Fecal alpha 1-antitrypsin detection of colorectal neoplasia. An evaluation using HemoQuant.
Fecal alpha 1-antitrypsin measurement may be of value for the detection of colorectal neoplasia and is compared with the HemoQuant test in 119 subjects with either a screen-positive Hemoccult result (N = 78) or iron-deficiency anaemia (N = 41). Nineteen patients were found to have colorectal cancer, 35 had colorectal adenomatous polyps, 5 had inflammatory bowel disease, and 60 had no detected cause of occult blood loss. Of the cancer patients, 63% (12/19) were detected by fecal alpha 1-antitrypsin and 63% (12/19) by HemoQuant. Of the adenomas > 1 cm in diameter 33% (7/23) were detected by fecal alpha 1-antitrypsin and 26% (6/23) by HemoQuant. There was a poor correlation between fecal alpha 1-antitrypsin and HemoQuant results for colorectal cancers (r = 0.37, P > 0.05), and combining the tests, the sensitivity for colorectal cancer was increased to 84% (16/19). Fecal protein loss, as measured using alpha 1-antitrypsin, appears to involve largely different mechanisms from that of blood loss from colorectal cancers.
Moran
A
A
Department of Gastroenterology, Birmingham Heartlands Hospital, UK.
Robinson
M
M
Lawson
N
N
Stanley
J
J
Jones
A F
AF
Hardcastle
J D
JD
D018256:Adenomatous Polyps / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D000368:Aged; D018798:Anemia, Iron-Deficiency / Q000175:diagnosis; D016022:Case-Control Studies; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009780:Occult Blood; D012680:Sensitivity and Specificity; D000515:alpha 1-Antitrypsin / Q000032:analysis*
D000515:alpha 1-Antitrypsin