Comparative evaluation of nine faecal immunochemical tests for the detection of colorectal cancer
Comparative evaluation of nine faecal immunochemical tests for the detection of colorectal cancer
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DOI：
10.3109/0284186x.2013.789141
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发表时间：
2013-11-01
期刊：
影响因子：
3.1
通讯作者：
Brenner, Hermann
中科院分区：
文献类型：
--
作者：
Tao, Sha;Seiler, Christoph M.;Brenner, Hermann
背景血红蛋白的粪便免疫化学试验（FIT）越来越多地用于结直肠癌（CRC）的非侵入性筛查，但用于检测CRC的不同FIT的大规模比较研究（总体和分期）很少。我们的目的是确定和比较不同的FIT检测CRC的性能，并评估其阶段特异性的灵敏度。材料和方法。我们评估了敏感性，特异性和相应的95%的置信区间为6定性FIT 74例结直肠癌（59%的I期或II期癌症）和1480例对照组无结直肠肿瘤。整体和特定阶段的接收器操作特性曲线，推导出三个定量的FIT。计算并比较曲线下面积（AUC）。结果定性FIT的总体敏感性和特异性对范围分别为66%和96%至92%和62%。对于三种定量检测，AUC范围为0.90至0.92，在临界值处的灵敏度范围为80%至87%，特异性为90%。I期、II期和晚期（III期和IV期）癌症的AUC范围分别为0.85 - 0.92、0.94 - 0.96和0.86 - 0.93。在90%的特异性下，该测试检测到65%-85%的I期癌症。结论FIT在检测CRC方面的诊断性能是有希望的，尽管需要调整一些定性FIT的预定义截止值以限制筛查环境中的假阳性率。在产生90%特异性的临界水平下，定量测试检测到绝大多数CRC，即使在早期阶段。
Background. Faecal immunochemical tests (FITs) for haemoglobin are increasingly used for non-invasive screening for colorectal cancer (CRC) but large scale comparative studies of different FITs for detection of CRC, overall and by stage, are sparse. We aimed to determine and compare performance of different FITs for the detection of CRC, and to assess their stage-specific sensitivities. Material and methods. We assessed sensitivity, specificity and their corresponding 95% confidence intervals for six qualitative FITs among 74 CRC cases (59% stage I or II cancers) and 1480 controls free of colorectal neoplasm. Overall and stage-specific receiver operating characteristic curves were derived for three quantitative FITs. The areas under the curves (AUCs) were calculated and compared. Results. Pairs of overall sensitivity and specificity of the qualitative FITs ranged from 66% and 96% to 92% and 62%, respectively. For the three quantitative tests, AUCs ranged from 0.90 to 0.92, with sensitivities ranging from 80% to 87% at cut-offs yielding 90% specificity. AUCs ranged from 0.85 to 0.92, 0.94 to 0.96, and 0.86 to 0.93 for stage I, stage II and advanced stages (stage III and IV) cancers, respectively. At a specificity of 90%, the tests detected 65%-85% of stage I cancers. Conclusion. The diagnostic performance of FITs regarding detection of CRC is promising, even though the pre-defined cut-offs of some of the qualitative FITs need to be adjusted to limit false-positive rates in screening setting. At cut-off levels yielding 90% specifi city, the quantitative tests detected the vast majority of CRCs, even at early stages.