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The Colon Mucus Test in Comparison with the Fecal Occult Blood Test in the Detection of Gastrointestinal Disease

Hiroyuki Watanabe, Ikurou Mouri, Yasushi Yamaguchi, Osamu Yamakawa, Hiroyasu Kawakami, Yoshitake Satomura, Hideki Ohta, Yoshiharu Motoo, Takashi Okai, Masanori Fukui, Norio Sawabu

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Abstract

Abstract: This study was undertaken to assess the diagnostic significance of the colon mucus test (CMT) by which the cancer‐associated carbohydrate antigen, β‐D‐Gal (1 ‐ 3)‐D‐GalNAc (T antigen) is measured in rectal mucus, chiefly in patients with various alimentary tract diseases. The incidence of a positive CMT was relatively high in colorectal cancer (69%) and gastric cancer (40%), and was similarly high in some benign colorectal diseases such as colonic diverticulum (42%) and colonic polyps (39%), and in gastric polyps (75%). On the other hand, the incidence of a positive CMT in other benign diseases or in healthy controls was less than 10%. A positive CMT was significantly more common in colorectal disease and in gastric tumors (cancer and polyps) than in the other diseases (p < 0.001). Of 28 colonic polyp patients, 20 (71%) had negative fecal occult blood test results (FOBT), and nine of them (45%) had positive CMT results. These results suggest that the CMT may be a useful screening test for alimentary tract disease, particularly colorectal disease and gastric tumors, although its specificity for colorectal cancer is only moderate. Furthermore, a combination assay using FOBT plus CMT may help to improve the diagnostic rate.

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What this paper is about

Abstract: This study was undertaken to assess the diagnostic significance of the colon mucus test (CMT) by which the cancer‐associated carbohydrate antigen, β‐D‐Gal (1 ‐ 3)‐D‐GalNAc (T antigen) is measured in rectal mucus, chiefly in patients with various alimentary tract diseases. The incidence of a positive CMT was relatively high in colorectal cancer (69%) and gastric cancer (40%), and was similarly high in some benign colorectal diseases such as colonic diverticulum (42%) and colonic polyps (39%), and in gastric polyps (75%). On the other hand, the incidence of a positive CMT in other benign diseases or in healthy controls was less than 10%. A positive CMT was significantly more common in colorectal disease and in gastric tumors (cancer and polyps) than in the other diseases (p < 0.001). Of 28 colonic polyp patients, 20 (71%) had negative fecal occult blood test results (FOBT), and nine of them (45%) had positive CMT results. These results suggest that the CMT may be a useful screening test for alimentary tract disease, particularly colorectal disease and gastric tumors, although its specificity for colorectal cancer is only moderate. Furthermore, a combination assay using FOBT plus CMT may help to improve the diagnostic rate.

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Available abstract

Abstract: This study was undertaken to assess the diagnostic significance of the colon mucus test (CMT) by which the cancer‐associated carbohydrate antigen, β‐D‐Gal (1 ‐ 3)‐D‐GalNAc (T antigen) is measured in rectal mucus, chiefly in patients with various alimentary tract diseases. The incidence of a positive CMT was relatively high in colorectal cancer (69%) and gastric cancer (40%), and was similarly high in some benign colorectal diseases such as colonic diverticulum (42%) and colonic polyps (39%), and in gastric polyps (75%). On the other hand, the incidence of a positive CMT in other benign diseases or in healthy controls was less than 10%. A positive CMT was significantly more common in colorectal disease and in gastric tumors (cancer and polyps) than in the other diseases (p < 0.001). Of 28 colonic polyp patients, 20 (71%) had negative fecal occult blood test results (FOBT), and nine of them (45%) had positive CMT results. These results suggest that the CMT may be a useful screening test for alimentary tract disease, particularly colorectal disease and gastric tumors, although its specificity for colorectal cancer is only moderate. Furthermore, a combination assay using FOBT plus CMT may help to improve the diagnostic rate.

Key concepts: Medicine, Gastroenterology, Fecal occult blood, Internal medicine, Colorectal cancer, Incidence (geometry), Cancer, Mucus

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