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ARTICLE | PREVENTIVE MEDICINE | poor take-up2 . Therefore, it is necessary to take steps in order to increase the early detection rate.


Colonoscopy as the gold standard Colonoscopy has, among other methods for colorectal carcinoma screening, reached a certain special status. Thanks to its high sensitivity and specificity (each more than 95% for large polyps), it remains the best method for a direct proof of polyps, adenomas and carcinomas in the entire colon. Another advantage of colonoscopy is that suspicious lesions can be removed in the course of the procedure2


. Nevertheless, certain areas of the colon, such as the


middle wall of the distal end of the ascending colon or areas near the ileocaecal valve, are often overlooked3


.


Sessile or flat polyps, and polyps localised on the left side, are associated with a significantly higher risk of being overlooked4


. Failure to diagnose cancer is a leading cause


of malpractice litigation against gastroenterologists. A study in which different examiners performed two consecutive colonoscopy procedures on the same day revealed a miss rate of 24% for adenomas overall and a miss rate of 6% for adenomas of 1 cm or more. Of the misses on colonoscopy, one half were ascribed to perception, and one half to incomplete viewing. Optical colonoscopy cannot be used to visualise areas behind tissue folds or to look through retained faeces, and the tip of the scope may not reach the end of the colon5–7


. The inadequate


preparation of the intestines also leads to false-negative results8, 9


element in the assessment of each investigation10–14


. Furthermore, the human factor is a crucial .


Occult blood testing and other recent methods for stool diagnosis After a positive result of the FOBT, the clarification of the result via colonoscopy is vitally important. A number of studies confirm the effectiveness of the FOBT with a subsequent endoscopic clarification: intestinal cancer mortality decreases from 34% to 21% if testing is carried out biennially2


an earlier diagnosis and to a decrease in the cancer incidence. Immunological and chemical laboratory examinations that confirm the presence of haemoglobin can be used for the diagnosis of adenomas. However, the sensitivity of those methods is not satisfactory. Genetic stool examinations aim at proving the


existence of tumour-specific enzymes, of which the M2-PK stool test is an example. According to some studies, the sensitivity for that test lies at 73%, while its specificity is at 78%15–18


. However, those results go back to


studies only carried out with a small number of cases, and the validity of which cannot be taken for granted. Therefore, genetic stool examinations do not provide a convincing alternative to colonoscopy.


The polyps-specific-polymers blood test The polyps-specific-polymers (PSP) blood test is a disease-specific application of the nanoparticle pattern and composition analysis, an innovative and as yet, not prevalent laboratory examination, which allows for a


54 ❚ January/February 2012 | prime-journal.com Colonoscopy


has, among other methods for colorectal carcinoma screening, reached a certain special status. Thanks to its high sensitivity and specificity, it remains the best method for a direct proof of polyps, adenomas and carcinomas in the entire colon.


range of statements that can best be compared with mass spectrometry. As a global test, the nanoparticle pattern and composition analysis analyses metabolic changes that allow for an organ-related early detection of relevant dysfunctions19


. The nanoparticle pattern and composition analysis


applied by the authors analyses changes in the metabolic balance of a whole blood sample after thermal disintegration and crystallisation within the nanoparticle range. The analysis of measurement results provide a quantitative and qualitative description of intensities and crystallisation patterns possible that resemble X-ray structure analysis20


.


The aim of the retrospective study Despite versatile scientific approaches, researchers have as yet not succeeded in developing a non-invasive diagnostic tool which completes the effectiveness of colonoscopy as a means of early detection in an optimal way. It has been the goal of this study to evaluate results using the laboratory’s patients, to compare them with colonoscopy results, and to isolate individual parameters, or a combination thereof, which allow for a sensitive and specific identification of intestinal polyps.


Methods Polyps-specific-polymers blood test Our blood is the most important means of transportation and communication between the organs. Its composition reflects the relevant changes in metabolism. Therefore, akin to traditional diagnostics, it is possible to obtain the necessary results from the blood using the PSP blood test, which will then help to identify healthy patients. The very moment a disease approaches or becomes


Figure 1 Typical endoscopic picture of polyps in the colon


. Investigatory tests after a positive FOBT lead to


apparent, our blood’s composition changes. Then, we are not only confronted with changes in the concentration of relevant substances in the whole blood; but the identification of new, non-physiological substances also becomes possible.


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