Association Between Early Stage Colon Neoplasms and False-negative Results From the Fecal Immunochemical Test
Association Between Early Stage Colon Neoplasms and False-negative Results From the Fecal Immunochemical Test
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DOI：
10.1016/j.cgh.2013.01.013
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发表时间：
2013-07-01
影响因子：
12.6
通讯作者：
Wu, Ming-Shiang
中科院分区：
文献类型：
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作者：
Chiu, Han-Mo;Lee, Yi-Chia;Wu, Ming-Shiang
背景与目的：粪便免疫化学试验（FIT）可以识别晚期结直肠肿瘤患者，但它也有很高的假阴性率。这将有助于描述FIT无法检测到的结直肠肿瘤，以帮助开发新的检测方法。我们的特点是结直肠肿瘤的患者有阴性结果的FIT.METHODS：我们分析了数据，从18,296名受试者的结肠镜检查和FIT在健康管理中心的国立台湾大学医院从2005年9月至2010年9月的结直肠癌。我们确定了4045例结直肠肿瘤患者（3385例非晚期腺瘤，632例晚期腺瘤，28例癌症）。我们分析了FIT在识别这些患者时的灵敏度，沿着病变大小、位置和形态的信息。FIT识别非晚期腺瘤、晚期腺瘤和癌症患者的敏感性值为10.6%（95%置信区间[CI]，10.2%-12.3%）、28.0%（95% CI，24.6%-31.7%）和78.6%（95% CI，58.5%-91.0%）。FIT检测近端进展期腺瘤和非息肉样病变的敏感性低于远端进展期腺瘤;在检测腺瘤方面，FIT的假阴性率较高
BACKGROUND & AIMS: The fecal immunochemical test (FIT) can identify patients with advanced colorectal neoplasms, but it also has a high rate of false-negative results. It would be helpful to characterize colorectal neoplasms that are not detected by FIT to aid in development of new tests. We characterized colorectal neoplasms from patients who had negative results from the FIT.METHODS: We analyzed data from 18,296 subjects who were screened for colorectal cancer by colonoscopy and the FIT at the Health Management Center of National Taiwan University Hospital from September 2005 through September 2010. We identified 4045 subjects with colorectal neoplasms (3385 with nonadvanced adenomas, 632 with advanced adenomas, and 28 with cancer). We analyzed the sensitivity of the FIT in identifying these patients, along with information on lesion size, location, and morphology.RESULTS: The FIT identified patients with nonadvanced adenomas, advanced adenomas, and cancer with sensitivity values of 10.6% (95% confidence interval [CI], 10.2%-12.3%), 28.0% (95% CI, 24.6%-31.7%), and 78.6% (95% CI, 58.5%-91.0%), respectively. The FIT detected proximal advanced adenomas and nonpolypoid lesions with lower levels of sensitivity than distal advanced adenomas; it had a high false-negative rate in detection of adenomas