Bujanda Luis, Sarasqueta Cristina, Vega Pablo, Salve María, Quintero Enrique, Alvarez-Sánchez Victoria, Fernández-Bañares Fernando, Boadas Jaume, Campo Rafel, Garayoa Ana, Ferrandez Angel, Torrealba Leyanira, Rodríguez-Alcaide Daniel, D'Amato Mauro, Hernández Vicent, Cubiella Joaquin
Gastroenterology Department, Hospital Universitario Donostia/Biodonostia Institute, University of the Basque Country (UPV/EHU), San Sebastián, Spain; and Centro de Investigación en Red en Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
Hospital Universitario Donostia/ Biodonostia Institute, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), San Sebastián, Spain.
United European Gastroenterol J. 2018 Feb;6(1):123-130. doi: 10.1177/2050640617707094. Epub 2017 Apr 21.
Aspirin (ASA) is a drug that can cause gastrointestinal lesions and symptoms. Colorectal cancer (CRC) is the most prevalent type of cancer in Western countries. We assessed the effect of aspirin on the diagnostic accuracy of the faecal immunochemical test (FIT) for CRC and/or advanced neoplasia (AN) in patients undergoing colonoscopy for gastrointestinal symptoms.
We conducted a prospective multicentre observational study of diagnostic tests that included patients with gastrointestinal symptoms undergoing colonoscopy between March 2012 and 2014 (the COLONPREDICT study). Symptoms were assessed and a FIT and blood tests assessing haemoglobin and carcinoembryonic antigen (CEA) levels were performed.
The study included 3052 patients: A total of 2567 did not take aspirin (non-user group) and 485 (16%) took aspirin (user group). Continuous treatment with ASA did not change the AUC (0.88, 0.82; = 0.06), sensitivity (92%, 88%; = 0.5) or specificity (71%, 67%; = 0.2) of the FIT for CRC detection. Similarly, we found no differences in the AUC (0.81, 0.79; = 0.6), sensitivity (74%, 75.5%; = 0.3) or specificity (76%, 73.6%; = 0.3) for AN detection. Patients with an aspirin use of ≥ 300 mg/day had a lower prevalence of AN and the sensitivity, specificity and AUC for AN for these patients were 54%, 68% and 0.66, significantly lower than for the non-user group ( = 0.03).
Aspirin does not modify the diagnostic accuracy of FIT for CRC and/or AN in patients with gastrointestinal symptoms. Aspirin use of ≥ 300 mg/day decreases the accuracy of the test.
阿司匹林（ASA）是一种可导致胃肠道病变和症状的药物。结直肠癌（CRC）是西方国家最常见的癌症类型。我们评估了阿司匹林对因胃肠道症状接受结肠镜检查的患者粪便免疫化学检测（FIT）诊断CRC和/或高级别瘤变（AN）准确性的影响。
我们对诊断试验进行了一项前瞻性多中心观察性研究，纳入了2012年3月至2014年间因胃肠道症状接受结肠镜检查的患者（COLONPREDICT研究）。评估了症状，并进行了FIT以及评估血红蛋白和癌胚抗原（CEA）水平的血液检测。
该研究纳入了3052例患者：共有2567例未服用阿司匹林（非使用者组），485例（16%）服用阿司匹林（使用者组）。持续使用ASA并未改变FIT检测CRC的曲线下面积（AUC）（分别为0.88、0.82；P = 0.06）、敏感性（分别为92%、88%；P = 0.5）或特异性（分别为71%、67%；P = 0.2）。同样，我们发现检测AN的AUC（分别为0.81、0.79；P = 0.6）、敏感性（分别为74%、75.5%；P = 0.3）或特异性（分别为76%、73.6%；P = 0.3）没有差异。阿司匹林使用量≥300mg/天的患者AN患病率较低，这些患者检测AN的敏感性、特异性和AUC分别为54%、68%和0.66，显著低于非使用者组（P = 0.03）。
阿司匹林不会改变因胃肠道症状接受结肠镜检查患者FIT诊断CRC和/或AN的准确性。阿司匹林使用量≥300mg/天会降低检测准确性。
