[The value of "occult blood bead" in detection of upper digestive tract disorders with bleeding].
OBJECTIVE
To evaluate the usefulness of "occult blood bead" (OBB) test in the screening of gastric and esophageal cancers.


METHODS
In the study, subjects with upper gastro-intestinal (GI) symptoms received gastric OBB test before gastroscopic examination. OBB test was scored as +(-)+++ according to the intensity of reactions. The sensitivity, specificity, and likelihood ratio of OBB test were evaluated according to results of gastroscopic and/or pathological examination.


RESULTS
Among 5,217 subjects, 2,403 showed positive OBB test (46.1%). In this series, 202 cases of malignant disorders were detected (gastric cancer in 155 and esophageal cancer in 47). There were 69 cancer cases among 1847 subjects presenting "+" OBB test, with a cancer detection rate of 3.7%. In 393 subjects presenting "++" OBB test, 28 were cancer (7.1%); while in 163 subjects presenting "+++" OBB test, 34 were diagnosed as gastric or esophageal cancer with a detection rate of 20.9%. The sensitivity of OBB test in detection of gastric and esophageal cancer was 0.65, the specificity was 0.55, likelihood ratio was 1.43 and the Youden Index was 0.2.


CONCLUSIONS
OBB test provides a new, simple and non-invasive method for detection of upper digestive tract bleeding. For detection of upper GI carcinomas it presents a reasonable sensitivity and specificity in a group of subjects with upper GI symptoms. OBB test can be used as a prelimnary screening tool for gastric and esophageal cancer in asymptomatic general population.
Zhou
L
L
Cancer Institute, Zhejiang Medical University, Hangzhou 310009.
Yu
H
H
Zheng
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004938:Esophageal Neoplasms / Q000175:diagnosis*; D005189:False Positive Reactions; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D013274:Stomach Neoplasms / Q000175:diagnosis*