阴性便免疫化学测试是否令人放心? 在多次阴性测试后结肠直肠癌的累积风险
Chi Pang Wen1,2,3, Min Kuang Tsai4, Christopher Wen5
1Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.
Gut and liver
|October 21, 2025
概括
阴性便免疫化学测试 (FIT) 结果并不能消除结直肠癌 (CRC) 风险,因为三分之二的10年风险仍然存在. 持续两年一次的FIT查对于监测CRC风险和降低死亡率至关重要.
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:
- 大肠直肠癌 (CRC) 的基线风险约为0.1%.
- 便免疫化学测试 (FIT) 用于CRC查,确定约5%的个体为阳性.
- 对于随后的CRC风险,负FIT结果的保证价值尚未完全确定.
研究的目的:
- 为了评估长期结肠直肠癌 (CRC) 风险,在便免疫化学测试 (FIT) 呈阴性结果后.
- 评估反复出现负FIT结果对CRC发病率和全因死亡率的影响.
- 在最初的负面FIT结果后,确定是否需要继续每两年进行一次选.
主要方法:
- 对141,982名年龄≥50岁的台湾人进行了回顾性队列研究,接受了查 (1994-2008).
- 通过国家癌症登记册和国家死亡档案识别的CRC病例和死亡.
- 负FIT定义为<20μg Hb/g;反复两年一次的查分析.
主要成果:
- 一个负的FIT将CRC发病率降低了63% (1.27到0.80/1000人年).
- 10年CRC风险的三分之二在一次负FIT后仍然存在;风险在2年后再次出现.
- 重复负面的FIT和持续负面的结果显著降低了CRC风险和所有原因的死亡率.
- 在5轮查中,84%的队列在5轮查中始终呈负FIT结果.
结论:
- 一个单一的负FIT结果不足以排除长期的CRC风险.
- 持续两年一次的FIT查是必不可少的,因为CRC风险在负测试后大约2年重新出现.
- 持续负面的FIT结果与显著降低的CRC风险和改善的生存结果有关.
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