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[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.
Conclusion:
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.
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