Korean J Lab Med.  2009 Jun;29(3):262-267. 10.3343/kjlm.2009.29.3.262.

Influence of the Pre-Analytical Specimen Storage Conditions on the Fecal Occult Blood Test Results

• Yoo SJ
• Moon SJ
• Gwack EH
• Shin BM

• KMID: 1096980
• DOI: http://doi.org/10.3343/kjlm.2009.29.3.262

Abstract

BACKGROUND: Korean national cancer screening program selected fecal occult blood test (FOBT) as a primary screening method of colorectal carcinoma in adult > or =50 yr old irrespective of symptom. Notice to pre-analytical errors is especially important for the FOBT because examinees collect and submit their specimens to laboratories by themselves. We examined the influences of the fecal storage temperatures, durations and with or without buffer on the FOBT results.
METHODS
Thirty FOBT-positive specimens above 100 ng/mL were used for the study from July to August 2008. Quantitative FOBT was performed with OC-sensors II (Eiken Chemical Co., Japan). Each specimen was divided into 4 groups. Two groups in plastic buffer-free containers were kept either at 4degrees C or room temperature (25-28degrees C), respectively. Another two groups in buffer-tubes were also kept either at 4degrees C or room temperature. Each group was repeatedly examined with same method every 24 hr up to 120 hr.
RESULTS
Eleven specimens (36.7%) in buffer-free containers converted to negative results (below the 100 ng/mL) after 24 hr and 17 specimens (56.7%) did after 48 hr at room temperature. Ten specimens (33.3%) in buffer-free containers converted to negative after 48 hr at 4degrees C. Specimens contained in buffer-tubes showed little change; 3 specimens (10.0%) at room temperature and no specimen at 4degrees C showed negative conversions after 48 hr.
CONCLUSIONS
Buffer-tube minimizes false negative FOBT results during pre-analytical delay of specimen. The examinees using buffer-free containers need to be educated to hand in their specimens to laboratories as soon as possible.

Keyword

Fecal occult blood; Pre-analytical error; Colorectal carcinoma; Screen

MeSH Terms

Buffers
Colorectal Neoplasms/*diagnosis
Humans
Middle Aged
*Occult Blood
*Specimen Handling
Temperature
Time Factors

Figure

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  Fig. 1. Percent change of fecal occult blood test results of 30 positive specimens for 5 days in different storage conditions. Percent value was calculated compared to each of 0 hr result and log transformation was performed. Points indicate mean percent values and vertical lines are 95% confidence intervals for mean values. Abbreviation: RT, room temperature.

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