低剂量阿司匹林的使用和免疫化学便隐性血液测试的执行
Hermann Brenner1, Sha Tao, Ulrike Haug
1Division of Clinical Epidemiology and Aging Research, German Cancer Research Center, Heidelberg, Germany. h.brenner@dkfz.de
JAMA
|December 9, 2010
概括
低剂量阿司匹林的使用显着增加了用于检测晚期结直肠瘤的免疫化学便隐性血液测试 (iFOBTs) 的灵敏度. 这种使用阿司匹林的特异性略低,但在查中显著提高敏感性.
科学领域:
- 胃肠道学和瘤学
- 诊断测试性能 诊断测试性能
- 结肠直肠癌查 结肠直肠癌查
背景情况:
- 免疫化学便隐性血液测试 (iFOBTs) 在结直肠癌查方面表现有前途.
- 低剂量阿司匹林的使用普遍存在,并可能增加胃肠道出血的风险.
研究的目的:
- 评估低剂量阿司匹林的使用如何影响两个定量IFOBT的性能.
- 在接受结直肠癌查的患者中评估iFOBT准确性.
主要方法:
- 一项涉及德国南部1979名患者 (2005-2009) 的诊断研究.
- 在低剂量阿司匹林使用者和非使用者之间比较两个iFOBT的性能指标 (灵敏度,特异性,ROC曲线).
- 包括检测晚期结直肠瘤 (癌症或晚期腺瘤).
主要成果:
- 在阿司匹林使用者的10.3%和非使用者的10.4%中发现了先进的瘤.
- 与非使用者 (P=.001) 相比,阿司匹林使用者的iFOBT敏感性明显更高 (例如,70.8%与35.9%相比).
- 用户的特异性略低 (例如,85.7%与89.2%相比),ROC AUC在用户中更高,特别是男性.
结论:
- 低剂量阿司匹林的使用与与iFOBTs检测晚期结肠直肠瘤的显著更高的敏感性有关.
- 低剂量阿司匹林使用时,iFOBTs的特异性仅略有降低.
- 研究结果表明,阿司匹林使用会影响结肠直肠癌查中的iFOBT性能.
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