進んだ大腸内腫瘍を検出するための検査感度に対する排泄物免疫化学検査前の単回アスピリンの効果: ランダム化臨床試験
Hermann Brenner1,2,3, Silvia Calderazzo4, Thomas Seufferlein5
1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
JAMA
|May 8, 2019
まとめ
一回投与したアスピリンは,進行性大腸内腫瘍を検出するための糞便の免疫化学検査の感度を有意に改善しなかった. この研究は,大腸がんのスクリーニングテストの精度を高めるためにアスピリンの使用を支持しませんでした.
科学分野:
- 胃腸内科
- 腫瘍学
- 臨床試験
背景:
- 糞便の免疫化学検査 (FIT) は結腸直腸がん (CRC) のスクリーニングに不可欠です.
- 以前の研究では,アスピリンは,特に男性において,進行した腫瘍に対するFITの感受性を高めることが示唆された.
研究 の 目的:
- 便サンプル採取の2日前に投与された単一の300mgのアスピリンが,進行した結腸直腸腫瘍を検出するためのFITの感度を増やすことができるかどうかを評価する.
主な方法:
- 40~80歳の参加者2422人を対象としたランダム化,プラセボ対照のダブルブラインド試験.
- 参加者はFIT採取の2日前に300mgのアスピリンまたはプラセボを投与された.
主要な成果:
- 先進的な腫瘍に対するFIT感度は,アスピリン投与では40. 2%,プラセボ投与では30. 4% (p=0. 14) で,別のカットオフ値では28. 6% 対22. 5% (p=0. 32) であった.
- アスピリン投与では,検査の感度が統計的に有意に増加することは観察されなかった.
結論:
- FIT前に投与されたアスピリンの単一投与は,この集団における進行性大腸内腫瘍の検出に対する検査の感度を有意に高めなかった.
- 発見は,CRCのスクリーニングでFITのパフォーマンスを改善するために単一のアスピリンの使用を支持しません.
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