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首页> 外文期刊>GMS Health Technology Assessment >Tests detecting biomarkers for screening of colorectal cancer: What is on the horizon?
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Tests detecting biomarkers for screening of colorectal cancer: What is on the horizon?

机译：测试检测生物标志物以筛查大肠癌的方法：即将出现什么？

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Aim: To identify new and emerging screening tests for colorectal cancer (CRC) that involves detection of various biomarkers like blood, DNA and RNA in samples of faeces, tissue or blood. Current practice: Screening for CRC can be done by bowel visualisation techniques and tests that measure biomarkers. The Bowel Cancer Screening Programme (BCSP) in England uses a guaiac faecal occult blood test. Methods: The strategy was to search available literature, identify developers and contact them for relevant information. Advice from experts was sought on potential utility and likely impact of identified technologies on the BCSP.Results: Ninety-three companies and five research groups were contacted. Sixty-nine relevant tests were identified. Detailed information was available for 48 tests, of these 73% were CE marked and the remainder were considered as emerging. Forty-nine tests use immunochemical methods to detect occult blood in faeces. Eight, four and two tests detect biomarkers in a sample of blood, or exfoliated cells either shed in faeces or collected from rectal mucosa respectively. Six tests were grouped as ‘other tests’. Most of the identified tests are performed manually and give qualitative detection of biomarkers. Conclusion: Variation in test performance and characteristics was observed amongst the 69 identified tests. Automated, quantitative FIT with a variable cut off are the preferred approach in the BSCP. However the units used to report FITs results do not enable comparison across products. Tests detecting biomarkers other than occult blood are more specific to neoplasms but have limited sensitivity due to the heterogeneity of cancer. Research is ongoing to identify an optimal panel of biomarkers, simplifying and automating the test, and reducing the cost.
机译：目的：确定大肠癌（CRC）的新兴筛查测试，涉及检测粪便，组织或血液样本中的各种生物标志物，例如血液，DNA和RNA。目前的实践：CRC的筛查可以通过肠道可视化技术和测量生物标志物的测试来完成。英格兰的肠癌筛查计划（BCSP）使用了愈创木脂粪便潜血测试。方法：策略是搜索可用的文献，识别开发人员并联系他们以获取相关信息。征求了专家的建议，以了解潜在的实用性以及已确定的技术可能对BCSP产生的影响。结果：与93家公司和5个研究小组进行了联系。确定了69个相关测试。目前有48项测试的详细信息，其中73％带有CE标记，其余被认为是新兴的。四十九项测试使用免疫化学方法检测粪便中的隐血。八项，四项和两项测试分别检测了从粪便中脱落或从直肠粘膜收集的血液或脱落细胞中的生物标志物。六个测试被归类为“其他测试”。大多数确定的测试是手动执行的，并可以对生物标志物进行定性检测。结论：在69个已鉴定的测试中观察到测试性能和特征的变化。在BSCP中，首选自动，定量FIT和可变截止值。但是，用于报告FIT结果的单位无法进行产品之间的比较。检测隐性血液以外的生物标志物的测试对肿瘤更具特异性，但由于癌症的异质性，灵敏度有限。正在进行研究以鉴定最佳的生物标记物组，简化和自动化测试并降低成本。

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