Cancer Research and Treatment

Original Articles

Single Immunochemical Fecal Occult Blood Test for Detection of Colorectal Neoplasia: Dae Kyung Sohn, Seung-Yong Jeong, Hyo Seong Choi, Seok-Byung Lim, Jin Myeong Huh, Dae-Hyun Kim, Dae Yong Kim, Young Hoon Kim, Hee Jin Chang, Kyung Hae Jung, Joong-Bae Ahn, Hyun Kyung Kim, Jae-Gahb Park; Cancer Res Treat. 2005;37(1):20-23. Published online February 28, 2005; DOI: https://doi.org/10.4143/crt.2005.37.1.20

Purpose

This study was designed to investigate the validity of a single immunochemical fecal occult blood test (FOBT) for detection of colorectal neoplasia.

Materials and Methods

A total of 3,794 average-risk screenees and 304 colorectal cancer patients admitted to the National Cancer Center, Korea, between May 2001 and November 2002, were studied prospectively. All screenees and admitted patients underwent FOBT and total colonoscopic examinations. Stools were self-collected, and examined using an immunochemical fecal occult blood test (OC-hemodia®, Eiken Chemical Co. Tokyo, Japan) and an OC-sensor analyzer® (Eiken Chemical Co. Tokyo, Japan).

Results

Of the 3,794 asymptomatic screenees, the colonoscopy identified colorectal adenomas and cancers in 613 (16.2%) and 12 (0.3%) subjects, respectively. The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The false positive rate of FOBT for colorectal cancer in screenees was 1.19%. For the total 316 colorectal cancer cases (including 12 cases from screenees), the FOBT sensitivities according to the T-stage were 38.5, 75.0%, 78.9 and 79.2% for T1, 2, 3 and 4 cancers, respectively. The sensitivities according to the Dukes stages A, B and C were 63.4, 79.3 and 78.6%, respectively.

Conclusion

The sensitivities of a single immunochemical FOBT for detecting colorectal cancers and adenomas in screenees were 25.0 and 2.4%, respectively. The sensitivities of FOBT were about 80% for Dukes B or C colorectal cancers and 63.4% for Dukes A.

Citations

Citations to this article as recorded by

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Clinical Value of Whole Body F-18 FDG PET in The Management of Recurrent Colorectal Malignancy: Seok Byung Lim, Hyo Seong Choi, Sung Bum Kang, Seung Chul Heo, Young Jin Park, Seung Yong Jeong, Kyu Joo Park, Han Kwang Yang, Kyung Hoon Hwang, Jae Min Jeong, Dong Soo Lee, June Key Chung, Myung Chul Lee, Keon Wook Kang, Jae Gahb Park; Cancer Res Treat. 2003;35(4):349-354. Published online August 31, 2003; DOI: https://doi.org/10.4143/crt.2003.35.4.349

Abstract PDF: PURPOSE
The aim of this study was to evaluate the clinical value of whole body 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) in the patient with a recurrence of a previously treated colorectal malignancy.
MATERIALS AND METHODS
Fifty-eight cases were scanned using PET at the PET Center of Seoul National University Hospital between May 1995 and Aug 2002. All the patients had had a previous operation for a colorectal malignancy. The PET scans were performed for the following reasons: - investigation of a recurrence (n=12), investigation of the operability (n=38) and clinical follow up (n=8). In these 58 cases, 47 of the CT scans and 55 of the CEA (Carcinoembryonic antigen) were checked prior to the FDG- PET. The accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the PET scans were calculated, and compared with those of conventional CT scan and CEA, which were also compared with the previous reported data. Eight cases, whose managements were influenced by the PET findings, were analyzed.
RESULTS
Recurrences, or metastases, of colorectal cancer developed in 51 cases, with 49 of these being detected by the PET. The accuracy, sensitivity and specificity of the PET were 96.6 (56/58), 96.1 (49/51) and 100% (7/7), respectively. The PPV and NPV of the PET were 100 (49/49) and 77.8% (7/9), respectively. The accuracy and sensitivity of the PET were higher than those of the CT (85.1 and 88.1%), with the differences being statistically significant (p-value 0.001 and 0.003, respectively).
CONCLUSION
It is concluded that a FDG-PET scan is a more accurate and sensitive diagnostic tool than a CT scan for the detection of a recurrence or metastasis in a colorectal malignancy. In addition, a FDG-PET may alter the management of patients with recurrent colorectal cancer. Therefore, it is recommended that a PET should be considered when a tumor recurrence is suspected during conventional follow up.

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