內科WANG, TEH-HONGTEH-HONGWANGLIN, JAW-TOWNJAW-TOWNLIN2008-12-292018-07-112008-12-292018-07-112003http://ntur.lib.ntu.edu.tw//handle/246246/95228Background/Aims: Fecal occult blood test has been,utilized to screen for lower gastrointestinal pathologies. such as colorectal cancer and polyps that bleed. Recent studies have revealed a relatively high frequency of upper gastrointestinal abnormalities in subjects with positive fecal occult blood by guaiac-based method. Although immunohistochemical tests of -fecal occult blood were assumed to have greater,. diagnostic validity, the distribution of gastrointestinal Pathology using such examinations is not Well., established., This study aims to investigate the efficacy of immunohistochemical analysis,of fecal occult blood in detecting upper and. lower gastrointestinal lesions in asymptomatic individuals. Methodology: Subjects who underwent regular healthy checkups were enrolled if they received both esophagogastroscopic and colonoscopic examinations. Each subject was tested by an immunohistochemical fecal occult blood test. The fecal occult. blood results were evaluated and correlated with lesions identified in endoscopic examinations. Results: In total 655 males and 722 females with age 46.2 +/- 12.1 years were enrolled. 287 cases (20.7%) had polypoid lesions of colon, including 6 colon cancers, 37 with polyps greater than or equal to1cm, 104 with polyp 5-9mm, and 140 with polyp <5mm . FOB was positive in 31 cases, of which 15 (15/31 , 48.4%) were polypoid lesions of colon, 1 was colonic ulcer , 9 (29.0%) were active gastroduodenal ulcers but 6 (19.4%) had no significant lesions. The positive and negative predictive value. for colon polyps was 48.4% and 80% , respectively. The sensitivity was 50% (3/6) for colon cancer and varied among polyps with different sizes: 16.2%. (6/37) for polyps greater than or equal to1cm; 5.8% (6/104) for polyps 5-9mm. and 0% (0/140) for polyps < 5mm. Conclusions: A substantial portion of subjects (29%) with positive fecal occult blood reaction of immunohistochemical analysis but negative colonoscopy still needs esophagogastroscopic examination to disclose upper gastrointestinal lesions. Immunohistochemical determination of fecal, occult blood remains imperfect for polypoid lesions of colon in view of its sensitivity and specificity.en-USCOLORECTAL ADENOMATOUS POLYPSASYMPTOMATIC PATIENTSNEGATIVE COLONOSCOPYPOSITIVE STOOLCANCERHEMOCCULT[SDGs]SDG3journal article