Kim Nam Hee, Kwon Min-Jung, Kim Hyun-Young, Lee Taeheon, Jeong Seok Hyeon, Park Dong Il, Choi Kyuyong, Jung Yoon Suk
Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Laboratory Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Dig Liver Dis. 2016 Jun;48(6):667-72. doi: 10.1016/j.dld.2016.03.001. Epub 2016 Mar 8.
Although a fecal immunochemical test (FIT) allows quantitation of fecal hemoglobin (f-Hb), it is typically used as a binary result to identify subjects above a predetermined cut-off concentration.
To investigate whether f-Hb concentration is useful for risk stratification of advanced colorectal neoplasia (CRN).
This was a retrospective study conducted in a university hospital in Korea. Of 34,547 participants who underwent FIT from June 2013 to May 2015, 1532 (4.4%) showed positive results (≥100ng Hb/ml). Of participants with positive results, 738 subjects aged ≥50 years who underwent colonoscopy were analyzed.
Increasing quartile of f-Hb concentration (Q4 vs. Q1; odds ratio, 3.87; 95% confidence interval, 2.36-6.34), as well as older age, male sex, smoking, and metabolic syndrome (MetS), was significantly associated with a higher prevalence of advanced CRN. Risk for advanced CRN increased 5.13-, 4.27-, 5.12-, and 7.15-fold, respectively, among individuals with f-Hb in the fourth quartile who had risk factors such as age ≥70 years, male sex, smoking, and MetS compared with individuals with first quartile levels of f-Hb who did not have those risk factors.
In addition to age, sex, smoking status, and MetS, f-Hb concentration in individuals with positive results from FIT can be used to stratify the probability of detection of advanced CRN.
尽管粪便免疫化学检测（FIT）可对粪便血红蛋白（f-Hb）进行定量，但它通常用作二元结果以识别高于预定临界浓度的受试者。
研究f-Hb浓度是否有助于晚期结直肠肿瘤（CRN）的风险分层。
这是在韩国一家大学医院进行的一项回顾性研究。在2013年6月至2015年5月接受FIT的34547名参与者中，1532名（4.4%）结果呈阳性（≥100ng Hb/ml）。对结果呈阳性的参与者中年龄≥50岁且接受结肠镜检查的738名受试者进行了分析。
f-Hb浓度四分位数增加（Q4与Q1相比；比值比，3.87；95%置信区间，2.36 - 6.34），以及年龄较大、男性、吸烟和代谢综合征（MetS）与晚期CRN的较高患病率显著相关。与没有年龄≥70岁、男性、吸烟和MetS等危险因素且f-Hb处于第一四分位数水平的个体相比，在具有这些危险因素且f-Hb处于第四四分位数的个体中，晚期CRN的风险分别增加了5.13倍、4.27倍、5.12倍和7.15倍。
除年龄、性别、吸烟状况和MetS外，FIT结果呈阳性个体的f-Hb浓度可用于分层晚期CRN的检出概率。
