Kang Q, Li N, Wang R F, Yang L, Jin P, Sheng J Q
Eastern Medical District of Chinese PLA General Hospital, Beijing 100011, China.
Department of Gastroenterology, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China.
Zhonghua Yi Xue Za Zhi. 2021 Dec 14;101(46):3825-3828. doi: 10.3760/cma.j.cn112137-20210713-01558.
To evaluate the efficacy of the Asia-Pacific colorectal screening (APCS) score combined with the quantitative fecal immunochemical test in colorectal neoplasia screening. Subjects who appointment to receive colonoscopy were recruited from August 2017 to May 2019 in the digestive endoscopy center. Before the colonoscopy, all subjects were scored by the Asia Pacific colorectal cancer screening scoring system and measured by quantitative fecal immunochemical test (QFIT). The detection rates of colorectal neoplasia were compared to evaluate the efficacy of the combined assay in colorectal neoplasia screening between APCS score and QFIT. A total of 1 420 subjects were enrolled in this study, APCS score medium-risk (MR) and high-risk (HR) groups were 847 (59.7%) and 573 (40.4%) and 26 cases (1.8%) of colorectal cancer, 196 cases (13.8%) of advanced adenoma, and 395 cases (27.8%) of non-advanced adenoma were detected. With the combination of APCS score and QFIT, participants were classified into 4 groups high-risk with positive QFIT result group G1, high-risk with negative QFIT result group G2, medium-risk with positive QFIT group G3, medium-risk negative QFIT group G4. The prevalence of colorectal neoplasia was 64.3%, 16.4%, 55.0%, and 9.8%, respectively. The prevalence of advanced neoplasia in high-risk with QFIT results was significantly higher than that in other 3 groups. HR and positive QFIT were the indicators for further colonoscopy, and MR with FIT negative group could postpone colonoscopy and conduct annual QFIT follow-up. The combination of APCS score and QFIT for colorectal neoplasia screening can reduce unnecessary colonoscopy, improve colonoscopy compliance and screening efficiency, and has important clinical significance and promotion value in colorectal tumor screening.
评估亚太结直肠癌筛查（APCS）评分联合定量粪便免疫化学检测在结直肠肿瘤筛查中的效果。2017年8月至2019年5月，在消化内镜中心招募预约接受结肠镜检查的受试者。在结肠镜检查前，所有受试者均采用亚太结直肠癌筛查评分系统进行评分，并通过定量粪便免疫化学检测（QFIT）进行检测。比较结直肠肿瘤的检出率，以评估APCS评分与QFIT联合检测在结直肠肿瘤筛查中的效果。本研究共纳入1420名受试者，APCS评分中危（MR）组和高危（HR）组分别为847名（59.7%）和573名（40.4%），检出结直肠癌26例（1.8%）、进展性腺瘤196例（13.8%）、非进展性腺瘤395例（27.8%）。将APCS评分与QFIT相结合，将参与者分为4组：QFIT结果阳性的高危组G1、QFIT结果阴性的高危组G2、QFIT阳性的中危组G3、QFIT阴性的中危组G4。结直肠肿瘤的患病率分别为64.3%、16.4%、55.0%和9.8%。QFIT结果为高危的进展期肿瘤患病率显著高于其他3组。HR且QFIT阳性是进一步行结肠镜检查的指标，FIT阴性的MR组可推迟结肠镜检查并每年进行QFIT随访。APCS评分与QFIT联合用于结直肠肿瘤筛查可减少不必要的结肠镜检查，提高结肠镜检查的依从性和筛查效率，在结直肠肿瘤筛查中具有重要的临床意义和推广价值。
