在新西兰肠道查试点中,经过负面便免疫化学测试后的间隔结肠直肠癌
Kai Sheng Saw1, Kerry Sexton2, Paul Frankish3
1Department of Surgery, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand kai.saw@auckland.ac.nz.
BMJ open gastroenterology
|November 25, 2023
概括
便免疫化学测试 (FIT) 显示了对结直肠癌 (CRC) 查的良好诊断性能. 然而,FIT间隔CRC病例,通常是近位瘤,结果较差,表明需要改进检测策略.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 公共卫生查 公共卫生查
背景情况:
- 新西兰肠道查试点 (BSP) 使用定量便免疫化学测试 (FIT) 检测结直肠癌 (CRC).
- 了解与FIT查相关的诊断性能和结果对于优化CRC检测程序至关重要.
研究的目的:
- 评估FIT在BSP中的诊断准确性.
- 在查轮 (FIT-间隔CRC) 之间诊断出结直肠癌的风险因素.
- 在BSP中描述被诊断患有CRC的参与者的长期生存率.
主要方法:
- 从BSP和新西兰癌症登记处收集的前性数据的回顾性分析.
- 包括在2012-2017年期间使用FIT (阳性值15μg Hb/g) 进行查的387,215名受邀个人.
- 后勤回归用于识别与FIT间隔CRC相关的因素 (在负FIT的24个月内诊断).
主要成果:
- 对CRC的FIT总体敏感度为78.7%,特异性为94.1%.
- 在520个CRC中,有111个 (21.3%) 被归类为FIT间隔CRC,在大多数情况下无法检测到便Hb.
- FIT间隔CRC与近位位置,晚期,高度瘤和较差的整体存活率有关.
结论:
- 与现有文献相比,BSP的FIT选显示出良好的灵敏度和特异性.
- 结直肠癌的FIT间隔存在挑战,原因是它们的近位位置和相关的长期不良结果.
- 减少FIT间隔CRC发生率和改善患者结果的策略需要进一步研究.
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