title: Laboratory screening markers in gastroenterology--state of the art.
abstract: BACKGROUND
  Screening tests for gastrointestinal diseases acceptable for population with a high sensitivity and high specificity can now be offered by clinical laboratories. This paper summarizes major recent advances in this area of laboratory medicine.
  
  
  METHODS
  Relevant articles published within the last 5 years in the NLM (National Library of Medicine) PubMed - Medline database covering the three gastrointestinal diseases - colorectal cancer, coeliac disease, and atrophic gastritis were included for this overview.
  
  
  RESULTS
  In Europe, colorectal cancer (CRCA) is the second most frequent malignant disease. Quantitative immunochemical analysis of the stool for haemoglobin provides the best screening test to date, with both sensitivity and specificity approaching 95%. Even though coeliac disease (CD) affects approximately 1% of the general population, it remains largely unrecognised. Recommended methods for screening currently involve the detection of IgA and IgG antibodies against tissue transglutaminase and deamidated gliadin peptide. Evaluations of screening are now discussed for other diseases of the gastrointestinal tract - such as chronic atrophic gastritis (CAG), and inflammatory bowel disease (IBD). Detection of infection by Helicobacter pylori and stomach-specific plasmatic biomarkers, especially pepsinogen I/II ratio, could help with the prevention of gastric carcinomas. The use of faecal calprotectin as a screening test could substantially reduce the number of invasive methods necessary for the diagnostic work-up of patients with IBD.
  
  
  CONCLUSIONS
  Screening tests for CRCA and CD have been used worldwide for many years. Screening strategies for gastrointestinal diseases are suggested in the text, based on recent basic science, clinical papers as well as our own experience.
authors.affiliation: Institute of Medical Biochemistry and Laboratory Diagnostics, 1st Faculty of Medicine, Charles University in Prague, Czech Republic. kocna@lf1.cuni.cz
authors.forename: Petr
authors.initials: P
authors.lastname: Kocna
authors.forename: Zdislava
authors.initials: Z
authors.lastname: Vanickova
authors.forename: Tomas
authors.initials: T
authors.lastname: Zima
mesh_terms: D015415:Biomarkers / Q000032:analysis*; D002446:Celiac Disease / Q000175:diagnosis; D015179:Colorectal Neoplasms / Q000175:diagnosis; D005243:Feces / Q000737:chemistry; D005757:Gastritis, Atrophic / Q000175:diagnosis; D005762:Gastroenterology / Q000379:methods*; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D016481:Helicobacter Infections / Q000175:diagnosis; D016480:Helicobacter pylori / Q000302:isolation & purification; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology; D007074:Immunoglobulin G / Q000276:immunology; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006454:Hemoglobins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D039841:Leukocyte L1 Antigen Complex