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基于粪便检测在结直肠癌检测中的应用:一项综述

Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review.

作者信息

Gómez-Molina Raquel, Suárez Miguel, Martínez Raquel, Chilet Marifina, Bauça Josep Miquel, Mateo Jorge

机构信息

Department of Laboratory Medicine, Virgen de la Luz Hospital, 16002 Cuenca, Spain.

Gastroenterology Department, Virgen de la Luz Hospital, 16002 Cuenca, Spain.

出版信息

Healthcare (Basel). 2024 Aug 18;12(16):1645. doi: 10.3390/healthcare12161645.

Abstract

Colorectal cancer (CRC) is a significant global health issue where early detection is crucial for improving treatment outcomes and survival rates. This comprehensive review assesses the utility of stool-based tests in CRC screening, including traditional fecal occult blood tests (FOBT), both chemical (gFOBT) and immunochemical techniques (FIT), as well as multitarget stool DNA (mt-sDNA) as a novel and promising biomarker. The advancements, limitations and the impact of false positives and negatives of these methods are examined. The review analyzed various studies on current screening methods, focusing on laboratory tests and biomarkers. Findings indicate that while FIT and mt-sDNA tests offer enhanced sensitivity and specificity over traditional guaiac-based FOBT, they also come with higher costs and potential for increased false positives. FIT shows better patient adherence due to its ease to use, but incorrect usage and interpretation of FOBT can lead to significant diagnostic errors. In conclusion, despite the improvements in FOBT methods like FIT in CRC detection, careful consideration of each method's benefits and drawbacks is essential. Effective CRC screening programs should combine various methods tailored to specific population needs, aiming for early detection and reduced mortality rates.

摘要

结直肠癌(CRC)是一个重大的全球健康问题,早期检测对于改善治疗效果和生存率至关重要。这篇综述评估了基于粪便的检测在结直肠癌筛查中的效用,包括传统的粪便潜血试验(FOBT),化学法(gFOBT)和免疫化学技术(FIT),以及多靶点粪便DNA(mt-sDNA)作为一种新的、有前景的生物标志物。研究了这些方法的进展、局限性以及假阳性和假阴性的影响。该综述分析了当前筛查方法的各种研究,重点是实验室检测和生物标志物。研究结果表明,虽然FIT和mt-sDNA检测比传统的基于愈创木脂的FOBT具有更高的灵敏度和特异性,但它们的成本也更高,且存在假阳性增加的可能性。FIT因其使用方便而显示出更好的患者依从性,但FOBT的不正确使用和解读可能导致重大诊断错误。总之,尽管在结直肠癌检测中FIT等FOBT方法有所改进,但仔细考虑每种方法的优缺点至关重要。有效的结直肠癌筛查计划应结合针对特定人群需求的各种方法,以实现早期检测并降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f43b/11353969/31442563b34e/healthcare-12-01645-g001.jpg

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