Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
Department of Surgery, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC; Division of Colorectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2018 Sep;81(9):759-765. doi: 10.1016/j.jcma.2017.11.015. Epub 2018 May 31.
The immunochemical fecal occult blood test (iFOBT) is an alternative method to colonoscopy that can be used for colorectal cancer (CRC) screening. If the iFOBT result is positive, a colonoscopy is recommended. In this retrospective study, we identify factors associated with negative colonoscopy and positive iFOBT results obtained during CRC screening.
We collected data for subjects who received a colonoscopy at Taipei Veterans General Hospital after receiving a positive iFOBT result during CRC screening from January 2015 to December 2015. Subjects' baseline data, medications, and co-morbidities as well as colonoscopy and histological findings were recorded. A negative colonoscopy result was defined as no detection of any colorectal neoplasia including non-advanced adenoma, advanced adenoma, and adenocarciona. Multivariate logistic regression analysis was conducted to identify the associated factors in screening subjects with positive iFOBT but negative colonoscopy results.
559 (46.3%) out of 1207 eligible study subjects received a colonoscopy with a negative result. Multivariate logistic regression analysis revealed that the use of antiplatelets [odds ratio (OR) = 0.654; 95% confidence interval (CI), 0.434-0.986], occurrence of hemorrhoid (OR = 0.595; 95% CI, 0.460-0.768), and the existence of colitis/ulcer (OR = 0.358; 95% CI, 0.162-0.789) were independent factors associated with negative colonoscopy but positive iFOBT results during CRC screening. The colon clean level, underlying diseases of gastrointestinal bleeding tendency (e.g., chronic kidney disease, cirrhosis), and the use of anticoagulant or nonsteroidal anti-inflammatory agents were not associated with negative colonoscopy and positive iFOBT results.
The use of antiplatelet agents and the presence of hemorrhoids and colitis/ulcers were factors associated with negative colonoscopy and positive iFOBT results.
免疫化学粪便潜血试验（iFOBT）是一种替代结肠镜检查的方法，可用于结直肠癌（CRC）筛查。如果 iFOBT 结果阳性，建议进行结肠镜检查。在这项回顾性研究中，我们确定了与 CRC 筛查中获得的阴性结肠镜检查和阳性 iFOBT 结果相关的因素。
我们收集了 2015 年 1 月至 2015 年 12 月期间在接受 CRC 筛查时 iFOBT 结果阳性后在台北荣民总医院接受结肠镜检查的受试者的数据。记录了受试者的基线数据、药物和合并症以及结肠镜检查和组织学发现。阴性结肠镜检查结果定义为未检测到任何结直肠肿瘤，包括非进展性腺瘤、进展性腺瘤和腺癌。进行多变量逻辑回归分析，以确定筛查中阳性 iFOBT 但阴性结肠镜检查结果的相关因素。
在 1207 名符合条件的研究受试者中，559 名（46.3%）接受了阴性结肠镜检查。多变量逻辑回归分析显示，使用抗血小板药物[比值比（OR）=0.654；95%置信区间（CI），0.434-0.986]、发生痔疮（OR=0.595；95%CI，0.460-0.768）和存在结肠炎/溃疡（OR=0.358；95%CI，0.162-0.789）是与 CRC 筛查中阴性结肠镜检查但阳性 iFOBT 结果相关的独立因素。结肠清洁程度、胃肠道出血倾向的基础疾病（如慢性肾脏病、肝硬化）以及抗凝剂或非甾体抗炎药的使用与阴性结肠镜检查和阳性 iFOBT 结果无关。
使用抗血小板药物以及存在痔疮和结肠炎/溃疡是与阴性结肠镜检查和阳性 iFOBT 结果相关的因素。
