在症状和查患者中检测结肠直肠癌的重复便免疫化学测试:系统性审查和元分析
Adam D Gerrard1,2, Roberta Garau1,2, Wei Xu1,3
1Cancer Research UK Scotland Centre, Institute of Genetics and Cancer, The University of Edinburgh, Edinburgh EH4 2XR, UK.
重复的便免疫化学测试 (FIT) 显著增加了结直肠癌 (CRC) 和晚期结直肠瘤 (ACRN) 的检测. 双FIT策略在诊断CRC方面表现出非常高的灵敏度,特别是在症状患者中.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 诊断医学 诊断医学
背景情况:
- 便免疫化学测试 (FIT) 是结直肠癌 (CRC) 查和患者症状评估的基石.
- 虽然单个FIT的性能已经很成熟,但重复测试以提高灵敏度的好处仍然不清楚.
研究的目的:
- 用额外的FIT来评估测试阳性的增加.
- 为了确定是否重复FIT检测错过的CRC和先进的结直肠瘤 (ACRN).
- 估计用于诊断CRC和ACRN的双FIT策略的敏感性.
主要方法:
- 在 MEDLINE,EMBASE 和 CENTRAL 的系统文献搜索.
- 包括报告单一轮或症状发作中多次FIT的研究.
- 根据患者群体对研究的分类:无症状,混合或有症状.
主要成果:
- 在10μg Hb/g下,第二次FIT增加了3-9.2个百分点的阳性,识别了额外的CRC病例,并将错过的CRC减少了至少50%.
- 在20μg Hb/g下,第二次FIT增加了1.3-6.7个百分点的阳性,在大多数研究中,错过的CRC减少了25%.
- 混合和症状队列中对CRC的双FIT敏感性估计分别为94%和98%在10μg Hb/g时.
结论:
- 重复使用FIT可以提高CRC的诊断,并适度增加阳性.
- 双FIT策略,特别是10μg Hb/g,在混合和有症状的人群中为CRC检测提供了非常高的灵敏度.
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