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Gut:基于粪便免疫化学试验的结直肠癌筛查项目长期性能如何?

2017-11-04 xing.T MedSci原创

由此可见,重复的FIT筛查可显著减轻结直肠疾病的负担,促进结肠镜检查资源的有效利用。五轮FIT试验累积检出率与结肠镜检查的初级筛查相似,这一结果支持在评估试验效能时考虑到重复FIT的累积敏感性。

基于2年粪便免疫化学试验(FIT)的结直肠癌(CRC)筛查项目长期性能仍不明确。近日,消化病领域权威杂志Gut上针对这一问题发表了一篇研究文章。

在50岁到69岁的个体组成的样本采用FIT(OC透析乳胶凝集试验;临界值为20 µg血红蛋白/g粪便)进行反复筛查,研究人员评估了:(1)在每一轮的筛查中,FIT试验的阳性率、CRC和晚期腺瘤的检出率以及FIT试验对晚期肿瘤的阳性预测值(PPV),(2)经过五轮FIT试验累计CRC和晚期腺瘤的检出率。

在12年间(2002年-2014年),123347名参与者进行了高达六次的FIT筛查,其中781例CRCs和4713例晚期腺瘤患者被诊断。从第一轮到第三轮(率比(RR)为0.25,95%可信区间为 0.20-0.32)和到第二轮(RR为0.51,95%可信区间为0.47-0.56 ),CRC和晚期腺瘤检出率大幅下降轮,然后保持稳定。在第二轮筛查中,晚期肿瘤的PPV下降了18%(RR为0.82,95%可信区间为0.77-0.89),没有进一步的降低,由于FIT的阳性率随之下降(从第一轮至第六轮FIT的RR为0.56,95%可信区间为0.53-0.60)。连续五轮筛查累积的CRC和晚期腺瘤的检出率分别为8.5‰(95%可信区间为7.8-9.2)和58.9‰(95%可信区间为56.9-61)。

由此可见,重复的FIT筛查可显著减轻结直肠疾病的负担,促进结肠镜检查资源的有效利用。五轮FIT试验累积检出率与结肠镜检查的初级筛查相似,这一结果支持在评估试验效能时考虑到重复FIT的累积敏感性。

原始出处:

Manuel Zorzi,et al. Long-term performance of colorectal cancer screening programmes based on the faecal immunochemical test. Gut. 2017. http://dx.doi.org/10.1136/gutjnl-2017-314753

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    2021-05-21 msqsky

    不错的研究

    0

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    2017-11-08 微分

    学习了谢谢了

    0

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    2017-11-06 1dd8c52fm63(暂无匿称)

    学习学习.继续关注

    0

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    2017-11-06 Homburg

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