Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Seoul, Republic of Korea.
Digestion. 2012;86(4):283-7. doi: 10.1159/000341738. Epub 2012 Oct 9.
BACKGROUND/AIMS: Fecal immunochemical test (FIT) is an integral component of most colorectal cancer (CRC) screening programs. However, little is known about clinical risk factors associated with advanced colorectal neoplasia (CRN) despite negative FIT results. The aim of this study was to determine the clinical predictors of advanced CRN despite negative FIT results.
We performed FITs for asymptomatic subjects ≥50 years from January 2009 to December 2010. Patients who underwent colonoscopy for a medical check-up, despite a negative FIT result, were included to evaluate the clinical predictors of advanced CRN based on colonoscopy.
During the study period, 373 subjects underwent screening colonoscopy despite their negative FIT results. Among those 373 subjects, 356 (95.4%) did not show any advanced CRNs; however, 17 (4.6%) subjects showed advanced CRNs on their colonoscopies despite negative FIT results. Being a first-degree relative of a CRC patient was significantly associated with advanced CRNs in univariate analysis (p = 0.031). According to multivariate logistic regression analysis, being a first-degree relative of a CRC patient was a significant predictor of advanced CRNs despite negative FIT results (OR 7.33; 95% CI, 0.53-35.08; p = 0.013).
First-degree relatives of CRC patients are likely to show advanced CRNs despite a negative FIT.
背景/目的：粪便免疫化学检测（FIT）是大多数结直肠癌（CRC）筛查计划的重要组成部分。然而，尽管 FIT 结果为阴性，与进展期结直肠肿瘤（CRN）相关的临床危险因素却知之甚少。本研究旨在确定尽管 FIT 结果为阴性，但仍存在进展期 CRN 的临床预测因素。
我们对 2009 年 1 月至 2010 年 12 月期间≥50 岁的无症状患者进行了 FIT 检测。对于因 FIT 检测结果为阴性而进行结肠镜检查的患者，我们纳入了此项研究，以评估基于结肠镜检查的进展期 CRN 的临床预测因素。
在研究期间，有 373 名患者因 FIT 检测结果为阴性而接受了筛查性结肠镜检查。在这 373 名患者中，有 356 名（95.4%）未出现任何进展期 CRN；然而，有 17 名（4.6%）患者尽管 FIT 检测结果为阴性，但在结肠镜检查中出现了进展期 CRN。在单因素分析中，CRC 患者的一级亲属与进展期 CRN 显著相关（p=0.031）。根据多因素逻辑回归分析，CRC 患者的一级亲属是尽管 FIT 检测结果为阴性但仍存在进展期 CRN 的显著预测因素（OR 7.33；95% CI，0.53-35.08；p=0.013）。
CRC 患者的一级亲属尽管 FIT 检测结果为阴性，但仍可能出现进展期 CRN。
