (95% CI: 1.6-2.7), respectively; compared to IFOBT, g-FOBT+ Tf+ IFOBT had a significantly higher positive rate for precancerous lesions (83% vs 58%, respectively; χ 2 = 9.1, P < 0.05). In patients with CRC and precancerous lesions, the sensitivities of Tf and IFOBT were 62% and 69% (χ 2 = 0.9, P > 0.05); specificities of those were 74.5% (95% CI: 70.6%-78.1%) and 75.5% (95% CI: 71.6%-79.0%); positive likelihood ratios of those were 2.5 (95% CI: 2.0-3.1) and 2.8 (95% CI: 2.3-3.5). Compared to IF-OBT alone, combining g-FOBT, IFOBT and Tf led to significantly increased sensitivity for detecting CRC and cancerous lesions (69% vs 88%, respectively; χ 2 = 9.0, P < 0.05). CONCLUSION: Tf dipstick test might be used as an ad- ditional tool for CRC and precancerous lesions screening in a high-risk cohort.展开更多
BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent co...BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent colonoscopy.AIM To determine the prevalence of advanced neoplasia in patients with a positive iFOBT after a recent colonoscopy, and clinical and endoscopic predictors for advanced neoplasia.METHODS The study recruited i FOBT positive patients who underwent colonoscopy between July 2015 to March 2020. Data collected included demographics, clinical characteristics, previous and current colonoscopy findings. Primary outcome was the prevalence of CRC and advanced neoplasia in a patient with positive iFOBT and previous colonoscopy. Secondary outcomes included identifying any clinical and endoscopic predictors for advanced neoplasia.RESULTS The study included 1051 patients(male 53.6%;median age 63). Forty-two(4.0%) patients were diagnosed with CRC, 513(48.8%) with adenoma/sessile serrated lesion(A-SSL) and 257(24.5%) with advanced A-SSL(AA-SSL). A previous colonoscopy had been performed in 319(30.3%). In this cohort, four(1.3%) were diagnosed with CRC, 146(45.8%) with A-SSL and 56(17.6%) with AA-SSL. Among those who had a colonoscopy within 4 years, none had CRC and 7 had AA-SSL. Of the 732 patients with no prior colonoscopy, there were 38 CRCs(5.2%). Independent predictors for advanced neoplasia were male [odds ratio(OR) = 1.80;95% confidence interval(CI): 1.35-2.40;P < 0.001), age(OR = 1.04;95%CI: 1.02-1.06;P < 0.001) and no previous colonoscopy(OR = 2.07;95%CI: 1.49-2.87;P < 0.001).CONCLUSION A previous colonoscopy, irrespective of its result, was associated with low prevalence of advanced neoplasia, and if performed within four years of a positive iFOBT result, was protective against CRC.展开更多
AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were inter...AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were interviewed and had blood drawn for serology. The first 109 patients were tested with BM-test (BM), Pyloriset Screen (PS) and QuickVue (QV), and the next 99 subjects were tested with PS and Unigold (UG).Endoscopies were performed blinded to rapid blood test results and biopsies were taken for culture and rapid urease test. Urea breath tests were performed after endoscopies. The rapid blood test results were compared with four reference tests (rapid urease test, culture,serology, and breath test).RESULTS: The study population composed of 208patients (mean age 43.1 years; range 18-73 years; 119males; 174 Chinese). The number of evaluable patientsfor BM, QV, UG and PS were 102, 102, 95, and 197,respectively. The sensitivity and specificity, respectively were: PS 80.2%, 95.8%; UG 55.9%, 100%; QV 43.3%,100%; BM 67.2%, 97.1%.CONCLUSION: The rapid blood test kits showed high specificity and positive predictive value (97-100%), while sensitivity and negative predictive value ranged widely (43%-80% and 47%-73%, respectively). Among test kits, PS showed the best sensitivity (80%), best negative predictive value (73%) and best negative likelihood ratio (0.207). PS had a specificity of 96%, positive predictive value of 97% and positive likelihood ratio of 19.1.展开更多
Objective:To analyze the screening effectiveness of combining the fecal occult blood test with tumor marker detection for colorectal cancer.Methods:A total of thirty patients with colorectal cancer and thirty patients...Objective:To analyze the screening effectiveness of combining the fecal occult blood test with tumor marker detection for colorectal cancer.Methods:A total of thirty patients with colorectal cancer and thirty patients with benign colon hyperplasia who received treatment from January 2020 to January 2023 were selected.These patients were assigned to the observation group and the control group,respectively.All patients in both groups underwent both fecal occult blood tests and tumor marker detection.The levels of tumor markers between the two groups were compared,the tumor marker levels in different stages were assessed within the observation group,and the positive detection rates for single detection and combined detection were compared.Results:The levels of various tumor markers in the observation group were significantly higher than those in the control group(P<0.05).Furthermore,as the Duke stage increased within the observation group,the levels of various tumor markers also increased(P<0.05).The positive detection rate of the combined test was notably higher than that of single detection(P<0.05).Conclusion:Combining the fecal occult blood test with tumor marker detection in colorectal cancer screening can significantly improve the overall detection rate.展开更多
AIM:To examine the feasibility of predicting the flareup of ulcerative colitis (UC) before symptoms emerge using the immunochemical fecal occult blood test (IFOBT).METHODS:We prospectively measured fecal hemoglobin co...AIM:To examine the feasibility of predicting the flareup of ulcerative colitis (UC) before symptoms emerge using the immunochemical fecal occult blood test (IFOBT).METHODS:We prospectively measured fecal hemoglobin concentrations in 78 UC patients using the I-FOBT every 1 or 2 mo.RESULTS:During a 20 mo-period,823 fecal samples from 78 patients were submitted.The median concentration of fecal hemoglobin was 41 ng/mL (range:0-392 500 ng/mL).There were three types of patients with regard to the correlation between I-FOBT and patient symptoms;the synchronous transition type with symptoms (44 patients),the unrelated type withsymptoms (19 patients),and the flare-up predictive type (15 patients).In patients with the flare-up predictive type,the values of I-FOBT were generally low during the study period with stable symptoms.Two to four weeks before the flare-up of symptoms,the I-FOBT values were high.Thus,in these patients,I-FOBT could predict the flare-up before symptoms emerged.CONCLUSION:Flare-up could be predicted by I-FOBT in approximately 20% of UC patients.These results warrant periodical I-FOBT in UC patients.展开更多
AIM To evaluate the one sampling and three sampling reverse passive hemagglutination fecal occult blood test (RPHA FOBT) for colorectal neoplasm screening.
To assess the prevalence of colorectal cancer (CRC) in Beijing and the reliabili ty of the sequential fecal occult blood test (SFOBT) for CRC screening Methods Of the natural population (48?100 persons) in seve...To assess the prevalence of colorectal cancer (CRC) in Beijing and the reliabili ty of the sequential fecal occult blood test (SFOBT) for CRC screening Methods Of the natural population (48?100 persons) in several Beijing communities, we screened 26?827 persons with age over 30 using the SFOBT screening p rogram, Guaiacum Fecal Occult Blood Test (GFOBT), Immuno Fecal Occult Blood Test (IFOBT), and colonoscopies Results The screening rate of the population was 74% The positive rate of SFOBT was 5 6% The prevalence of CRC in the entire population of Beijing was therefore c alculated to be 36 57/10 5 Of 12 CRC detected patients, 4 cases were in stage Dukes A (33 33%), 7 cases in stage Dukes B (58 33%), only 1 case (8 34% ) in stage Dukes C Conclusions The prevalence of CRC in Beijing is one of the highest in China Individuals at high risk for CRC or those over 50 years of age should be considered as primary candidates for screening SFOBT screening is a cost effective and reliable me thod for early detection of CRC展开更多
A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fibero...A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994展开更多
AIM: To elucidate the association between small bowel diseases(SBDs) and positive fecal occult blood test(FOBT) in patients with obscure gastrointestinal bleeding(OGIB).METHODS: Between February 2008 and August 2013, ...AIM: To elucidate the association between small bowel diseases(SBDs) and positive fecal occult blood test(FOBT) in patients with obscure gastrointestinal bleeding(OGIB).METHODS: Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy(CE) and FOBT were enrolled(mean age; 63.6 ± 14.0 years, 118 males, 96 previous overt bleeding, 106 with occult bleeding). All patients underwent immunochemical FOBTs twice prior to CE. Three experienced endoscopists independently reviewed CE videos. All reviews and consensus meeting were conducted without any information on FOBT results. The prevalence of SBDs was compared between patients with positive and negative FOBT.RESULTS: CE revealed SBDs in 72 patients(36%). FOBT was positive in 100 patients(50%) and negative in 102(50%). The prevalence of SBDs was significantly higher in patients with positive FOBT than those with negative FOBT(46% vs 25%, P = 0.002). In particular, among patients with occult OGIB, the prevalence of SBDs was higher in positive FOBT group than negative FOBT group(45% vs 18%, P = 0.002). On the other hand, among patients with previous overt OGIB, there was no significant difference in the prevalence of SBDs between positive and negative FOBT group(47% vs 33%, P = 0.18). In disease specific analysis among patients with occult OGIB, the prevalence of ulcer and tumor were higher in positive FOBT group than negative FOBT group. In multivariate analysis, only positive FOBT was a predictive factors of SBDs in patients with OGIB(OR = 2.5, 95%CI: 1.4-4.6, P = 0.003). Furthermore, the trend was evidentam on g patients with occult OGIB who underwent FOBT on the same day or a day before CE. The prevalence of SBDs in positive vs negative FOBT group were 54% vs 13% in patients with occult OGIB who underwent FOBT on the same day or the day before CE(P = 0.001), while there was no significant difference between positive and negative FOBT group in those who underwent FOBT two or more days before CE(43% vs 25%, P = 0.20).CONCLUSION: The present study suggests that positive FOBT may be useful for predicting SBDs in patients with occult OGIB. Positive FOBT indicates higher likelihood of ulcers or tumors in patients with occult OGIB. Undergoing CE within a day after FOBT achieved a higher diagnostic yield for patients with occult OGIB.展开更多
文摘Objective: To analyze the effectiveness of blood test indicators in the differential diagnosis of anemia. Methods: Sixty patients diagnosed with anemia (disease group) from June 2021 to June 2024 were selected. Based on the type of disease, the group was subdivided into iron deficiency anemia (IDA) with 31 cases, hemolytic anemia (HA) with 11 cases, and aplastic anemia (AA) with 18 cases. Based on the severity of the disease, the group was divided into mild anemia (30 cases), moderate anemia (19 cases), and severe anemia (11 cases). Sixty healthy individuals (control group) were also included, and all underwent blood tests. Comparisons were made between the red blood cell (RBC) indicators of the disease group and the control group, the blood test indicators of different types of anemia, and the serum iron levels of varying severity of anemia. Results: Except for red cell distribution width (RDW), the RBC indicators in the disease group were lower than those in the control group (P < 0.05). Comparisons of RBC indicators among different types of anemia showed significant differences (P < 0.05). Serum iron levels varied significantly among different degrees of anemia severity (P < 0.05). Conclusion: Blood tests can detect anemia, distinguish types of anemia, and assess anemia severity, offering high diagnostic value.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.
文摘AIM To evaluate the value of blood testing after elective laparoscopic cholecystectomy and its association with procedure related complications.METHODS Charts of all patients undergoing elective laparoscopic cholecystectomy from January 2013 through December2014 were reviewed retrospectively for demographics,indication for surgery,operative course and outcome.In our institution the decision to perform postoperative blood analysis is left for the discretion of the surgeon,therefore we had the possibility to compare the results of those who had blood analyses results to those who did not.Analysis was performed to identify variables associated with the decision to perform postoperative blood tests.Subsequently a univariate and multivariate analyses was performed comparing the two cohorts.Secondary subgroup analysis was performed to identify factors associated with procedure related complications.RESULTS Five hundred and thirty-two elective laparoscopic cholecystectomies for symptomatic gallstones were performed during the study period.Sixty-four percent of the patients(n=340)had blood tests taken post operatively.Patients that had laboratory tests taken were older(P=0.006,OR=1.01),had longer surgery(P<0.001,OR=3.22)had more drains placed(P<0.001,OR=3.2)and stayed longer in the hospital(P<0.001,OR=1.2).A subgroup analysis of the patients who experienced complications revealed longer stay in the hospital(P<0.001),higher body mass index(BMI)(P=0.04,OR=1.08),increased rates of drain placement(P=0.006,OR=3.1)and higher conversion rates(P=0.01,OR=14.6).Postoperative blood tests withdrawals were not associated with complications(P=0.44).On Multivariate analysis BMI and drain placement were independently associated with complications.CONCLUSION The current study indicate that routine postoperative blood tests after elective laparoscopic cholecystectomy for symptomatic gallstones does not predict complications and may have an added benefit in diagnosis and management of cases were the surgeon encountered true technical difficulty during surgery.
文摘BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.
文摘AIM： To report our experience with computed tomography colonography （CTC） systematically performed in subjects with positive faecal occult blood test （FOBT） and an incomplete colonoscopy in the setting of a population-based screening for colorectal cancer （CRC）. METHODS： From April 2006 to April 2007, 43 290 individuals （age range 50-70） who adhered to the regional screening program for the prevention of CRC underwent immunochemical FOBT. FOBT was positive in 1882 subjects （4.3%）. 1463 （77.7%） of these subjects underwent colonoscopy, 903 performed in a single center. Of 903 colonoscopies 65 （7.2%） were incomplete. Forty-two of these subjects underwent CTC. CTC was performed with a 16-MDCT scanner after standard bowel prep （polyethyleneglycole） in both supine and prone position. Subjects whose CTC showed polyps or masses were referred to the endoscopist for repeat colonoscopy under sedation or underwent surgery. Perlesion and per-segment positive predictive values （PPV） were calculated. RESULTS： Twenty-one （50%） of 42 CTCs showed polyps or masses. Fifty-five of these subjects underwent a repeat colonoscopy, whereas 2 subjects underwent surgery for colonic masses of indeterminate nature. Four subjects refused further examinations. CTC correctly identified 2 colonic masses and 20 polyps. PPV for masses or polyps greater than 9 mm was of 87.5%. Per-lesion and per-segment PPV were, respectively, 83.3% and 83.3% for polyps greater or equal to 10 mm, and 77.8% and 85.7% for polyps of 6-9 mm. CONCLUSION： In the context of a screening program for CRC based on FOBT, CTC shows high per-segment and per-lesion PPV for colonic masses and polyps greater than 9 mm. Therefore, CTC has the potential to become a useful technique for evaluation of the non visualized part of the colon after incomplete colonoscopy.
基金Supported by National Natural Science Foundation of China,No. 81071832the Key Scientific Research Project of the Health Bureau of Hubei Province, No. JX5A01
文摘AIM: To evaluate the sensitivity and specificity of transfesrrin dipstick test (Tf) in colorectal cancer (CRC) screening and precancerous lesions screening. METHODS: Eight hundreds and sixty-one individuals at high-risk for CRC were recruited. Six hundreds and eleven subsequently received the three fecal occult blood tests and colonoscopy with biopsy performed as needed. Fecal samples were obtained on the day before colonoscopy. Tf, immuno fecal occult blood test (IFOBT) and guaiac fecal occult blood test (g-FOBT) were performed simultaneously on the same stool. To minimize false-negative cases, all subjects with negative samples were asked to provide an additional stool specimen for a second test even a third test. If the results were all negative after testing three repeated samples, the subject was considered a true negative. The performance characteristics of Tf for detecting CRC and precancerous lesions were examined and compared to those of IFOBT and the combination of Tf, IFOBT and g-FOBT. RESULTS: A total of six hundreds and eleven subjects met the study criteria including 25 with CRC and 60 with precancerous lesions. Sensitivity for detecting CRC was 92% for Tf and 96% for IFOBT, specificities of Tf and IFOBT were both 72.0% (95% CI: 68.2%-75.5%; χ2 = 0.4, P > 0.05); positive likelihood ratios of those were 3.3 (95% CI: 2.8-3.9) and 3.4 (95% CI: 2.9-4.0), respectively. In precancerous lesions, sensitivities for Tf and IFOBT were 50% and 58%, respectively (χ 2 = 0.8, P > 0.05); specificities of Tf and IFOBT were 71.5% (95% CI: 67.6%-75.1%) and 72.2% (95% CI: 68.4%-75.8%); positive likelihood ratios of those were 1.8 (95% CI: 1.3-2.3) and 2.1 (95% CI: 1.6-2.7), respectively; compared to IFOBT, g-FOBT+ Tf+ IFOBT had a significantly higher positive rate for precancerous lesions (83% vs 58%, respectively; χ 2 = 9.1, P < 0.05). In patients with CRC and precancerous lesions, the sensitivities of Tf and IFOBT were 62% and 69% (χ 2 = 0.9, P > 0.05); specificities of those were 74.5% (95% CI: 70.6%-78.1%) and 75.5% (95% CI: 71.6%-79.0%); positive likelihood ratios of those were 2.5 (95% CI: 2.0-3.1) and 2.8 (95% CI: 2.3-3.5). Compared to IF-OBT alone, combining g-FOBT, IFOBT and Tf led to significantly increased sensitivity for detecting CRC and cancerous lesions (69% vs 88%, respectively; χ 2 = 9.0, P < 0.05). CONCLUSION: Tf dipstick test might be used as an ad- ditional tool for CRC and precancerous lesions screening in a high-risk cohort.
文摘BACKGROUND Colorectal cancer(CRC) is a major health problem. There is minimal consensus of the appropriate approach to manage patients with positive immunochemical fecal occult blood test(iFOBT), following a recent colonoscopy.AIM To determine the prevalence of advanced neoplasia in patients with a positive iFOBT after a recent colonoscopy, and clinical and endoscopic predictors for advanced neoplasia.METHODS The study recruited i FOBT positive patients who underwent colonoscopy between July 2015 to March 2020. Data collected included demographics, clinical characteristics, previous and current colonoscopy findings. Primary outcome was the prevalence of CRC and advanced neoplasia in a patient with positive iFOBT and previous colonoscopy. Secondary outcomes included identifying any clinical and endoscopic predictors for advanced neoplasia.RESULTS The study included 1051 patients(male 53.6%;median age 63). Forty-two(4.0%) patients were diagnosed with CRC, 513(48.8%) with adenoma/sessile serrated lesion(A-SSL) and 257(24.5%) with advanced A-SSL(AA-SSL). A previous colonoscopy had been performed in 319(30.3%). In this cohort, four(1.3%) were diagnosed with CRC, 146(45.8%) with A-SSL and 56(17.6%) with AA-SSL. Among those who had a colonoscopy within 4 years, none had CRC and 7 had AA-SSL. Of the 732 patients with no prior colonoscopy, there were 38 CRCs(5.2%). Independent predictors for advanced neoplasia were male [odds ratio(OR) = 1.80;95% confidence interval(CI): 1.35-2.40;P < 0.001), age(OR = 1.04;95%CI: 1.02-1.06;P < 0.001) and no previous colonoscopy(OR = 2.07;95%CI: 1.49-2.87;P < 0.001).CONCLUSION A previous colonoscopy, irrespective of its result, was associated with low prevalence of advanced neoplasia, and if performed within four years of a positive iFOBT result, was protective against CRC.
文摘AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were interviewed and had blood drawn for serology. The first 109 patients were tested with BM-test (BM), Pyloriset Screen (PS) and QuickVue (QV), and the next 99 subjects were tested with PS and Unigold (UG).Endoscopies were performed blinded to rapid blood test results and biopsies were taken for culture and rapid urease test. Urea breath tests were performed after endoscopies. The rapid blood test results were compared with four reference tests (rapid urease test, culture,serology, and breath test).RESULTS: The study population composed of 208patients (mean age 43.1 years; range 18-73 years; 119males; 174 Chinese). The number of evaluable patientsfor BM, QV, UG and PS were 102, 102, 95, and 197,respectively. The sensitivity and specificity, respectively were: PS 80.2%, 95.8%; UG 55.9%, 100%; QV 43.3%,100%; BM 67.2%, 97.1%.CONCLUSION: The rapid blood test kits showed high specificity and positive predictive value (97-100%), while sensitivity and negative predictive value ranged widely (43%-80% and 47%-73%, respectively). Among test kits, PS showed the best sensitivity (80%), best negative predictive value (73%) and best negative likelihood ratio (0.207). PS had a specificity of 96%, positive predictive value of 97% and positive likelihood ratio of 19.1.
文摘Objective:To analyze the screening effectiveness of combining the fecal occult blood test with tumor marker detection for colorectal cancer.Methods:A total of thirty patients with colorectal cancer and thirty patients with benign colon hyperplasia who received treatment from January 2020 to January 2023 were selected.These patients were assigned to the observation group and the control group,respectively.All patients in both groups underwent both fecal occult blood tests and tumor marker detection.The levels of tumor markers between the two groups were compared,the tumor marker levels in different stages were assessed within the observation group,and the positive detection rates for single detection and combined detection were compared.Results:The levels of various tumor markers in the observation group were significantly higher than those in the control group(P<0.05).Furthermore,as the Duke stage increased within the observation group,the levels of various tumor markers also increased(P<0.05).The positive detection rate of the combined test was notably higher than that of single detection(P<0.05).Conclusion:Combining the fecal occult blood test with tumor marker detection in colorectal cancer screening can significantly improve the overall detection rate.
文摘AIM:To examine the feasibility of predicting the flareup of ulcerative colitis (UC) before symptoms emerge using the immunochemical fecal occult blood test (IFOBT).METHODS:We prospectively measured fecal hemoglobin concentrations in 78 UC patients using the I-FOBT every 1 or 2 mo.RESULTS:During a 20 mo-period,823 fecal samples from 78 patients were submitted.The median concentration of fecal hemoglobin was 41 ng/mL (range:0-392 500 ng/mL).There were three types of patients with regard to the correlation between I-FOBT and patient symptoms;the synchronous transition type with symptoms (44 patients),the unrelated type withsymptoms (19 patients),and the flare-up predictive type (15 patients).In patients with the flare-up predictive type,the values of I-FOBT were generally low during the study period with stable symptoms.Two to four weeks before the flare-up of symptoms,the I-FOBT values were high.Thus,in these patients,I-FOBT could predict the flare-up before symptoms emerged.CONCLUSION:Flare-up could be predicted by I-FOBT in approximately 20% of UC patients.These results warrant periodical I-FOBT in UC patients.
文摘AIM To evaluate the one sampling and three sampling reverse passive hemagglutination fecal occult blood test (RPHA FOBT) for colorectal neoplasm screening.
文摘To assess the prevalence of colorectal cancer (CRC) in Beijing and the reliabili ty of the sequential fecal occult blood test (SFOBT) for CRC screening Methods Of the natural population (48?100 persons) in several Beijing communities, we screened 26?827 persons with age over 30 using the SFOBT screening p rogram, Guaiacum Fecal Occult Blood Test (GFOBT), Immuno Fecal Occult Blood Test (IFOBT), and colonoscopies Results The screening rate of the population was 74% The positive rate of SFOBT was 5 6% The prevalence of CRC in the entire population of Beijing was therefore c alculated to be 36 57/10 5 Of 12 CRC detected patients, 4 cases were in stage Dukes A (33 33%), 7 cases in stage Dukes B (58 33%), only 1 case (8 34% ) in stage Dukes C Conclusions The prevalence of CRC in Beijing is one of the highest in China Individuals at high risk for CRC or those over 50 years of age should be considered as primary candidates for screening SFOBT screening is a cost effective and reliable me thod for early detection of CRC
文摘A high risk population consisting of 3034 people with history of rectal polyps or ulcers were screened for colorectal neoplasia with Reverse Passive Hemagglutination Fecal Occult Blood Test (RPHA FOB) and 60 cm fiberoptic colonoscopy. Among 2553 subjects (84.1%)who completed both tests, 11 cases of colorectal malignancies and 465 cases of polyps were detected.Using colonoscopic finding and histopathological examination as the 'gold standard' of diagnosis, results showed that FOB positivity of polyps was related to their size, macroscopic appearance and surface features but no correlation between bleeding of polyps and their location, numbers, pathological types were found. In this study the sensitivity of RPHA in screening of colorectal malignancy was 63.6% (7/11), while that for polyps was only 21.1% (98/465) . For screening of colorectal neoplasia (cancer+polyps) the overall sensitivity and specificity of RPHA FOB were 22.1% and 82.4%, the positive and negative predictive values were 22.3% and 82.2% respectively. Amoug 465 polyps there were 195 adenomas, further analysis showed that villous and tubulovillous adenomas had higher intestinal bleeding rate (FOB positive)than tubular type (45.5%,30.0% and 17.8% respectively, X2=5.8, p=0.05). The results indicate that although the sensitivity of RPHA FOB in screening for colorectal polyps was generally low, but about 40% (8/21) of villous and tubulovillous adenoma which present higher tendency of malignant transformation can be detected by RPHA FOB as a screening Procedure. So the authors suggest that screening of colorectal neoplasia be not only a procedure of secondary prevention but also a measure of primary prevention for colorectal cancer.Accepted March 22, 1994
文摘AIM: To elucidate the association between small bowel diseases(SBDs) and positive fecal occult blood test(FOBT) in patients with obscure gastrointestinal bleeding(OGIB).METHODS: Between February 2008 and August 2013, 202 patients with OGIB who performed both capsule endoscopy(CE) and FOBT were enrolled(mean age; 63.6 ± 14.0 years, 118 males, 96 previous overt bleeding, 106 with occult bleeding). All patients underwent immunochemical FOBTs twice prior to CE. Three experienced endoscopists independently reviewed CE videos. All reviews and consensus meeting were conducted without any information on FOBT results. The prevalence of SBDs was compared between patients with positive and negative FOBT.RESULTS: CE revealed SBDs in 72 patients(36%). FOBT was positive in 100 patients(50%) and negative in 102(50%). The prevalence of SBDs was significantly higher in patients with positive FOBT than those with negative FOBT(46% vs 25%, P = 0.002). In particular, among patients with occult OGIB, the prevalence of SBDs was higher in positive FOBT group than negative FOBT group(45% vs 18%, P = 0.002). On the other hand, among patients with previous overt OGIB, there was no significant difference in the prevalence of SBDs between positive and negative FOBT group(47% vs 33%, P = 0.18). In disease specific analysis among patients with occult OGIB, the prevalence of ulcer and tumor were higher in positive FOBT group than negative FOBT group. In multivariate analysis, only positive FOBT was a predictive factors of SBDs in patients with OGIB(OR = 2.5, 95%CI: 1.4-4.6, P = 0.003). Furthermore, the trend was evidentam on g patients with occult OGIB who underwent FOBT on the same day or a day before CE. The prevalence of SBDs in positive vs negative FOBT group were 54% vs 13% in patients with occult OGIB who underwent FOBT on the same day or the day before CE(P = 0.001), while there was no significant difference between positive and negative FOBT group in those who underwent FOBT two or more days before CE(43% vs 25%, P = 0.20).CONCLUSION: The present study suggests that positive FOBT may be useful for predicting SBDs in patients with occult OGIB. Positive FOBT indicates higher likelihood of ulcers or tumors in patients with occult OGIB. Undergoing CE within a day after FOBT achieved a higher diagnostic yield for patients with occult OGIB.
