Fecal α1-antitrypsin measurement may be of value for the detection of coloreactal 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 coloreactal 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 α1-antitrypsin, and 63% (12/19) by HemoQuant. Of the adenomas >1 cm in diameter 33% (7/23) were detected by fecal α1-antitrypsin and 26% (6/23) by HemoQuant. There was a poor correlation between fecal α1-antitrypsin, and HemoQuant results for colorectal cancers (r=0.37,P>0.05), and combining the tests, the sensitivity for colorectal cancer was incerased to 84% (16/19). Fecal proteins loss, as measured using α1-antitrypsin, appears to involve largely different mechanisms from that of blood loss from colorectal cancers.
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Greegor, DH: Diagnosis of large bowel cancer in the asymptomatic patient. JAMA 101:943–945, 1967
Winawer, SJ, Andrews, M, Flehinge, B, Sherlock P, Schottenfeld D, Miller DG Progress report on controlled trial of faecal occult blood testing for the detection of colorectal neoplasia. Cancer 45:2959–2964, 1980
Hardcastle JD, Farands PA, Balfour TW, Chamberlain J: Controlled trial of faecal occult blood screening in the detection of colorectal cancer. Lancet 2:1–4, 1983
Mandel JS, Bond JH, Church TR, Snover DC, Bradley GM, Schuman LM, Ederer F: Reducing mortality from colorectal cancer by screening for fecal occult blood. N Eng J Med 328:1365–1371, 1993
Weil J, Langman MJS: Screening for gastrointestinal cancer: An epidemiological review. Gut 32:220–224, 1991
Moran A, Radley S, Neoptolemos J, Jones AF, Asquith P: Detection of colorectal cancer by faecal alpha-1-antitrypsin. Ann Clin Biochem 30:28–33, 1993
Ahlquist DA, Klee GG, McGill DB, Ellefson RD. Colorectal cancer in the practice setting. Arch Intern Med 150:1041–1045, 1990
Doran J, Hardcastle JD: Bleeding patterns in colorectal cancer: The effect of aspirin and the implications for faecal occult blood testing. Br J Surg 69:711–713, 1982
Morrow RJ, Lawson N, Hussaini SH, Asquith P:A comparison of faecal haemoglobin, albumin and alpha-1-antitrypsin in the detection of gastro-intestinal bleedings. Ann Clin Biochem 27:208–212, 1990
Perlmutter DH, Daniels JD, Auerbach HS, De Schryver-Kecskemeti K, Winter HS, Alpers DH: The alpha-1-antitrypsin gene is expressed in a human intestinal epithelial cell line. J Biol Chem 264:9485–9490, 1989
Kataoka H, Nabeshima K, Komada N, Koono M: New human colorectal carcionma cell-lines that secrete proteinase inhibitorsin vitro. Virchows Arch B Cell Pathol 57:157–165, 1989
Florent C, L'Hirondel C, Desmazures C, Aymes C, Bernier JJ: Intestinal clearance of alpha-1-antitrypsin. A sensitive method for the detection of protein-losing enteropathy. Gastroenterology 81:777–780, 1981
Moran A, Panos MZ, Jones AF: Validity of alpha-1-antitrypsin as a test of enteric protein loss—upper gastro-intestinal origins. Gut 36:A63, 1995
Hardcastle JD, Thomas WM, Chamberlain J, Pye G, Sheffield J, James PD: Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Lancet 1:1160–1164, 1989
Ahlquist DA, McGill DB, Schartz S, Taylor WF, Ellefson BS, Owen RA: HemoQuant, a new quantitative assay for faecal haemoglobin. Ann Intern Med 101:297–302, 1984
Schwartz S, Dahl J, Ellefson M, Ahlquist D: The “Hemoquant” test: A specific and quantitative determination of haem (haemoglobin) in faeces and other materials. Clin Chem 29:2061–2067, 1983
Ahlquist DA, Wiend HS, Moertal CG, McGill DB, Loprinzi CL, O'Connell MJ, Maillard JA, Gerstner JB, Pandya K, Ellefson RD: Accuracy of faecal occult blood screening for colorectal neoplasia. JAMA 269:1262–1267, 1993
Ahlquist DA, McGill DB, Fleming JL, Schwartz S, Wiend HS, Rubin J, Moertel CG: Parterns of occult bleeding in asymptomatic colorectal cancer. Cancer 63:1826–1830, 1989
Stroehlein JR, Fairbanks VF, McGill DB, Go VLW: Hemoccult detection of faecal occult blood quantitated by radioassay. Am J Dig Dis 21:841–844, 1976
Ahlquist DA, McGill DB, Schwartz S, Taylor WF, Owen RA: Faecal blood levels in health and disease. N Engl J Med 312:1422–1428, 1985
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Moran, A., Robinson, M., Lawson, N. et al. Fecal α1-antitrypsin detection of colorectal neoplasia. Digest Dis Sci 40, 2522–2525 (1995). https://doi.org/10.1007/BF02220436
- occult blood
- colorectal neoplasms
- iron-deficiency anemia