FECAL ALPHA(1)-ANTITRYPSIN DETECTION OF COLORECTAL NEOPLASIA - AN EVALUATION USING HEMOQUANT

Fecal alpha(1)-antitrypsin measurement may be of value for the detecti on of colorectal neoplasia and is compared with the HemoQuant test in 119 subjects with either a screen-positive Hemoccult result (N = 78) o r iron-deficiency anaemia (N = 41). Nineteen patients were found to ha ve colorectal cancer, 35 had colorectal adenomatous polyps, 5 had infl ammatory bowel disease, and 60 had no detected cause of occult blood l oss. Of the cancer patients, 63% (12/19) were detected by fecal alpha( 1)-antitrypsin and 63% (12/19) by HemoQuant. Of the adenomas >1 cm in diameter 33% (7/23) were detected by fecal alpha(1)-antitrypsin and 26 % (6/23) by HemoQuant. There was a poor correlation between fecal alph a(1)-antitrypsin and HemoQuant results for colorectal cancers (r = 0.3 7, P > 0.05), and combining the tests, the sensitivity for colorectal cancer was increased to 84% (16/19). Fecal protein loss, as measured u sing alpha(1)-antitrypsin, appears to involve largely different mechan isms from that of blood loss from colorectal cancers.