Qin Boyu, Niu Haitao, Qiu Lupeng, Zhou Hongfeng, Lyu Peng
Department of Oncology, The Fifth Medical Center of PLA General Hospital, Beijing 100071, China.
National Health Commission of the People's Republic of China, Beijing 100044, China.
Cancer Pathog Ther. 2024 Feb 24;3(1):60-67. doi: 10.1016/j.cpt.2024.02.002. eCollection 2025 Jan.
Colorectal cancer (CRC) is a major public health concern and the second leading cause of cancer-related deaths worldwide. However, challenges remain in deploying effective screening strategies for early-stage CRC. This study aimed to evaluate the effectiveness of a fecal-based syndecan-2 () methylation test for the detection of colorectal lesions and CRC.
We retrospectively collected data on participants who underwent fecal methylation testing from January 1, 2019, to May 30, 2023. Patients with positive results were recommended to undergo colonoscopy. Performance indicators associated with certain clinical characteristics, including positive rate (PR), positive predictive value (PPV), and colonoscopy compliance rate (CCR), were subjected to statistical analysis.
We analyzed data from 113,209 participants, of whom 11,841 (10.4% PR) had positive fecal methylation test results. A total of 4315 participants with positive results adhered to the colonoscopy recommendations, and the CCR was 36.4%. Finally, 3169 colorectal lesions were detected, including 1134 polyps, 875 non-advanced adenomas (NAAs), 770 advanced adenomas (AAs), and 390 CRCs, with PPV values of 26.3% (1134/4315), 20.3% (875/4315), 17.8% (770/4315), and 9.0% (390/4315), respectively. Notably, the PPV for CRC increased significantly with age ( = 164.40, < 0.0001). In addition, as the cycle threshold (CT) values increased, the PPVs of AAs and CRCs generally decreased, whereas those of NAAs and polyps significantly increased. Moreover, the clinical patient group had the highest incidence of late-stage CRC (stage II and higher), whereas asymptomatic populations from the staff physical examination group and rural town-based screening programs had the highest number of stage 0 and I CRCs detected ( = 0.0107).
This study indicates that fecal methylation testing combined with colonoscopy may be an effective screening method for colorectal lesions and CRC.
结直肠癌（CRC）是一个重大的公共卫生问题，是全球癌症相关死亡的第二大主要原因。然而，在部署有效的早期结直肠癌筛查策略方面仍存在挑战。本研究旨在评估基于粪便的syndecan-2（）甲基化检测对结直肠病变和结直肠癌的检测效果。
我们回顾性收集了2019年1月1日至2023年5月30日接受粪便甲基化检测的参与者的数据。结果呈阳性的患者被建议进行结肠镜检查。对与某些临床特征相关的性能指标，包括阳性率（PR）、阳性预测值（PPV）和结肠镜检查依从率（CCR）进行统计分析。
我们分析了113209名参与者的数据，其中11841人（PR为10.4%）粪便甲基化检测结果呈阳性。共有4315名结果呈阳性的参与者遵守了结肠镜检查建议，CCR为36.4%。最终，检测到3169例结直肠病变，包括1134例息肉、875例非进展性腺瘤（NAA）、770例进展性腺瘤（AA）和390例结直肠癌，PPV值分别为26.3%（1134/4315）、20.3%（875/4315）、17.8%（770/4315）和9.0%（390/4315）。值得注意的是，结直肠癌的PPV随年龄显著增加（=164.40，<0.0001）。此外，随着循环阈值（CT）值的增加，AA和结直肠癌的PPV通常下降，而NAA和息肉的PPV则显著增加。此外，临床患者组晚期结直肠癌（II期及更高）的发病率最高，而职工体检组和农村乡镇筛查项目的无症状人群检测到的0期和I期结直肠癌数量最多（=0.0107）。
本研究表明，粪便甲基化检测联合结肠镜检查可能是一种有效的结直肠病变和结直肠癌筛查方法。
