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GUT:粪便免疫与结肠镜对中度结肠癌风险人群筛查效果比较研究

2018-12-12 zhangfan MedSci原创

研究认为,对于中等结肠癌风险人群,采用粪便免疫化学法进行定期筛查可减少71%的筛查次数,大幅降低筛查费用,但检查敏感性有所下降

目前英国大肠癌筛查计划建议直肠癌中度风险患者(3-4个小腺瘤或1例10mm以上)每年进行3次结肠镜检查。近日研究人员考察了采用粪便化学检查(FITS)是否能够代替内镜检查,减轻患者负担。

60-72岁的中度风险人群参与研究,随访3年,在第1、2、3年进行FIT检查,若患者在第1或2年FITS阳性(血红蛋白≥40μg/g),则提前进行结肠镜检查;所有参与在第3年进行结肠镜检查,比较不同方法对CRC和进展期腺瘤(AAs)诊断的准确性。

5938患者参与研究,其中97%的参与者在第2、3年接受了FITs 。3年中,血红蛋白≥40μg/g的患者累积率为13%,≥10μg/g累积率为29%,其中29人确诊CRC,446人确诊AAs,以≥40μg/g 为阈值,FITS 对CRC以及AAs检查的敏感性为59%和33%,以10μg/g为阈值时上升至72%和57%。结肠镜与FIT (40μg/g)相比,每发现1例AA 和CRC导致的花费分别为180 778和7354欧。

研究认为,对于中等结肠癌风险人群,采用粪便免疫化学法进行定期筛查可减少71%的筛查次数,大幅降低筛查费用,但检查敏感性有所下降。

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2061812, encodeId=e541206181241, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Oct 25 05:21:00 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434468, encodeId=3f0b14344680b, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466841, encodeId=1315146684124, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046694, encodeId=2db0104669445, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Dec 12 13:21:00 CST 2018, time=2018-12-12, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=2061812, encodeId=e541206181241, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Oct 25 05:21:00 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434468, encodeId=3f0b14344680b, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466841, encodeId=1315146684124, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046694, encodeId=2db0104669445, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Dec 12 13:21:00 CST 2018, time=2018-12-12, status=1, ipAttribution=)]
    2018-12-14 zhouqu_8
  3. [GetPortalCommentsPageByObjectIdResponse(id=2061812, encodeId=e541206181241, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Oct 25 05:21:00 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434468, encodeId=3f0b14344680b, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466841, encodeId=1315146684124, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046694, encodeId=2db0104669445, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Dec 12 13:21:00 CST 2018, time=2018-12-12, status=1, ipAttribution=)]
    2018-12-14 Homburg
  4. [GetPortalCommentsPageByObjectIdResponse(id=2061812, encodeId=e541206181241, content=<a href='/topic/show?id=e6e1e15509f' target=_blank style='color:#2F92EE;'>#癌风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71550, encryptionId=e6e1e15509f, topicName=癌风险)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Fri Oct 25 05:21:00 CST 2019, time=2019-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434468, encodeId=3f0b14344680b, content=<a href='/topic/show?id=95de81e4889' target=_blank style='color:#2F92EE;'>#肠镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81748, encryptionId=95de81e4889, topicName=肠镜)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1466841, encodeId=1315146684124, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Dec 14 01:21:00 CST 2018, time=2018-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046694, encodeId=2db0104669445, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Dec 12 13:21:00 CST 2018, time=2018-12-12, status=1, ipAttribution=)]
    2018-12-12 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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