抗血栓药物不影响免疫化学粪便潜血试验的阳性预测值。

Antithrombotic drug does not affect the positive predictive value of an immunochemical fecal occult blood test.

机构信息

Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; Department of Gastroenterology, NTT Medical Center Tokyo, Tokyo, Japan.

出版信息

Dig Endosc. 2014 May;26(3):424-9. doi: 10.1111/den.12208. Epub 2013 Dec 10.

DOI:10.1111/den.12208

PMID:24325675

Abstract

BACKGROUND AND AIM

Antithrombotic drugs may affect the diagnostic performance of immunochemical fecal occult blood test (iFOBT) for colorectal cancer (CRC) screening. The aim of the present study was to assess the effect of antithrombotic drugs on the diagnostic performance of iFOBT.

METHODS

We analyzed 1016 patients who underwent colonoscopy for positive iFOBT. Patients were classified as follows: patients who had advanced neoplasms detected and those who did not; patients who had cancers detected and those who did not; patients who had any neoplasms detected and those who did not. We compared the following factors between two paired groups: sex, age, endoscopists' experience, and antithrombotic drug usage.

RESULTS

A total of 139 patients were taking antithrombotic drugs (13.7%). Advanced neoplasms, cancers, and any neoplasms were detected in 196 (19.3%), 59 (5.8%), and 490 (48.2%)patients, respectively. There were no higher detection rates in the antithrombotic drug (-) group than in the (+) group (advanced neoplasms: 19.3% vs 19.4%, P=1.000; cancers: 5.8% vs 5.8%, P=1.000; any neoplasms: 48.4% vs 47.5%, P=0.856). Multivariate logistic regression analysis revealed that none of aspirin, warfarin, or other antithrombotic drugs was a significant factor for advanced neoplasms (95% CI 0.350-1.216, P=0.179; 95% CI 0.421-1.899, P=0.772; 95% CI 0.323-1.810, P=0.764, respectively). As to cancers and any neoplasms, no antithrombotic drug also proved to be a significant factor.

CONCLUSION

The present study demonstrated that the positive predictive value of iFOBT was not affected by ongoing antithrombotic therapy.

摘要

背景与目的

抗血栓药物可能会影响免疫化学粪便潜血试验（iFOBT）用于结直肠癌（CRC）筛查的诊断性能。本研究旨在评估抗血栓药物对 iFOBT 诊断性能的影响。

方法

我们分析了 1016 例因 iFOBT 阳性而行结肠镜检查的患者。患者分为以下几类：发现进展性肿瘤和未发现进展性肿瘤的患者；发现癌症和未发现癌症的患者；发现任何肿瘤和未发现任何肿瘤的患者。我们比较了两组配对患者之间的以下因素：性别、年龄、内镜医生的经验和抗血栓药物的使用情况。

结果

共有 139 例患者正在服用抗血栓药物（13.7%）。在 196 例（19.3%）、59 例（5.8%）和 490 例（48.2%）患者中分别发现了进展性肿瘤、癌症和任何肿瘤。抗血栓药物（-）组的检出率并不高于（+）组（进展性肿瘤：19.3%比 19.4%，P=1.000；癌症：5.8%比 5.8%，P=1.000；任何肿瘤：48.4%比 47.5%，P=0.856）。多变量逻辑回归分析显示，阿司匹林、华法林或其他抗血栓药物均不是进展性肿瘤的显著因素（95%CI 0.350-1.216，P=0.179；95%CI 0.421-1.899，P=0.772；95%CI 0.323-1.810，P=0.764）。对于癌症和任何肿瘤，也没有抗血栓药物被证明是一个显著因素。