增加两便便免疫化学试验 (FIT) 切断期后结肠镜检查结果:SCREESCO随机试验的截面分析
Marcus Westerberg1, Julia Eriksson2, Chris Metcalfe3
1Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Journal of internal medicine
|June 7, 2024
概括
将便免疫化学测试 (FIT) 的切断值提高到20-40μg/g,可以更好地检测晚期瘤 (AN) 并减少不必要的结肠镜检查. 这种策略在结直肠癌查中对男性和女性都有效.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 预防医学 预防医学
背景情况:
- 便免疫化学测试 (FIT) 是结直肠癌 (CRC) 查的一个关键工具.
- 优化FIT切线对于平衡检测率和医疗保健资源利用至关重要.
研究的目的:
- 评估增加FIT截止值对结肠镜阳性和诊断准确性的影响.
- 评估更高的FIT值在识别晚期瘤 (AN) 和结直肠癌 (CRC) 的有效性.
主要方法:
- 从瑞典结肠试验 (ClinicalTrials.gov,NCT02078804) 的查中对3841名参与者的横截面分析.
- 在10,20和40μg/g的截止值分析了FIT结果.
- 对AN和CRC计算了正预测值 (PPV),范围所需的数量 (NNS),灵敏度和特异性.
主要成果:
- 将FIT切线从10μg/g增加到20μg/g和40μg/g显著增加了AN的PPV.
- 检测CRC的NNS随着更高的FIT截止值 (从41到19),大幅下降.
- 对AN的PPV在男性中始终高于女性,尽管相对敏感性和特异性在两性之间仍然相似.
结论:
- 与10μg/g的切断相比,FIT切断值为20-40μg/g的切断值提高了晚期瘤的检测.
- 更高的FIT截止值减少了所需的结肠镜检查次数,提高了结肠直肠癌查计划的效率.
- 这种方法对男性和女性都有好处,优化了查结果.
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