Kim Nam Hee, Park Jung Ho, Park Dong Il, Sohn Chong Il, Choi Kyuyong, Jung Yoon Suk
Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Yonsei Med J. 2017 Jan;58(1):150-157. doi: 10.3349/ymj.2017.58.1.150.
False-positive (FP) results of fecal immunochemical tests (FITs) conducted in colorectal cancer (CRC) screening could lead to performing unnecessary colonoscopies. Hemorrhoids are a possible cause of FP FIT results; however, studies on this topic are extremely rare. We investigated whether hemorrhoids are associated with FP FIT results.
A retrospective study was conducted at a university hospital in Korea from June 2013 to May 2015. Of the 34547 individuals who underwent FITs, 3946 aged ≥50 years who underwent colonoscopies were analyzed. Logistic regression analysis was performed to determine factors associated with FP FIT results.
Among 3946 participants, 704 (17.8%) showed positive FIT results and 1303 (33.0%) had hemorrhoids. Of the 704 participants with positive FIT results, 165 had advanced colorectal neoplasia (ACRN) and 539 had no ACRN (FP results). Of the 1303 participants with hemorrhoids, 291 showed FP results, of whom 81 showed FP results because of hemorrhoids only. Participants with hemorrhoids had a higher rate of FP results than those without hemorrhoids (291/1176, 24.7% vs. 248/2361, 10.5%; p<0.001). Additionally, the participants with hemorrhoids as the only abnormality had a higher rate of FP results than those experiencing no such abnormalities (81/531, 15.3% vs. 38/1173, 3.2%; p<0.001). In multivariate analysis, the presence of hemorrhoids was identified as an independent predictor of FP results (adjusted odds ratio, 2.76; 95% confidence interval, 2.24-3.40; p<0.001).
Hemorrhoids are significantly associated with FP FIT results. Their presence seemed to be a non-negligible contributor of FP results in FIT-based CRC screening programs.
在结直肠癌（CRC）筛查中进行的粪便免疫化学检测（FIT）出现假阳性（FP）结果可能会导致进行不必要的结肠镜检查。痔疮是FIT结果出现假阳性的一个可能原因；然而，关于这一主题的研究极为罕见。我们调查了痔疮是否与FIT假阳性结果相关。
于2013年6月至2015年5月在韩国一家大学医院进行了一项回顾性研究。在34547名接受FIT检测的个体中，对3946名年龄≥50岁且接受了结肠镜检查的个体进行了分析。进行逻辑回归分析以确定与FIT假阳性结果相关的因素。
在3946名参与者中，704名（17.8%）FIT结果呈阳性，1303名（33.0%）有痔疮。在704名FIT结果呈阳性的参与者中，165名患有晚期结直肠肿瘤（ACRN），539名没有ACRN（假阳性结果）。在1303名有痔疮的参与者中，291名出现假阳性结果，其中81名仅因痔疮出现假阳性结果。有痔疮的参与者假阳性结果的发生率高于没有痔疮的参与者（291/1176，24.7%对248/2361，10.5%；p<0.001）。此外，仅以痔疮作为唯一异常情况的参与者假阳性结果的发生率高于没有此类异常情况的参与者（81/531，15.3%对38/1173，3.2%；p<0.001）。在多变量分析中，痔疮的存在被确定为假阳性结果的独立预测因素（调整后的优势比，2.76；95%置信区间，2.24 - 3.40；p<0.001）。
痔疮与FIT假阳性结果显著相关。在基于FIT的CRC筛查项目中，痔疮的存在似乎是假阳性结果的一个不可忽视的因素。
