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Missed colorectal cancers in a fecal immunochemical test-based screening program: Molecular profiling of interval carcinomas
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作者 Manon van der Vlugt Beatriz Carvalho +7 位作者 Joelle Fliers Nahid Montazeri Christian Rausch Esmée J Grobbee Manon van Engeland Manon C W Spaander Gerrit A Meijer evelien dekker 《World Journal of Gastrointestinal Oncology》 SCIE 2022年第11期2195-2207,共13页
BACKGROUND For optimizing fecal immunochemical test(FIT)-based screening programs,reducing the rate of missed colorectal cancers(CRCs)by FIT(FIT-interval CRCs)is an important aspect.Knowledge of the molecular make-up ... BACKGROUND For optimizing fecal immunochemical test(FIT)-based screening programs,reducing the rate of missed colorectal cancers(CRCs)by FIT(FIT-interval CRCs)is an important aspect.Knowledge of the molecular make-up of these missed lesions could facilitate more accurate detection of all(precursor)lesions.AIM To compare the molecular make-up of FIT-interval CRCs to lesions that are detected by FIT[screen-detected CRCs(SD-CRCs)].METHODS FIT-interval CRCs observed in a Dutch pilot-program of FIT-based screening were compared to a control group of SD-CRCs in a 1:2 ratio,resulting in 27 FIT-interval CRC and 54 SD-CRCs.Molecular analyses included microsatellite instability(MSI),CpG island methylator phenotype(CIMP),DNA sequence mutations and copy number alterations(CNAs).RESULTS Although no significant differences were reached,FIT-interval CRCs were more often CIMP positive and MSI positive(33%CIMP in FIT-interval CRCs vs 21%in SD-CRCs(P=0.274);19%MSI in FIT-interval CRCs vs 12%in SD-CRCs(P=0.469)),and showed more often serrated pathway associated features such as BRAF(30%vs 12%,P=0.090)and PTEN(15%vs 2.4%,P=0.063)mutations.APC mutations,a classic feature of the adenoma-carcinoma-sequence,were more abundant in SD-CRCs(68%vs 40%in FIT-interval CRCs P=0.035).Regarding CNAs differences between the two groups;FIT-interval CRCs less often showed gains at the regions 8p11.22-q24.3(P=0.009),and more often gains at 20p13-p12.1(P=0.039).CONCLUSION Serrated pathway associated molecular features seem to be more common in FIT-interval CRCs,while classic adenoma carcinoma pathway associated molecular features seem to be more common in SD-CRCs.This indicates that proximal serrated lesions may be overrepresented among FITinterval CRCs. 展开更多
关键词 Fecal immunochemical test-interval colorectal cancer Mutation analysis Colorectal cancer screening Serrated pathway Adenoma-carcinoma pathway
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Similar fecal immunochemical test results in screening and referral colorectal cancer
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作者 Sietze T van Turenhout Leo GM van Rossum +10 位作者 Frank A Oort Robert JF Laheij Anne F van Rijn Jochim S Terhaar sive Droste Paul Fockens René WM van der Hulst Anneke A Bouman Jan BMJ Jansen Gerrit A Meijer evelien dekker Chris JJ Mulder 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第38期5397-5403,共7页
AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective coh... AIM: To improve the interpretation of fecal immunochemical test (FIT) results in colorectal cancer (CRC) cases from screening and referral cohorts. METHODS: In this comparative observational study, two prospective cohorts of CRC cases were compared. The first cohort was obtained from 10 322 average risk subjects invited for CRC screening with FIT, of which, only subjects with a positive FIT were referred for colonoscopy. The second cohort was obtained from 3637 subjects scheduled for elective colonoscopy with a positive FIT result. The same FIT and positivity threshold (OC sensor; ≥ 50 ng/mL) was used in both cohorts. Colonoscopy was performed in all referral subjects and in FIT positive screening subjects. All CRC cases were selected from both cohorts. Outcome measurements were mean FIT results and FIT scores per tissue tumor stage (T stage). RESULTS: One hundred and eighteen patients with CRC were included in the present study: 28 cases obtained from the screening cohort (64% male; mean age 65 years, SD 6.5) and 90 cases obtained from the referral cohort (58% male; mean age 69 years, SD 9.8). The mean FIT results found were higher in the referral cohort (829 ± 302 ng/mLvs 613 ± 368 ng/mL,P = 0.02). Tissue tumor stage (T stage) distribution was dif-ferent between both populations [screening population: 13 (46%) T1, eight (29%) T2, six (21%) T3, one (4%) T4 carcinoma; referral population: 12 (13%) T1, 22 (24%) T2, 52 (58%) T3, four (4%) T4 carcinoma], and higher T stage was significantly associated with higher FIT results (P < 0.001). Per tumor stage, no significant difference in mean FIT results was observed (screening vs referral: T1 498 ± 382 ng/mL vs 725 ± 374 ng/mL, P = 0.22; T2 787 ± 303 ng/mL vs 794 ± 341 ng/mL, P = 0.79; T3 563 ± 368 ng/mLvs 870 ± 258 ng/mL,P = 0.13; T4 not available). After correction for T stage in logistic regression analysis, no significant differences in mean FIT results were observed between both types of cohorts (P = 0.10). CONCLUSION: Differences in T stage distribution largely explain differences in FIT results between screening and referral cohorts. Therefore, FIT results should be reported according to T stage. 展开更多
关键词 Screening population Referral cohort Fecal immunochemical test Tumor stage distribution Colorectal cancer
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较大直肠腺瘤中经肛门内镜显微手术与内镜下黏膜切除术的随机对照试验(TREND研究) 被引量:1
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作者 Renee M Barendse Gijsbert D Musters +19 位作者 Eelco J R de Graaf Frank J C van den Broek Esther C J Consten Pascal G Doornebosch James C Hardwick Ignace H J T de Hingh Chrisiaan Hoft Jeroen M Jansen A W Marc van Milligen de Wit George P van der Schelling Erik J Schoon Matthijs P Schwartz Bas L A M Weusten Marcel G Dijkgraaf Paul Fockens Willem A Bemelman evelien dekker TREND研究小组 李佳宁(译) 吴东(校) 《英国医学杂志中文版》 2018年第11期676-676,共1页
摘要 目的 非随机研究表明内镜下黏膜切除术(endoscopic mucosal resection,EMR)在切除直肠较大腺瘤时与经肛门内镜显微手术(transanal endoscopic microsurgery,TEM)同样有效,但EMR可能更具成本效益且相对安全。本试验旨在对比摘除较... 摘要 目的 非随机研究表明内镜下黏膜切除术(endoscopic mucosal resection,EMR)在切除直肠较大腺瘤时与经肛门内镜显微手术(transanal endoscopic microsurgery,TEM)同样有效,但EMR可能更具成本效益且相对安全。本试验旨在对比摘除较大直肠腺瘤时EMR与TEM的临床结局与成本效益。 展开更多
关键词 随机对照试验 显微手术 切除术 内镜 黏膜 肛门 肠腺 成本效益
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