Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology


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Indexed in KCI, KoreaMed, Synapse, DOAJ
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pISSN 2288-0585 eISSN 2288-6850

Clinical Utility of Fecal Immunochemical Transferrin Test in Gastrointestinal Bleeding Detection

Original article

Annals of Clinical Microbiology (Ann Clin Microbiol) 2018 September, Volume 21, Issue 3, pages 51-57.

Clinical Utility of Fecal Immunochemical Transferrin Test in Gastrointestinal Bleeding Detection

Jong-Mi Lee1, Mi Jung Park1, Woong Heo1, Kang Gyun Park1, Yong Gyu Park2, Seung Beom Han3, Young-Seok Cho4, Yeon-Joon Park1
Departments of 1Laboratory Medicine, 2Medical Life Science, 3Pediatrics, 4Gastroenterology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea


Background: Gastrointestinal (GI) bleeding can result from various conditions, including ulcers, neoplasms and infectious enterocolitis. The aim of this study was to evaluate the utility of the fecal immunochemical transferrin test compared with the fecal Hb test in various clinical settings.

Methods: A total of 1,116 clinical stool specimens submitted for fecal occult blood testing were prospectively examined using both FIT Hb and FIT Tf kits (AlfresaPharma, Japan). To verify the specificity of the two tests, stool specimens from 265 health check-up examinees were also included.

Results: A review of medical records revealed that 396 patients had clinical conditions associated with GI bleeding. FIT Hb and FIT Tf results were positive in 156 (39.4%) and 137 (34.6%) cases, respectively, and an additional 194 (49.0%) cases tested positive with either FIT Hb or FIT Tf. The two tests showed a moderate strength of agreement (kappa value; 0.56). Colitis (n=71) was associated with the most GI bleedings, followed by acute gastroenteritis (n=29), GI ulcers (n=27) and GI cancers (n=15). While the first two groups had higher positive rates on FIT Tf, patients in the latter two groups had higher positive rates on FIT Hb. Notably, four of nine specimens from premature babies tested positive only on FIT Tf. The specificity of FIT Hb and FIT Tf was 100% and 99.6%, respectively.

Conclusion: Concurrent use of FIT Hb and FIT Tf improved the detection rate of occult GI bleeding, especially in patients with infectious GI disease (such as colitis or gastroenteritis) and in premature babies. (Ann Clin Microbiol 2018;21:51-57)


Fecal occult blood test, Hemoglobin, Prematurity, Transferrin