【摘要】 为减少序贯普查便隐血试验（ＦＯＢＴ）对大肠癌筛检的漏检率，我们联合采用人血红蛋白抗血清包被的含Ａ蛋白葡萄球菌（ＳＰＡ）进行免疫便隐血试验（ＳＰＡ试验）和直肠粘液Ｔ抗原检测（即Ｓｈａｍｓ试验）用于大肠癌普查初筛，以验证两者的互补效果。在７７４０例无症状人群中，阳性率ＳＰＡ试验为１１．１％Ｓ，ｈａｍｓ试验为８．９％共１４９８例阳性者行纤维结肠镜检查，检出大肠癌１１例，腺瘤８８例。其中ＳＰＡ试验中仅９例癌、５５例腺瘤呈阳性结果。Ｓｈａｍｓ试验中８例癌、５１例腺瘤阳性。由于癌肿有时对两种试验的阳性结果不重叠，因此结合两种试验可使癌检出率从单一初筛试验的８１．８％（ＳＰＡ试验）或７２．７％（Ｓｈａｍｓ试验）提高到９０．９％对腺瘤检出的互补作用则更为明显。本实验结果提示单纯以ＦＯＢＴ作为初筛指标进行序贯普查有一定局限性，利用对癌的检出具有不同机制和检出效果的初筛试验进行互补性普查，可减少大肠癌及癌前病变的漏检率。更多还原

【Abstract】 oth SPA immunological fecal occult blood test (SPA FOBT test)and detection of T一antigen inrectal mucus(Shams′test) were used as screening tests in asymptomatic mass screening to evaluate thecomplementary effect of both tests for detection ofcolorectal cancers. SPA FOBT test showed a positiverate of 11.1% and shams′test 89% among 7 740 subjects. In 1 498 cases with positive sereening test,11cases of careinomas and 88 adenomas were found with colonoscopy.Only 9 caneers and 55 adenomasshowed positive result in SPA FOBT test and 8 cancers and 51 adenomas in Shams′test.Both testscombined could enhanee the detective rate of cancer in asymptomatic mass sereening from 81.8% withSPA FOBT test or 72.7% with Shams′test to 90.9%。 This complementary effect was more obvious inadenoma detection. It is suggested that there were some shortcomings in sequential FOBT test for can-eer detection, the combined use of the two different screening tests for detection of colorectal cancercould decrease the rate of missed detection.更多还原