Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results
Hemorrhoids detected at colonoscopy: an infrequent cause of false-positive fecal immunochemical test results
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DOI：
10.1016/j.gie.2012.03.169
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发表时间：
2012-07-01
影响因子：
7.7
通讯作者：
van Rossum, Leo G. M.
中科院分区：
文献类型：
--
作者：
van Turenhout, Sietze T.;Oort, Frank A.;van Rossum, Leo G. M.
背景资料：通过粪便免疫化学试验（FIT）进行结直肠癌筛查受到频繁的假阳性（FP）结果的阻碍，因此存在并发症和结肠镜检查能力紧张的风险。痔疮可能是FP结果的合理原因。目的：确定痔疮对FP FIT结果频率的贡献。设计：前瞻性队列研究的回顾性分析。设置：五家大型教学医院，包括一家学术医院。患者：所有计划进行择期结肠镜检查的受试者。干预措施：肠道准备前的FIT。主要结果测量：与FP FIT在无相关异常的受试者中的结果相比，FP FIT在痔疮受试者中的结果频率是唯一相关异常。Logistic回归分析，以确定结肠异常影响FP结果。结果：在2855例患者中，434例FIT结果阳性：213例晚期肿瘤和221例FP结果。在FP FIT结果的9名个体（4.1%; 95% CI，1.4-6.8）中，痔疮是唯一的异常。在单变量未校正分析中，与无任何异常的受试者（43/886; 4.9%; P = 0.396）相比，痔疮作为唯一异常的受试者（9/134; 6.7%）的阳性结果并不更多。Logistic回归分析确定了痔疮、非晚期息肉和一组其他异常，这些都显著影响假阳性率。1000名受试者与痔疮，67将FP结果，其中18人将FP结果，因为hemorrhoids only.Limitations：潜在的漏报痔疮;高危individual.Conclusions：痔疮在个人参与结直肠癌筛查可能不会导致大量的假阳性检测结果。（Gastrointest Endosc 2012;76：136-43.）
Background: Colorectal cancer screening by fecal immunochemical tests (FITs) is hampered by frequent false-positive (FP) results and thereby the risk of complications and strain on colonoscopy capacity. Hemorrhoids might be a plausible cause of FP results.Objective: To determine the contribution of hemorrhoids to the frequency of FP FIT results.Design: Retrospective analysis from prospective cohort study.Setting: Five large teaching hospitals, including 1 academic hospital.Patients: All subjects scheduled for elective colonoscopy.Interventions: FIT before bowel preparation.Main Outcome Measurements: Frequency of FP FIT results in subjects with hemorrhoids as the only relevant abnormality compared with FP FIT results in subjects with no relevant abnormalities. Logistic regression analysis to determine colonic abnormalities influencing FP results.Results: In 2855 patients, 434 had positive FIT results: 213 had advanced neoplasia and 221 had FP results. In 9 individuals (4.1%; 95% CI, 1.4-6.8) with an FP FIT result, hemorrhoids were the only abnormality. In univariate unadjusted analysis, subjects with hemorrhoids as the only abnormality did not have more positive results (9/134; 6.7%) compared with subjects without any abnormalities (43/886; 4.9%; P = .396). Logistic regression identified hemorrhoids, nonadvanced polyps, and a group of miscellaneous abnormalities, all significantly influencing false positivity. Of 1000 subjects with hemorrhoids, 67 would have FP results, of whom 18 would have FP results because of hemorrhoids only.Limitations: Potential underreporting of hemorrhoids; high-risk individuals.Conclusions: Hemorrhoids in individuals participating in colorectal cancer screening will probably not lead to a substantial number of false-positive test results. (Gastrointest Endosc 2012;76:136-43.)