The performance of three-sample qualitative immunochemical fecal test to detect colorectal adenoma and cancer in gastrointestinal outpatients: an observational study.
The performance of three-sample qualitative immunochemical fecal test to detect colorectal adenoma and cancer in gastrointestinal outpatients: an observational study.
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DOI：
10.1371/journal.pone.0106648
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Li JN
中科院分区：
文献类型：
--
作者：
Wu D;Luo HQ;Zhou WX;Qian JM;Li JN
重复定性粪便免疫化学检测（qlFIT）是一种广泛用于检测下消化道病变的临床策略，但其在结直肠肿瘤机会性筛查中的诊断能力尚未得到评估。本研究旨在确定三样本 qlFIT 在高危参与者筛查结直肠癌及其癌前病变中的表现。 513 名胃肠门诊患者在标准结肠镜检查前获得了 3 份 qlFIT。我们评估了作为阳性阈值的 1 个、2 个和 3 个阳性 qlFIT 的诊断价值。还确定了结直肠肿瘤产生阳性 qlFIT 的危险因素。 52名患者被诊断为结直肠癌，70名患者被诊断为晚期腺瘤性息肉。对于结直肠癌，一项阳性 qlFIT 的敏感性和特异性分别为 90.4% 和 53.8%，两项阳性 qlFIT 的敏感性和特异性分别为 80.8% 和 75.1%，三项阳性的敏感性和特异性分别为 53.9% 和 88.5%。对于晚期腺瘤性息肉，一项qlFIT阳性的敏感性和特异性分别为81.4%和54.2%，两项qlFIT阳性的敏感性和特异性分别为50.0%和72.5%，三项阳性的敏感性和特异性分别为28.6%和86.2%。左侧位置（OR 2.50，95% CI 1.26–4.95）和肿瘤的晚期组织学（OR 3.08，95% CI 1.58–6.01）与阳性 qlFIT 独立相关。三样本 qlFIT 是检测高危人群结直肠肿瘤的一种相当好的方法。左侧肿瘤或具有晚期病理特征的肿瘤更有可能产生阳性 qlFIT。
Repeated qualitative fecal immunochemical test (qlFIT) is a clinical strategy widely used to detect lower gastrointestinal lesions, but its diagnostic power has not been assessed in opportunistic screening for colorectal neoplasia. This study aimed to determine the performance of three-sample qlFIT in screening for colorectal cancer and its precursors in high-risk participants. 513 gastrointestinal outpatients yielded three qlFITs before a standard colonoscopy. We evaluated the diagnostic value of one, two, and three positive qlFITs serving as the positivity threshold. The risk factors of colorectal neoplasia to yield positive qlFITs were also determined. 52 patients were diagnosed with colorectal cancer and 70 with advanced adenomatous polyp. For colorectal cancer, the sensitivity and specificity of one positive qlFIT were 90.4% and 53.8%, of two were 80.8% and 75.1%, and of three were 53.9% and 88.5%, respectively. For advanced adenomatous polyp, the sensitivity and specificity of one positive qlFIT were 81.4% and 54.2%, of two were 50.0% and 72.5%, and of three were 28.6% and 86.2%. Left-sided location (OR 2.50, 95%CI 1.26–4.95) and advanced histology of tumors (OR 3.08, 95%CI 1.58–6.01) were independently associated with positive qlFITs. Three-sample qlFIT is a reasonably good method to detect colorectal neoplasia in high-risk population. Tumors in the left side or with advanced pathological features are more likely to produce positive qlFITs.
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影响因子：
39.2
作者：
Hundt, Sabrina;Haug, Ulrike;Brenner, Hermann
通讯作者：
Brenner, Hermann
影响因子：
24.5
作者：
Senore, Carlo;Ederle, Andrea;Segnan, Nereo
通讯作者：
Segnan, Nereo
影响因子：
7.6
作者：
Rozen, P.;Levi, Z.;Niv, Y.
通讯作者：
Niv, Y.
影响因子：
8.4
作者：
Faivre, J.;Dancourt, V.;Bretagne, J. F.
通讯作者：
Bretagne, J. F.
影响因子：
7.6
作者：
Hazazi, R.;Rozen, P.;Niv, Y.
通讯作者：
Niv, Y.