在症状结肠镜检查中FIT选的现实性能:英国国家内镜数据库 (NED) 的分析
David Beaton1,2, Mahmoud Mohamed3, Linda Sharp2
1Northumbria NHS Foundation Trust, North Shields, UK.
Alimentary pharmacology & therapeutics
|January 28, 2026
概括
便免疫化学测试 (FIT) 有效地对英国的症状结肠镜转诊进行分类. 10或更高的FIT水平可以识别高风险患者,显著提高癌症检测率.
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:
- 英国使用便免疫化学测试 (FIT) 进行选症状患者,转诊结肠镜检查.
- 这种方法旨在优化结直肠疾病的诊断途径.
研究的目的:
- 在症状结肠镜检查中量化FIT的诊断产量.
- 评估FIT,年龄,性别和症状对检测聚和癌症的影响.
- 为了评估基于症状的转诊与基于症状的转诊相比,基于FIT的分组的有效性.
主要方法:
- 从国家内镜数据库 (2023年6月至2025年8月) 收集的前性结肠镜报告的全国性分析.
- 包括症状性手术,包括铁缺乏性贫血 (IDA) 的手术.
- 混合效应物流回归和后估计边际被用于基于FIT水平,年龄和症状的癌症产量模型.
主要成果:
- 对447109次症状结肠镜检查的分析显示,总体癌症产量为1.9%.
- FIT水平≥10与3.8%的癌症产量相关,尤其是年轻年龄组的癌症产量更高 (例如,在40-49岁的人群中为2.5%).
- FIT <10显示癌症产量显著降低 (0.3%). 缺铁性贫血 (IDA) 与癌症风险增加有关 (aOR 2.2).
- 结合FIT,年龄和IDA的组合模型检测到超过94%的癌症,并减少了超过40%的结肠镜需求.
结论:
- 基于FIT的分组优于基于症状的转诊进行症状结肠镜检查.
- FIT ≥10有效地识别高风险个体,包括年龄在40-49岁的人,进行紧急调查.
- FIT <10表明结直肠癌的风险非常低,允许潜在的诊断强度降低.
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