Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Molecular Oncology of Research Center, Barretos Cancer Hospital, Barretos, Brazil.
Anticancer Res. 2020 Feb;40(2):575-581. doi: 10.21873/anticanres.13987.
Previous randomized studies suggest that fecal occult blood test (FOBT) screening can reduce mortality from colorectal cancer (CRC). Our aim was to review the current status of FOBTs in CRC screening. FOB is measured using either the traditional guaiac-based tests or more recently introduced fecal immunochemical tests (FITs). FITs have several advantages over guaiac-based FOBTs, including higher sensitivity and specificity, resulting in improved clinical performance and higher efficiency. Another advantage in population screening according to European Guidelines for quality assurance in CRC screening is that FITs can be automated and user can adjust the cut-off at which a positive result is reported. In population-based screening, all those testing positively with any FOBT should be referred for colonoscopy. Conclusion: Although a plethora of FOBTs are available on the market, relatively few have been extensively tested for clinical sensitivity and specificity in CRC screening. Current data imply that new FITs have superior test characteristics as compared with guaiac-based FOBTs. The latest development in the field is represented by the proteomic-based tests that may further reduce false-negative rates in CRC screening. Simple stool sample preservation and automatic analysis are other important issues in population-based screening for CRC.
先前的随机研究表明，粪便潜血试验（FOBT）筛查可以降低结直肠癌（CRC）的死亡率。我们旨在回顾 FOBT 在 CRC 筛查中的现状。FOB 可使用传统的基于愈创木脂的检测方法或最近引入的粪便免疫化学检测（FIT）进行测量。FIT 相对于基于愈创木脂的 FOBT 具有几个优势，包括更高的敏感性和特异性，从而改善了临床性能和效率。根据欧洲 CRC 筛查质量保证指南，在人群筛查中另一个优势是 FIT 可以自动化，用户可以调整报告阳性结果的截止值。在基于人群的筛查中，所有用任何 FOBT 检测呈阳性的人都应转介进行结肠镜检查。结论：尽管市场上有大量的 FOBT，但相对较少的 FOBT 经过广泛测试以确定其在 CRC 筛查中的临床敏感性和特异性。目前的数据表明，新型 FIT 与基于愈创木脂的 FOBT 相比具有更好的测试特性。该领域的最新发展代表了基于蛋白质组学的检测方法，这可能进一步降低 CRC 筛查中的假阴性率。简单的粪便样本保存和自动分析是 CRC 人群筛查中的另一个重要问题。
