J Gastroen Hepatol:常见结肠癌筛查方法的比较

2017-07-27 zhangfan MedSci原创

研究发现,现有的3种常见结肠癌确诊方法表现出不同疾病确诊准确度,在众多的单独或联合方法中,乙状结肠镜检查是准确度以及敏感性较好的方法

近日研究人员通过对乙状结肠镜筛查,粪便免疫化学试验(FIT),亚太地区结直肠癌筛查(APCs)系统以及这些方法组合效果的比较,以得出晚期大肠癌筛查(ACRN)的最佳策略选择。

研究对患者结肠癌确诊结果所采用的方法进行回顾,根据不同的确诊方法分为,基于乙状结肠镜检查、基于粪便免疫化学试验以及基于APCS,考察各种方法的敏感性以及所需的结肠镜次数减少(NNScope)。

研究招募了23023名患者,其中398人(1.7%) 为晚期大肠癌。研究发现,对于病情的确诊能力,乙状结肠镜检查最为有效(比值比[OR]: 22.96, 95% CI,18.26–29.07), 其次是FIT (OR: 7.18, 95% CI,5.28–9.68) 最后为APCS (对于高风险患者:[≥4] OR: 2.59, 95% CI,1.87–3.58; 中等风险患者:[2–3] OR: 1.66, 95% CI,1.28–2.17)。研究发现,对于乙状结肠镜检查为基础的方法,仅乙状结肠镜检查阳性或乙状结肠镜检查阳性且APCS≥4是最佳方法(可减少结肠镜次数: 79–86%; 敏感性: 73–78%)。对于基于FIT的方法,FIT 阳性且 APCS ≥4是最优策略(NNScope减少: 72%; 敏感性: 37%)。对于基于APCS的方法,APCS ≥2具有较高的敏感性,APCS ≥4可减少结肠镜的次数。

研究发现,现有的3种常见结肠癌确诊方法表现出不同疾病确诊准确度,在众多的单独或联合方法中,乙状结肠镜检查是准确度以及敏感性较好的方法。

原始出处:

Yoon Suk Jung et al. Identifying the optimal strategy for screening of advanced colorectal neoplasia. J Gastroen Hepatol. April 27 2017.

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    2017-07-29 gwc384
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    2017-07-28 luominglian113

    学习了,谢谢分享

    0

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    2017-07-28 318490

    学习了

    0

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    2017-07-27 131****1460

    学习了受益匪浅

    0

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    2017-07-27 清风拂面

    谢谢分享,学习了

    0

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    2017-07-27 1e0e5a1fm42(暂无匿称)

    henhao

    0

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