View source for Immunochemical test of blood in stool

{{Zkontrolováno|20091126121845|[[Uživatel:Kocna|MUDr. Petr Kocna, CSc.]] |340540|20160303131956}}
[[Soubor:Pozitivita FOBT - Guajak test x imunochmie.jpg|thumb|Pozitivita FOBT – guajakový test × imunochemie]]

'''Immunochemical detection of blood in stool (iFOBT)''' is intended, in contrast to the [[Haemoccult|guaiac screening test]] (Haemoccult, gFOBT), to exclude gastrointestinal bleeding. The test is based on the [[Imunochemie|immunochemical]] detection of [[hemoglobin]] by reaction with a [[Monoklonální protilátky|monoclonal antibody]] against human hemoglobin. Sensitivity and positive detection are also significantly affected by the different degradation of both hemoglobin components with respect to the proximodistal gradient in the [[Trávicí ústrojí|gastrointestinal tract]]. Globin is degraded much faster, and the positivity of immunochemical tests almost eliminates the detection of bleeding in the upper gastrointestinal tract. Hemagglutination, latex immunoprecipitation, radial immunodiffusion and immunoaffinity [[chromatography]] tests are based on the immunochemical principle. Detection of protein (human hemoglobin) by a [[Monoklonální protilátky|monoclonal antibody]] eliminates the possibility of influencing by another source of hemoglobin (food), no interference from chemicals, no special diet is necessary. The sensitivity of immunochemical tests is significantly higher; depending on the technique i <0.1 mg hemoglobin per gram of stool. Immunochemical tests include, for example, the Hemolex latex test, the Heme-Select reverse passive hemagglutination principle, the ImmoCare immunoaffinity chromatography, the Dialab FOB test, the Hexagon OBTI, the Actim test and others. 

__NOTOC__
== Performing the test ==
[[Soubor:Imunochemické testy - FOBT.jpg|thumb|Imunochemické testy – FOBT]]
Immunochemical tests vary considerably depending on the type of technique used. Recently, the most common variant is immunoaffinity [[chromatography]]. The patient takes 1 stool sample into a collection container with a stabilizing solution. However,[[Vyšetření stolice|stool sampling]] involves a significant risk of preanalytical error. Laboratory processing consists of applying a drop of extract to the test and reading 1 or 2 colored strips that detect the presence of only an antibody with a colored marker (negative test, 1 colored strip) or the formation of an antigen-antibody complex (positive test, 2 colored strips). The evaluation is again only qualitative.

Studies in recent years have tested several immunochemical analyzers for the quantitative determination of hemoglobin in stool (qi-FOBT), most of which are Japanese-made. ROC curves show 95.3% specificity for advanced adenomas at a sensitivity of 100 ng Hb / mL.
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[[Kategorie:Gastroenterologie]]
[[Kategorie:Vnitřní lékařství]]
[[Kategorie:Všeobecné praktické lékařství]]