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在牛津-FIT数据集中对COLOFIT结肠直肠癌风险预测模型的外部验证:人口特征和临床相关评估指标的重要性
Andres Tamm1,2, Brian Shine3, Tim James3
1Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK. andres.tamm@phc.ox.ac.uk.
BMC medicine
|August 27, 2025
概括
结合便免疫化学测试 (FIT) 和其他数据的COLOFIT模型显示,有可能减少结直肠癌 (CRC) 的转诊. 然而,它的有效性各不相同,需要仔细考虑FIT正值和CRC率以实现最佳实施.
科学领域:
- 癌症学
- 胃肠病学
- 临床诊断
背景情况:
- 便免疫化学测试 (FIT) ≥10μg/g是英国诊断症状结直肠癌 (CRC) 患者的标准.
- COLOFIT模型将FIT结果与人口统计和血液测试相结合,以完善CRC的转诊决定.
- 这项研究旨在利用现实数据对COLOFIT模型的性能进行外部验证.
研究的目的:
- 在初级保健中对结直肠癌 (CRC) 风险评估进行外部验证.
- 与标准FIT值相比,评估COLOFIT模型的校准和预测精度.
- 评估在保持癌症检测率的同时,可能减少不必要的转诊.
主要方法:
- 使用了来自牛津大学医院 (OUH) 的51477名CRC随访者的数据.
- 包括FIT结果,人口统计数据和血液测试作为COLOFIT模型的预测因素.
- 在不同时间段对COLOFIT方程进行了外部验证,并估计了转诊降低值.
主要成果:
- COLOFIT显示了可变的校准 (O/ E比率整体为1. 52,随着时间的推移改进到1. 09).
- 与FIT≥10μg/ g相比,该模型减少了没有缺失结直肠癌 (CRC) 的整体转诊率8%.
- 根据评估期和人群特征,推率大幅下降 (23%下降至2%增加).
结论:
- COLOFIT模型的实用性取决于FIT阳性率 (≥17%) 和CRC流行率 (1.3-1.6%).
- 临床采用需要仔细考虑局部检测量和患者症状概况.
- 建议在不同人群中进行进一步验证,以优化其在结直肠癌诊断途径中的作用.
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