在有症状的患者中检测结肠直肠癌的便免疫化学测试:诊断准确性研究
Farzana Rahman1, Mihir Trivedy1,2, Christopher Rao3,4
1Barking, Havering and Redbridge University Hospitals NHS Trust, Romford RM7 0A, UK.
Diagnostics (Basel, Switzerland)
|July 29, 2023
概括
便免疫化学测试 (FIT) 对结直肠癌 (CRC) 检测表现良好,但在有症状的患者中错过了显著比例的CRC病例,这引发了对其独立使用的担忧.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 诊断的准确性 诊断的准确性
背景情况:
- 英国NHS在2020年6月为症状患者推了便免疫化学测试 (FIT),以管理COVID-19期间的诊断服务限制.
- FIT是一种非侵入性查工具,用于检测便隐性血液,这是结肠直肠癌 (CRC) 的潜在指标.
研究的目的:
- 评估FIT在疑似CRC转诊的症状患者的诊断性能.
- 确定FIT阴性CRC病例的比例,并探索缓解策略.
- 评估FIT在确定诊断调查优先级方面的作用.
主要方法:
- 追溯队列诊断准确性研究,分析生物化学和癌症数据库.
- 涉及的患者从怀疑CRC的初级护理转移到二级护理信托.
- 在检测CRC时,FIT的性能被评估为10μgHb/g的值.
主要成果:
- 在进行的7653项FIT测试中,86名患者被诊断出CRC;16.6%的CRC病例的FIT结果低于10μgHb/g的值.
- 在10μgHb/g值时,FIT表现出0.814的灵敏度和0.770的特异性.
- 很大一部分患者 (48%) 在初始评估之前完成了FIT,而22%的样本由于不足而被排除在外.
结论:
- 有关FIT合规性和FIT阴性CRC在推值时的发病率存在担忧.
- 仅仅FIT可能不足以确定所有症状患者的二级护理转诊或进一步调查.
- 虽然FIT在COVID-19期间有助于确定优先级,但其局限性需要谨慎应用,以避免错过CRC诊断.
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