Gastroenterology:粪便免疫化学试验阳性阈值敏感性的影响

2019-12-02 MedSci MedSci原创

研究发现,不同粪便免疫化学试验阳性阈值差异导致结肠癌筛查的敏感性发生显著变化

粪便免疫化学试验(FITs)常用于直肠癌(CRC)的筛查。近日研究人员就CRC和晚期腺瘤患者FIT筛查的敏感性进行了考察。

本次研究为系统综述及荟萃分析,涉及无症状患者接受CRC-FIT筛查的研究,研究人员计算了敏感性和特异性,以及检测到的癌症数量,晚期腺瘤,以及阳性阈值≤10μg血红蛋白/g粪便、10至≤20μg/g、20至≤30μg/g和>30μg/g时的结果差异。

46个研究,涉及240万参与者,其中6478名肿瘤患者。当阳性阈值范围在10-20μg/g时,FITs 用于CRC检测的敏感性为69%,而阳性阈值降低≤10μg/g时,敏感性增加至80%。阳性阈值降低≤10μg/g时,晚期腺瘤诊断的敏感性从21%提高到31%,特异性从94%下降到91%。分层研究中,男性和女性对FIT-CRC检测的敏感性分别为77%和81%。在按年龄分层的研究中,50~59岁和60~69岁人群对CRC检测的敏感性分别为85%和73%。结肠镜筛查的敏感性与2年FIT随访敏感性相当(74% vs 75%)。

研究发现,不同粪便免疫化学试验阳性阈值差异导致结肠癌筛查的敏感性发生显著变化。

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    2020-04-01 许安
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    2019-12-04 Homburg
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    2019-12-04 qjddjq

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