Sensitivity, but Not Specificity, of a Quantitative Immunochemical Fecal Occult Blood Test for Neoplasia Is Slightly Increased by the Use of Low-Dose Aspirin, NSAIDS, and Anticoagulants
Sensitivity, but Not Specificity, of a Quantitative Immunochemical Fecal Occult Blood Test for Neoplasia Is Slightly Increased by the Use of Low-Dose Aspirin, NSAIDS, and Anticoagulants
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DOI：
10.1038/ajg.2009.14
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发表时间：
2009-04-01
影响因子：
9.8
通讯作者：
Niv, Yaron
中科院分区：
文献类型：
--
作者：
Levi, Zohar;Rozen, Paul;Niv, Yaron
目的：我们评估了使用阿司匹林，非甾体抗炎药（NSAIDS）和抗凝剂对免疫化学粪便潜血试验（I-FOBT）的性能的影响。方法：一项前瞻性，横断面研究1,221例门诊患者准备三个I-FOBT后进行全结肠镜检查。从健康医疗组织（HMO）数据库中收集有关药物使用的信息。I-FOBT与OC-MICRO仪器分析，使用缓冲阈值>= 75和100 ngHb/ml来确定positive.RESULTS：结直肠癌（CRC）17例，晚期腺瘤性息肉（AAP）97例。在I-FOBT测试时，共有212名患者正在使用阿司匹林/NSAIDS。AAP/CRC检测的定性分析揭示了阿司匹林/NSAIDS使用敏感性增加的趋势。在75 ng/ml的阳性阈值下，阿司匹林/NSAIDS使用者检测AAP/CRC的灵敏度为66.7%，而非药物使用者为51.2%（P = 0.20），在100 ng/ml的阈值下，灵敏度为66.7 vs. 46.5%（P = 0.09）。然而，特异性不受阿司匹林/NSAIDS使用的影响。在75 ng/ml阳性阈值时，阿司匹林/NSAIDS使用者检测AAP/CRC的特异性为89.5%，而非药物使用者为91.2%（P = 0.47），在100 ng/ml阈值时，特异性为92.17 vs. 93.0%（P = 0.69）。在I-FOBT检测时，共有33例患者正在使用抗血栓药物/凝血剂。这个群体很小;然而，似乎它们的使用也与敏感性增加的趋势相关，而特异性没有变化。结论：阿司匹林/NSAIDS和抗凝剂的使用与AAP/CRC检测的敏感性增加的趋势相关，而特异性没有变化。这项研究表明，在I-FOBT测试之前没有必要停止这些药物。
OBJECTIVES: We evaluated the effect of the use of aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS), and anticoagulants on the performance of immunochemical fecal occult blood test (I-FOBT).METHODS: A prospective, cross-sectional study of 1,221 ambulatory patients having total colonoscopy after preparing three I-FOBTs. Information regarding the use of medications was collected from the health medical organization (HMO) database. I-FOBT was analyzed with the OC-MICRO instrument using both >= 75 and 100 ngHb/ml of buffer thresholds to determine positivity.RESULTS: Colorectal cancer (CRC) was found in 17 and advanced adenomatous polyp (AAP) in 97 patients. A total of 212 patients were using aspirin/NSAIDS at the time of I-FOBT testing. Qualitative analysis for the detection of AAP/CRC reveals a trend for an increased sensitivity with aspirin/NSAIDS use. At the threshold 75 ng/ml for positivity, the sensitivity for the detection of AAP/CRC was 66.7% for aspirin/NSAIDS use vs. 51.2% for nondrug takers (P = 0.20), and at the threshold of 100 ng/ml, the sensitivity was 66.7 vs. 46.5% (P = 0.09). The specificity, however, was not affected by the use of aspirin/NSAIDS. At the threshold of 75 ng/ml for positivity, the specificity for the detection of AAP/CRC was 89.5% for aspirin/NSAIDS use vs. 91.2% for nondrug takers (P = 0.47), and at the threshold of 100 ng/ml, the specificity was 92.17 vs. 93.0% (P = 0.69). A total of 33 patients were using antithrombotics/coagulants at the time of I-FOBT testing. This group was small; however, it appears that their use was also associated with a trend for increased sensitivity and no change in specificity.CONCLUSIONS: The use of aspirin/NSAIDS and anticoagulants was associated with a trend for increased sensitivity with no change in specificity for the detection of AAP/CRC. This study suggests that there is no need to stop these agents before I-FOBT testing.