Hyder C S, Uddin M A, Jalal M T, Karim S S, Taher M A, Nahar K, Hossain M S, Sheikh M S H, Islam M S
Dr Chowdhury Sazzad Hyder, Assistant Professor, Department of Surgery, Shaheed Suhrawardy Medical College, Sher-e-Bangla Nagar, Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2025 Jul;34(3):745-751.
Colorectal cancer is a challenging clinical entity worldwide. Adenomatous polyps are considered precursors to cancer. Detection and confirmation of mucosal healing of ulcerative colitis require a colonoscopy. For early detection of polyps or ulcers, different screening investigations like colonoscopy, Fecal Immunochemistry Test, gFOBT, CT colonography, etc. are used. Though gold standard colonoscopy has both diagnostic and therapeutic roles, Fecal Immunochemistry Test can detect advanced adenoma or established cancer or mucosal status of Ulcerative colitis. The Fecal Immunochemistry Test is a less expensive technique for the early detection of colonic pathology and is suitable for our demographic. The aim of the study was to observe the frequency and pattern of premalignant and malignant lesions among Fecal Immunochemical Test (FIT) positive patients. This observational cross-sectional study was conducted from July 2019 to June 2020 among 105 Fecal Immunochemical Test (FIT) positive patients. The observational cross-sectional study was carried out in the Department of Colorectal Surgery, Bangabandhu Sheikh Mujib Medical University and some private hospitals, Bangladesh. FIT tests were done in ICDDR`B. Among 105 Fecal immunochemical test positive study patients, colonoscopy evaluations were done. Among these, 58 cases (55.2%) revealed different types of polyps. Pedunculated polyps 42(40.0%) were predominant, present in 42(40.0%) of patients. Other than polyps, there were ulcers 14(13.3%), malignant looking growth 3(2.9%), hemorrhoid 13(12.4%) and normal findings in 15(14.3%) cases. The age range was 40-70 years. The mean age was 51.73±7.97 years. Adenomatous polyps and malignancies were 47(44.7%) and 5(4.8%). Advanced adenomas were 11(10.4%) cases. Thirty six (62.1%) polyps were in the left colon. Patients with normal findings, diverticulosis and hemorrhoids had not undergone biopsy. Fecal immunochemical test (FIT) can predominantly detect adenomas, especially advanced adenoma and precursor lesions. The study finding showed that both non-neoplastic, neoplastic polyps and ulcers had occult bleeding. So, they became FIT positive. Though colonoscopy is the gold standard in the detection of polyps, ulcers, or malignant lesions, FIT can be a good supportive tool for screening.
在全球范围内，结直肠癌是一个具有挑战性的临床实体。腺瘤性息肉被认为是癌症的前体。溃疡性结肠炎黏膜愈合的检测和确认需要进行结肠镜检查。为了早期发现息肉或溃疡，人们使用了不同的筛查方法，如结肠镜检查、粪便免疫化学检测、粪便潜血试验、CT结肠成像等。虽然金标准的结肠镜检查兼具诊断和治疗作用，但粪便免疫化学检测可以检测出高级别腺瘤、确诊的癌症或溃疡性结肠炎的黏膜状态。粪便免疫化学检测是一种用于早期检测结肠病变的成本较低的技术，适合我们的人口统计学情况。本研究的目的是观察粪便免疫化学检测（FIT）阳性患者中癌前病变和恶性病变的频率及模式。这项观察性横断面研究于2019年7月至2020年6月在105名粪便免疫化学检测（FIT）阳性患者中进行。该观察性横断面研究在孟加拉国班加班杜·谢赫·穆吉布医科大学的结直肠外科和一些私立医院开展。FIT检测在国际腹泻病研究中心孟加拉国分中心进行。在105名粪便免疫化学检测阳性的研究患者中，进行了结肠镜评估。其中，58例（55.2%）发现了不同类型的息肉。带蒂息肉42例（40.0%）最为常见，有42名（40.0%）患者存在。除息肉外，还有溃疡14例（13.3%）、疑似恶性肿物3例（2.9%）、痔疮13例（12.4%），15例（14.3%）检查结果正常。年龄范围为40 - 70岁。平均年龄为51.73±7.97岁。腺瘤性息肉和恶性肿瘤分别有47例（44.7%）和5例（4.8%）。高级别腺瘤有11例（10.4%）。三十六例（62.1%）息肉位于左半结肠。检查结果正常、患有憩室病和痔疮的患者未进行活检。粪便免疫化学检测（FIT）主要能检测出腺瘤，尤其是高级别腺瘤和癌前病变。研究结果表明，非肿瘤性息肉、肿瘤性息肉和溃疡均有隐匿性出血。因此，它们的FIT检测呈阳性。虽然结肠镜检查是检测息肉、溃疡或恶性病变的金标准，但FIT可以作为一种很好的筛查辅助工具。
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