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ARTICLE | PREVENTIVE MEDICINE | Owing to the low sensitivity and the particularities of


the FOBT, immunological tests for human haemoglobin (iFOBT) have been developed. The peroxidase activity can be measured without being disturbed by peroxidases of plant or animal origin if a specific monoclonal antibody against human haemoglobin is used. Another advantage offered is the opportunity of a quantitative interpretation of the results (Table 2). As the work of Hundt et al shows23


, there are considerable


differences between the six tests — bioNexia FOBplus, bioNexia Hb/Hp Complex, Prevent ID CC, immoCARE-C, FOB advanced, and QuickVue iFOB — with regard to sensitivity and specificity. Sensitivity rose from 11.4% to 58% for all adenomas, and from 25.4% to 71.5% for advanced adenomas. For the guaiac test, it only amounted to 5.4% for all and to 9.4% for advanced adenomas. Specificity rose from 58.8% to 96.7%. However, only the specificity of immoCARE-C, FOB advanced and the guaiac went above 90%. Disproportionately often, the outcome of the remaining immunochemical tests was false-positive. Genetic tests can prove the existence of M2-PK


expressions. M2-PK is a key enzyme in the metabolism of polyps and intestinal cancer, and it can detect both bleeding and non-bleeding polyps and cancers. The M2-PK test is insensitive to blood in the stool, which is why there cannot be any false-positive results as a result of haemorrhoids or other intestinal bleeding. This method achieves a specificity of 74% and a sensitivity of 48%.


Conclusions As a result of its higher sensitivity and specificity values (92.5% to 93.1% respectively), it seems that the PSP blood test is better suited for the detection of intestinal polyps than the methods described above. The PSP blood test can be used as an alternative to endoscopy, particularly in patients for whom a complete colonoscopy is not possible for anatomic reasons, or owing to stenotic lesions. The PSP blood test can also be taken into consideration when an endoscopy is connected with a higher risk or greater effort. As a non-invasive method,


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Figure 5 EDAX1: Spectra from the Energy Dispersive Analysis of X-Rays show the elemental composition of a polymer


the PSP blood test is patient-friendly and therefore makes an important contribution to a wider acceptance of preventive measures and the participation in regular preventive check-ups for intestinal cancer. A prospective study is needed to demonstrate whether


the specificity and sensitivity values of the PSP blood test gained retrospectively can be confirmed in the identification of adenomatous polyps. In the longer term, the PSP blood test promises to take an important role in the early detection of intestinal cancer.


 Declaration of interest none


January/February 2012 | prime-journal.com


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