定量免疫粪便隐血试验联合危险度评估在社区结直肠癌筛查中的应用

Application of quantitative fecal immunochemical testing combined with risk assessment in colorectal cancer screening in community

目的探讨定量免疫粪便隐血试验(fecal immunochemical testing,FIT)联合危险度评估在社区结直肠癌(colorectal cancer,CRC)筛查中的应用价值。方法选择2022年9月至2022年12月在吴江区开展CRC筛查的人群为研究对象。评估结果为阳性的有613例;评估阳性的人群中有320例作为试验组(1次定性FIT+1次定量FIT),293例作为对照组(2次定性FIT)。试验组中有59例接受了肠镜检查,对照组中有36例接受了肠镜检查。结果试验组的初筛阳性率为25.93%(83例),对照组的初筛阳性率为18.77%(55例),差异有统计学意义(P=0.034)。试验组接受肠镜检查的人群中,病变(CRC或结直肠腺瘤)的检出率为83.05%(49例),对照组接受肠镜检查的人群中,病变(CRC或结直肠腺瘤)的检出率为63.89%(23例),差异有统计学意义(P=0.032)。受试者操作特征曲线(receiver operator characteristic curve,ROC曲线)分析显示,定量FIT筛查早期肠道病变的曲线下面积为0.842(P=0.002,95%CI 0.695~0.989)。结论定量FIT在社区CRC筛查中的应用价值高。

Objective To explore the application value of quantitative fecal immunochemical testing(FIT)combined with risk assessment in colorectal cancer(CRC)screening in community.Method The population screened for CRC in Wujiang District from September 2022 to December 2022 was selected as the research objects.There were 613 positive cases based on the evaluation results,and among these positive patients,320 cases were selected in the experimental group(1 qualitative FIT+1 quantitative FIT)and 293 cases were selected in the control group(2 qualitative FIT).A total of 59 people in the experimental group underwent colonoscopy,while 36 people in the control group underwent colonoscopy.Result The positive rate of initial screening in the experimental group was 25.93%(n=83),while that of the control group was 18.77%(n=55),the difference was statistically significant(P=0.034).Among those undergoing colonoscopy,the detection rate of lesions(CRC or colorectal adenoma)was 83.05%(n=49)in the experimental group and 63.89%(n=23)in the control group,the difference was statistically significant(P=0.032).Receiver operator characteristic curve(ROC curve)analysis showed that the area under the curve of quantitative FIT for early intestinal lesions screening was 0.842(P=0.002,95%CI 0.695-0.989).Conclusion Quantitative FIT has high application value in CRC screening in community.