Niedermaier Tobias, Weigl Korbinian, Hoffmeister Michael, Brenner Hermann
Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
United European Gastroenterol J. 2018 Feb;6(1):13-21. doi: 10.1177/2050640617737004. Epub 2017 Oct 9.
Colorectal cancer (CRC) is a common but largely preventable cancer. Although fecal immunochemical tests (FITs) detect the majority of CRCs, they miss some of the cancers and most advanced adenomas (AAs). The potential of blood tests in complementing FITs for the detection of CRC or AA has not yet been systematically investigated.
We conducted a systematic review of performance of FIT combined with an additional blood test for CRC and AA detection versus FIT alone. PubMed and Web of Science were searched until June 9, 2017.
Some markers substantially increased sensitivity for CRC when combined with FIT, albeit typically at a major loss of specificity. For AA, no relevant increase in sensitivity could be achieved.
Combining FIT and blood tests might be a promising approach to enhance sensitivity of CRC screening, but comprehensive evaluation of promising marker combinations in screening populations is needed.
结直肠癌（CRC）是一种常见但在很大程度上可预防的癌症。尽管粪便免疫化学检测（FIT）能检测出大多数结直肠癌，但仍会遗漏一些癌症以及大多数进展期腺瘤（AA）。血液检测在补充FIT用于检测结直肠癌或AA方面的潜力尚未得到系统研究。
我们对FIT联合另一项血液检测用于结直肠癌和AA检测的性能与单独使用FIT进行了系统评价。检索了PubMed和Web of Science直至2017年6月9日。
一些标志物与FIT联合使用时可显著提高结直肠癌的检测灵敏度，尽管通常会大幅降低特异性。对于AA，无法实现灵敏度的相关提高。
联合使用FIT和血液检测可能是提高结直肠癌筛查灵敏度的一种有前景的方法，但需要在筛查人群中对有前景的标志物组合进行全面评估。
