Investigation of usefulness of simultaneous determination of hemoglobin, transferrin, and lactoferrin concentration in feces in colorectal cancer screening.

Abstract

The purpose of this study is to investigate whether the simultaneous determination of hemoglobin, transferrin, and lactoferrin concentrations in feces in colorectal cancer screening can better discriminate cancer positive outcomes within false-negative results in cancer patients undergoing assay for hemoglobin only and, thereby, decrease the colonoscopy examination rate. We investigated the relationship of hemoglobin, transferrin, and lactoferrin values to the cancer detection rate. Of 1073 subjects, 91 were colorectal cancer positive; 21 advanced cancers, 20 pSM cancers, and 50 pM cancers. Sensitivities of hemoglobin for advanced, pSM, and pM cancers were 95%, 90%, and 58%, respectively; sensitivity for the advanced cancer did not decrease at a cut-off value of 1,000 ng/ml. Sensitivities of transferrin and lactoferrin were significantly lower than that of hemoglobin. Three invasive cancer outcomes failed to be detected due to false-negative results by hemoglobin assay alone. All were located in ascending colon. Only one patient with advanced cancer was lactoferrin positive. This study confirms that hemoglobin testing in colorectal cancer screening is effective and suggests the possibility of raising the cut-off value. It was not found that the simultaneous determination of transferrin and lactoferrin concentrations in addition to hemoglobin concentration in colorectal cancer screening was effective.