中文摘要：

目的系统性评价免疫法粪便潜血试验（immunochemical fecal occult blood tests,iFOBT）与愈创木脂化学法粪便潜血试验（guaiac-based fecal occult blood tests,gFOBT）相比,是否能获得更高的筛检进展期结直肠肿瘤的临床应用价值。方法利用中英文检索词检索相关电子数据库,纳入直接比较iFOBT与gFOBT筛查结直肠肿瘤的随机临床试验,并提取其特征信息。根据QUADAS质量评价标准评价纳入文献的质量,荟萃分析各项研究中不同潜血试验方法对结直肠肿瘤的检出率和患者的依从性,计算相应的OR值和95%可信区间。通过漏斗图肉眼观察是否存在发表偏倚,并做Egger检验进一步验证。结果共5项随机临床试验（共22 709例）符合纳入标准。iFOBT与gFOBT对于结直肠癌及进展期腺瘤的检出率分别为2.23%和1.24%,合并OR值为1.50（95%CI：0.94~2.39）。而这种优越性主要体现在iFOBT与传统的化学法HemoccultⅡ相比时（OR=2.12,95%CI：1.66~2.71）。患者对于iFOBT和gFOBT的依从性分别为52.66%和43.93%,合并OR值为1.40（95%CI：1.16~1.68）。结论与传统gFOBT相比,iFOBT能够提高结直肠肿瘤筛检的准确性及患者的依从性。

英文摘要：

Objective To systematically evaluate whether iFOBT could improve clinical performance and test accuracy in screening for advanced colorectal neoplasms.Methods Eligible articles were identified by searches of electronic databases.We included all randomized trials directly comparing gFOBT and iFOBT.QUADAS items were used to evaluate the quality of the included studies.The pooled odds ratio（OR） of improving advanced colorectal neoplasms detection rate and 95% confidence intervals（95%CI） were calculated.Publication bias was assessed with funnel plot.Results Five randomized trials（22 709 participants） were identified.In randomized trials,the detection rates of iFOBT and gFOBT for colorectal neoplasms were 2.23% and 1.24%.Pooled OR for advanced neoplasm detection rate of iFOBT and gFOBT was 1.50（95% CI： 0.94～2.39）,especially compared with conventional Hemoccult Ⅱ（OR= 2.12,95% CI： 1.66～2.71）.The compliance rates of iFOBT and gFOBT were 52.66% and 43.93%（OR=1.40,95% CI： 1.16～1.68）.ConclusionOur review suggests that iFOBT can perform better in increasing detection rate of advanced colorectal neoplasms and the participants compliance.