Alpha1-antitrypsin was measured in 5-day faecal collections from patients with colorectal cancer or adenomatous polyps and a symptomatic control group. Collections were homogenized and lyophilized prior to measurement of α1-antitrypsin by radial immuno-diffusion. Colorectal cancer dry weight concentrations were significantly higher than the symptomatic control results, with 57% having results greater than 95% normal values of this control group. There was no significant difference between adenomatous polyp dry weight concentrations and symptomatic control results. Wet weight concentrations were calculated from wet/dry ratios. Colorectal cancer wet weight concentrations were significantly higher than symptomatic control results with 48% having results greater than 95% normal values of this control group. Alpha1-antitrypsin was also measured in non-lyophilized samples from an asymptomatic control group (n = 39). Colorectal cancer wet weight concentrations were significantly higher than asymptomatic control results, with 62% having results greater than 95% normal values of this control group. Faecal α1-antitrypsin measurement deserves further assessment for use in detecting colorectal cancer.
GreegorDH. Diagnosis of large bowel cancer in the asymptomatic patient. JAMA1967; 101: 943–5.
2.
WinawerSJAndrewsMFlehingeBSherlockPSchottenfeldDMillerDG. Progress report on controlled trial of faecal occult blood testing for the detection of colorectal neoplasia. Cancer1980; 45: 2959–64.
3.
HardcastleJDFarrandsPABalfourTWChamberlainJ. Controlled trial of faecal occult blood screening in the detection of colorectal cancer. Lancet1983; ii: 1–4.
4.
AhlquistDAKleeGGMcGillDBEllefsonRD. Colorectal cancer in the practice setting. Arch Intern Med1990; 150: 1041–5.
5.
FarrandsPAHardcastleJD. Accuracy of occult blood tests over a six-day period. Clin Oncol1983; 9: 217–25.
6.
WeilJLangmanMJS. Screening for gastrointestinal cancer: An epidemiological review. Gut1991; 32: 220–4.
7.
PerlmutterDHDanielsDDAuerbachHSDe Schryver-KecskemetiKWinterHSAlpersDH. The α-1-antitrypsin gene is expressed in a human intestinal epithelial cell line. J Biol Chem1989; 264: 9485–90.
8.
CrossleyJRElliottRB. Simple method for diagnosing protein-losing enteropathies. BMJ1977; 1: 428–9.
9.
QuigleyEMMRossINHaeneyMRHolbrookIBMarshMN. Reassessment of faecal α-1-antitrypsin excretion for use as a screening test for intestinal protein loss. J Clin Pathol1987; 40: 61–6.
10.
KarbachUEweKBodensteinH. Alpha-1-antitrypsin, a reliable endogenous marker for intestinal protein loss and its application in patients with Crohn's disease. Gut1983; 24: 718–23.
11.
ThomasDWSinatraFRMerrittRJ. Faecal alpha-1-antitrypsin in young people with Crohn's disease. J Paediatr Gastroenterol Nutr1983; 2: 491–6.
12.
MorrowRJLawsonNHusainiSHAsquithP. Usefulness of faecal haemoglobin, albumin and α1-antitrypsin in the detection of gastro-intestinal bleeding. Ann Clin Biochem1990; 27: 208–12.
13.
BoegeFFischbachW. Structural heterogeneity of faecal α-1-antitrypsin shown by immunoblot analysis in patients with Crohn's disease. Gut1991; 32: 496–9.
14.
MizonCEl YamaniJColombelJ-FMaesPBalduyckMLaineADeglycosylation of α-1-proteinase inhibitor is impaired in the faeces of patients with active inflammatory bowel disease (Crohn's disease). Clin Sci1991; 80: 517–23.
15.
FlorentCL'HirondelCDesmazuresCAymesCBernierJJ. Intestinal clearance of α-1-antitrypsin. A sensitive method for the detection of protein-losing enteropathy. Gastroenterology1981; 81: 777–80.
HintonJMLennardJE JonesYoungAC. A new method for studying gut transit times using radio-opaque markers. Gut1969; 10: 842–7.
18.
KasparPMollerGWahlefeldA. New photometric assay for chymotrypsin in stool. Clin Chem1984; 30: 1753–7.
19.
HardcastleJDThomasWMChamberlainJPyeGSheffieldJJamesPD. Randomised, controlled trial of faecal occult blood screening for colorectal cancer. Lancet1989; i: 1160–4.
20.
SimonJB. The pros and cons of faecal occult blood testing for colorectal neoplasms. Cancer Metastasis Rev1987; 6: 397–411.
21.
FleisherMWinawerSJZauberAGSmithCSchwartzMK. And the National Polyp Study Work Group. Accuracy of faecal occult blood test interpretation. Ann Intern Med1991; 114: 875–6.
22.
WindeierJKobberlingJ. Colorectal carcinoma and Haemoccult. A study of its value in mass screening using meta-analysis. Int J Colored Dis1987; 2: 223–8.
23.
MandelJSBondJHBradleyMSnoverDCChurchTRWilliamsSSensitivity, specificity, and positive predictivity of the Hemoccult test in screening for colorectal cancers. Gastroenterology1989; 97: 597–600.
24.
StroehleinJRFairbanksVFMcGillDBGoVLW. Hemoccult detection of faecal occult blood quantitated by radioassay. Dig Dis1976; 21: 841–4.
25.
BernackaKKuryliszyn-MoskalASierkowskiS. The levels of alpha-1-antitrypsin and alpha-1-antichymotrypsin in the sera of patients with gastrointestinal cancers during diagnosis. Cancer1988; 62: 1188–93.
26.
DoranJHardcastleJD. Bleeding patterns in colorectal cancer: The effect of aspirin and the implications for faecal occult blood testing. Br J Surg1982; 69: 711–13.
27.
PollockAMQuirkeP. Adenoma screening and colorectal cancer. BMJ1991; 303: 3–4.
28.
RansohoffDFLangCA. Small adenomas detected during faecal occult blood test screening for colorectal cancer. JAMA1990; 264: 76–8.
29.
IllingworthDG. Influence of diet on occult blood tests. Gut1965; 6: 595–8.
30.
ThomasWMHardcastleJD. Role of upper gastrointestinal investigations in a screening study for colorectal neoplasia. Gut1990; 31: 1294–7.
31.
MorrisDWHansellJROstrowJDLeeCS. Reliability of chemical tests for faecal occult blood in hospitalised patients. Am J Dig Dis1976; 21: 845–52.
32.
RoseISYoungGPSt JohnDJBDeaconMCBlakeDHendersonRW. Effect of ingestion of haemoproteins on faecal excretion of haems and porphyrins. Clin Chem1989; 35: 2290–6.
