粪便肿瘤标志物对胃肠道肿瘤的筛查

胃肠道肿瘤的是世界范围内发病率非常高的肿瘤,人一生中患该病风险为6%。早期检测是减少胃肠道肿瘤病死率的关键因素。常用的筛查手段包括内镜检查、粪便隐血试验和粪便DNA分析。内镜检查为金标准方法,但存在有一定的缺陷和局限性。基于联苯胺及其衍生物为底物的化学法隐血试验是较常用的方法,较好的降低了胃肠道肿瘤的发生率和病死率。针对于人血红蛋白的免疫学隐血试验,改善了化学隐血试验受食物及药物的影响,并提高了隐血试验的检出率。粪便DNA检测是早期胃肠道肿瘤检测的新手段,其灵敏度与特异性均达90%,但其存在价格高的不足之处。本文对粪便肿瘤标志物在早期胃肠道肿瘤中的筛查意义作综述。

Gastrointestinal cancer is one of the most prevalent cancers worldwide and the lifetime risk is almost 6%. Early detection is clearly a key factor in reducing mortality for gastrointestinal cancer. Several screening regimens for gastrointestinal cancer are recommended, including colonoscopy, fecal occult blood testing(FOBT), and fecal DNA analysis. The commonly used guaiac-based FOBT is an effective screening tool when used programmatically, reducing the incidence and the mortality. Superior performance can be attributed to immunochemical FOBT(FIT) assays, which are specific for human hemoglobin, and eliminate the need for dietary restrictions and have a similar or better sensitivity. The analysis of fecal DNA represents an emerging new field for early detection of colorectal neoplasia. The specificity of the assay is high ranging from 93 to 100%. The major drawback of fecal DNA testing, compared with other fecal colorectal cancer screening tests, is the unacceptable high cost. The following review is a summary of the current of fecal tumor markers in gastrointestinal cancer.