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| PREVENTIVE MEDICINE | ARTICLE Table 1 Results


Positive colonoscopy Negative colonoscopy


Positive PSP blood test Negative PSP blood test 37 2


3 29 PSP Blood Test 100 80


60 40


20 0 0 20 40 60 100-specificity


Devices The CF-Q180AI/L colonoscope made by Olympus.


Pre-medication Propofol (150–450 mg, depending on indication).


Polypectomy Every time a polyp was detected during examination, it was ablated using an electric sling in the course of the same session.


Test persons Patient inclusion criteria for this study were asymptomatic adults following a referral for a colorectal carcinoma screening.


Table 2 Proof of small and large adenomas Haemoccult Immunological tests for the proof of:


Haemoglobin


bioNexia Prevent ID Immo FOBplus CC


Sensitivity (%) Specificity (%)


Stool examination Blood examination Price (€)


5.4 95.9


35.8 81.9


30–40 30


29.6 81.8


30 11.4 96.7 30 FOB 18 92.9 30 CARE-C advanced iFOB


45.2 70.2


30


Haemoglobin/ Haptoglobin Complex


QuickVue bioNexia


Hb/Hp Complex


58 58.8 30 20–30* not stated 150 38 * oral manufacturer’s specification prime-journal.com | January/February 2012 ❚ 80 100


Figure 4 This ROC (receiver operating characteristic) curve is a graphical method used to visualise and analyse a diagnostic system. If the result (the true positive values in this case) is located above the diagonal, it gains sensitivity and specificity in comparison with a random decision


!


Sensitivity Spefificity Criterion


92.5 93.1 >0


The exclusion criteria were:


■ Positive haemoccult test or iron deficiency anaemia during the preceding 6 months


■ Rectal bleeding or loss of blood from the anus ■ Unintended weight loss of more than 5 kg within the preceding 12 months


■ Anamnesis with adenomatous polyps, colon carcinoma, inflammatory intestinal disease.


Results The authors examined 71 patients retrospectively using a PSP blood test. In 40 patients it was possible to endoscopically prove adenomatous intestinal polyps (Table 1). The authors carried out nine measurements per


patient, searching for the typical polymers for intestinal polyps (Figure 3). The PSP blood test results correlated significantly with the endoscopically proven intestinal polyps. The ROC curve showed a good diagnostic suitability (CI: 0.72 – 0.85; P < 0.001) (Figure 4). Intestinal polyps could be determined with a sensitivity of 92.5%, a specificity of 93.1%, a positive predictive value of 94.9%, and a negative predictive value of 90%.


Discussion Colonoscopy offers a high reliability in the diagnosis of adenomatous intestinal polyps, the advantage being that therapeutic measures such as a polypectomy can be carried out during the same examination. There are a range of non-invasive methods for the


detection of intestinal polyps available on the market. It is their goal to supplement free preventive check-ups by means of colonoscopy using simple methods. The guaiac test for FOBT has been part of the German


examination programme since the 1970s. If carried out regularly, the FOBT reduces mortality by approximately 30%1–4


. The FOBT measures the peroxidase activity in


the haemoglobin. However, this reaction is not specific, as both the peroxidases of plant and animal foodstuffs also react. Another big disadvantage of the FOBT consists in its low sensitivity to cancers and large polyps, which can only be compensated through annual repetition.


Epi proColon PSP


57


Sensitivity


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