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首页> 外文期刊>European journal of gastroenterology and hepatology >Screening for familial colorectal cancer with a sensitive immunochemical fecal occult blood test: a pilot study.
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Screening for familial colorectal cancer with a sensitive immunochemical fecal occult blood test: a pilot study.

机译：用敏感的免疫化学粪便潜血试验筛查家族性大肠癌：一项初步研究。

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OBJECTIVE: Colonoscopy is empirically recommended as the first choice screening strategy in first-degree relatives of patients with colorectal cancer (CRC). However, this strategy is accepted by less than 40% of the risk population and two-thirds of screened individuals and renders a normal exploration. This pilot study assessed the accuracy of a latex agglutination immunochemical fecal occult blood test (LA-FOBT) for detecting advanced colorectal neoplasm (cancer or adenomatous polyps > or =1 cm in size, with villous pattern or high grade dysplasia) in asymptomatic first-degree relatives of patients with CRC. METHODS: One hundred and sixty-nine first-degree relatives of 135 index cases were prospectively included. All participants received a sensitive LA-FOBT (hemoglobin detection limit of 50 ng/ml buffer), and were invited to undergo colonoscopy. On the whole, 116 (69%) participants returned LA-FOBT and underwent colonoscopy. RESULTS: LA-FOBT was positive in 19 of 116 (16%) cases. Colonoscopy detected neoplasms in 49 of 116 (42%) patients: 37 of 116 (32%) were nonadvanced adenomas and 12 of 116 (10%) advanced adenomas. LA-FOBT detected 10 of 12 (83%) advanced adenomas showing a sensitivity, specificity, positive predictive value, and negative predictive value of 83, 91, 53, and 98%, respectively. In patients with positive LA-FOBT, 1.9 colonoscopies were necessary for detecting one advanced adenoma, whereas in case of not performing this test 10 colonoscopies would be needed. Overall, approximately 80% of screening colonoscopies could be precluded using a LA-FOBT. CONCLUSION: One-time screening with LA-FOBT successfully detects advanced colorectal adenomas and may save unnecessary colonoscopies in first-degree relatives of patients with CRC.
机译：目的：根据经验，建议将结肠镜检查作为结直肠癌（CRC）患者一级亲属的首选筛查策略。但是，只有不到40％的风险人群和三分之二的受筛查者接受了这种策略，因此可以正常进行探索。这项前瞻性研究评估了乳胶凝集免疫化学粪便潜血试验（LA-FOBT）在无症状的首发性结肠癌中检测晚期大肠肿瘤（癌性或腺瘤性息肉>或= 1厘米大小，具绒毛状或高度不典型增生）的准确性。 CRC患者的近亲属。方法：前瞻性纳入135例索引病例的169名一级亲属。所有参与者均接受了敏感的LA-FOBT（血红蛋白检测极限为50 ng / ml缓冲液），并应邀接受结肠镜检查。总体上，有116名（69％）参与者返回了LA-FOBT并接受了结肠镜检查。结果：LA-FOBT在116例病例中有19例阳性（16％）。结肠镜检查在116例患者中有49例（42％）肿瘤：116例中37例（32％）为非晚期腺瘤，116例中12例（10％）为晚期腺瘤。 LA-FOBT检测出12个晚期腺瘤中的10个（83％），其敏感性，特异性，阳性预测值和阴性预测值分别为83％，91％，53％和98％。在LA-FOBT阳性的患者中，需要进行1.9例结肠镜检查才能检测出一种晚期腺瘤，而如果不进行此项检查，则需要10例结肠镜检查。总体而言，使用LA-FOBT可以排除大约80％的结肠镜检查筛查。结论：一次LA-FOBT筛查成功地检测了晚期大肠腺瘤，并可能为CRC患者的一级亲属节省不必要的结肠镜检查。

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