Kawamura Takuji, Inoue Takato, Shinomiya Ryo, Sakai Hiroaki, Amamiya Kana, Sakiyama Naokuni, Shirakawa Atsushi, Okada Yusuke, Sanada Kasumi, Nakase Kojiro, Mandai Koichiro, Suzuki Azumi, Kamaguchi Mai, Morita Atsushi, Nishioji Kenichi, Tanaka Kiyohito, Uno Koji, Yokota Isao, Kobayashi Masao, Yasuda Kenjiro
Department of Gastroenterology Kyoto Second Red Cross Hospital Kyoto Japan.
Department of Health Care Kyoto Second Red Cross Hospital Kyoto Japan.
JGH Open. 2020 Apr 16;4(5):898-902. doi: 10.1002/jgh3.12346. eCollection 2020 Oct.
As the significance of the quantitative fecal immunochemical test (FIT) in patients who previously underwent a colonoscopy is unknown, this study aimed at investigating the association between fecal hemoglobin concentration and the risk of colorectal cancer (CRC).
We retrospectively analyzed FIT-positive patients who underwent a colonoscopy through our opportunistic annual screening program from April 2010 to March 2017 at the Kyoto Second Red Cross Hospital. We stratified them into no colonoscopy and past colonoscopy (>5 years or ≤5 years) groups based on whether they had a history of undergoing a colonoscopy and analyzed the correlation between fecal hemoglobin concentration and advanced neoplasia or invasive cancer detection in each group. We analyzed 1248 patients with positive FIT results. There were 748 (59.9%), 198 (15.9%), and 302 (24.2%) patients in the no colonoscopy, past colonoscopy (>5 years), and past colonoscopy (≤5 years) groups, respectively. In the no colonoscopy group, the advanced neoplasia detection rate significantly increased with the fecal hemoglobin concentration ( < 0.001). However, no significant trend was observed in the past colonoscopy (both >5 years and ≤5 years) group ( = 0.982). No invasive cancer was detected in the past colonoscopy (≤5 years) group.
The risk of CRC might be low even if fecal hemoglobin concentration was high, especially in those who underwent colonoscopy within 5 years.
由于定量粪便免疫化学检测（FIT）在既往接受过结肠镜检查的患者中的意义尚不清楚，本研究旨在调查粪便血红蛋白浓度与结直肠癌（CRC）风险之间的关联。
我们回顾性分析了2010年4月至2017年3月在京都第二红十字医院通过机会性年度筛查计划接受结肠镜检查的FIT阳性患者。根据他们是否有结肠镜检查史，将他们分为未进行结肠镜检查组和既往结肠镜检查（>5年或≤5年）组，并分析每组中粪便血红蛋白浓度与高级别瘤变或浸润性癌检测之间的相关性。我们分析了1248例FIT结果阳性的患者。未进行结肠镜检查组、既往结肠镜检查（>5年）组和既往结肠镜检查（≤5年）组分别有748例（59.9%）、198例（15.9%）和302例（24.2%）患者。在未进行结肠镜检查组中，高级别瘤变检测率随粪便血红蛋白浓度显著增加（<0.001）。然而，在既往结肠镜检查（>5年和≤5年）组中未观察到显著趋势（=0.982）。在既往结肠镜检查（≤5年）组中未检测到浸润性癌。
即使粪便血红蛋白浓度较高，CRC风险可能也较低，尤其是在5年内接受过结肠镜检查的患者中。
