Department of Gastroenterology, Complexo Hospitalario Universitario de Ourense, Ourense, Spain.
Department of Gastroenterology, Complexo Hospitalario Universitario de Vigo, Vigo, Spain ; 'IBIV' Institute of Biomedical Research of Vigo, Vigo, Spain.
United European Gastroenterol J. 2014 Dec;2(6):522-9. doi: 10.1177/2050640614553285.
There is little information about the fecal immunochemical test (FIT) in familial-risk colorectal cancer (CRC) screening.
The objective of this article is to investigate whether FIT diagnostic accuracy for advanced neoplasia (AN) differs between average and familial-risk (first-degree relative) patients.
A total of 1317 consecutive participants (595 familial) who collected one stool sample before performing a colonoscopy as a CRC screening test were included. FIT diagnostic accuracy for AN was evaluated with Chi-square test at a 20 µg hemoglobin/g of feces cut-off value. Finally, we determined which variables were independently related to AN.
An AN was found in 151 (11.5%) patients. The overall accuracy was not statistically different between both cohorts for AN (88.4%, 91.7%; p = 0.051). At the cut-off stablished, differences in FIT sensitivity (31.1%, 40.6%; p = 0.2) or specificity (96.5%, 97.3%; p = 0.1) were not statistically significant. Finally, independent variables such as sex (male) (odds ratio (OR) 2.1, 95% confidence interval (CI) 1.4-3.1), age (50-65, >65 years) (OR 2.1, 95% CI 1.1-4.3; OR 2.7, 95% CI 1.2-6.1), previous colonoscopy (OR 0.4, 95% CI 0.2-0.9) and FIT ≥20 µg/g feces (OR 17.7, 95% CI 10.8-29.1) were associated with AN diagnosis.
FIT accuracy for AN detection is equivalent in average and familial-risk CRC screening cohorts.
关于家族性结直肠癌（CRC）筛查中粪便免疫化学检测（FIT）的信息较少。
本文旨在探讨 FIT 对进展期腺瘤（AN）的诊断准确性在普通人群和家族性风险（一级亲属）患者之间是否存在差异。
共纳入 1317 例连续接受粪便样本检测的患者（595 例家族性），所有患者均接受结肠镜检查作为 CRC 筛查试验。采用 Chi-square 检验评估 20μg 血红蛋白/g 粪便截断值下 FIT 对 AN 的诊断准确性。最后，确定与 AN 相关的独立变量。
151 例（11.5%）患者存在 AN。在两个队列中，AN 的总体准确性无统计学差异（88.4%，91.7%；p=0.051）。在建立的截断值下，FIT 的敏感性（31.1%，40.6%；p=0.2）或特异性（96.5%，97.3%；p=0.1）差异无统计学意义。最后，独立变量如性别（男性）（比值比（OR）2.1，95%置信区间（CI）1.4-3.1）、年龄（50-65 岁、>65 岁）（OR 2.1，95% CI 1.1-4.3；OR 2.7，95% CI 1.2-6.1）、既往结肠镜检查（OR 0.4，95% CI 0.2-0.9）和粪便 FIT≥20μg/g（OR 17.7，95% CI 10.8-29.1）与 AN 诊断相关。
在普通人群和家族性 CRC 筛查队列中，FIT 对 AN 检测的准确性相当。
