Stool Based Testing for Colorectal Cancer: an Overview of Available Evidence
Stool Based Testing for Colorectal Cancer: an Overview of Available Evidence
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DOI：
10.1007/s11894-017-0579-4
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发表时间：
2017-07
影响因子：
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通讯作者：
Kevin M. Rank;A. Shaukat
中科院分区：
文献类型：
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作者：
Kevin M. Rank;A. Shaukat
综述目的本综述的目的是总结结直肠癌（CRC）的粪便检测。本综述回答的关键问题是每种可用的基于粪便的 CRC 检测的优点和局限性，并检查其相对功效。最新发现基于愈创木脂的粪便潜血检测 (gFOBT) 不再是 CRC 筛查的相关测试。粪便免疫化学检测（FIT）检测，尤其是定量检测，显然是一种可靠的粪便检测。多目标 DNA (mtsDNA) 粪便检测也可能是一种可行的选择，尽管成本和测试特征尚未完全确定。总结FIT 和 mtsDNA 代表了基于粪便的 CRC 筛查的选择。在较大的筛查中心，定量 FIT 检测是粪便检测的一个有吸引力的选择。定性 FIT 适用于较小的中心。尽管大型验证试验显示了 mtsDNA 有希望的结果，但与 FIT 进行的进一步的头对头试验将有助于确定 mtsDNA 的最终作用。然而，最终，CRC 筛查的最佳测试是基于粪便的 CRC 筛查，作为初始或替代选择可以增加 CRC 筛查的参与度。
Purpose of ReviewThe goal of this review is to summarize stool-based testing for colorectal cancer (CRC). The key questions answered in this review were the advantages and limitations of each available stool-based test for CRC and to examine their comparative efficacy.Recent FindingsGuaiac-based fecal occult blood testing (gFOBT) is no longer a relevant test for CRC screening. fecal immunochemical testing (FIT) tests, especially quantitative assays, are clearly a reliable stool-based test. Multitarget DNA (mtsDNA) stool testing may represent a viable option as well, although cost and test characteristics are yet fully defined.SummaryFIT and mtsDNA represent the options for stool-based CRC screening. In larger screening centers, quantitative FIT assays represent an attractive option for stool-based testing. Qualitative FIT has applicability in smaller centers. Although a large validation trial showed promising results for mtsDNA, further head-to-head trials with FIT will help define the ultimate role of mtsDNA. Ultimately, however, the best test for CRC screening is the one performed stool-based CRC screening as an initial or alternative option can increase participation in CRC screening.