Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy.
BMC Gastroenterol. 2010 May 12;10:45. doi: 10.1186/1471-230X-10-45.
Since population screening has the potential to reduce mortality from rectal cancer (RC), novel methods with improved cost-effectiveness warrant consideration. In a previous pilot study, we found that the rapid, inexpensive and non-invasive electromagnetic detection of RC is a highly specific and sensitive technique. The aim of the present prospective study was to evaluate the prediction accuracy of electromagnetic detection of RC.
304 eligible subjects were consecutively enrolled in our Institute and subjected to electromagnetic detection followed by colonoscopy and histopathologic analysis of biopsies. A putative RC carrier status was attributed to subjects showing an electromagnetic signal < 50 units (U).
RC patients showed a significantly lower electromagnetic signal (40.9 +/- 0.9 U; mean +/- S.E.) than did non-RC subjects (79.2 +/- 1.4 U; P < 2.2e-16). At a threshold < 50 U, electromagnetic detection identified 103 putative patients, whereas colonoscopy detected 108 patients, with an overlap of 91 patients between the two methods. The 15.7% false-negative rate by electromagnetic detection was brought to zero by raising the threshold value to 70 U; on the other hand, such a threshold increased the false-positive rate to 30%.
Electromagnetic detection of RC at a signal threshold < 70 U appears to eliminate false-negative results. Although colonoscopy would still be required in examining the false-positives associated with the < 70 U electromagnetic threshold, the need for this method would be reduced. Thus, electromagnetic detection represents a new accurate, rapid, simple, and inexpensive tool for early detection of RC that merits testing in large population-based programs.
由于人群筛查有可能降低直肠癌(RC)的死亡率,因此需要考虑具有更高成本效益的新方法。在之前的一项试点研究中,我们发现快速、廉价且非侵入性的电磁 RC 检测是一种高度特异和敏感的技术。本前瞻性研究的目的是评估电磁 RC 检测的预测准确性。
我们连续纳入了 304 名符合条件的受试者,对他们进行了电磁检测,随后进行了结肠镜检查和活检的组织病理学分析。将电磁信号<50 单位(U)的受试者归为疑似 RC 携带者。
RC 患者的电磁信号明显低于非 RC 患者(40.9 +/- 0.9 U;均值 +/- S.E.)(P < 2.2e-16)。电磁检测在阈值<50 U 时识别出 103 名疑似患者,而结肠镜检查发现了 108 名患者,两种方法的重叠患者为 91 名。电磁检测的 15.7%假阴性率通过将阈值提高到 70 U 降至零;另一方面,这样的阈值将假阳性率提高到 30%。
电磁 RC 检测在信号阈值<70 U 时似乎消除了假阴性结果。虽然在检查<70 U 电磁阈值相关的假阳性时仍需要进行结肠镜检查,但对这种方法的需求将会减少。因此,电磁检测代表了一种新的准确、快速、简单且廉价的 RC 早期检测工具,值得在大型基于人群的项目中进行测试。