多靶点粪便DNA检测与噗噗管法FIT在体检人群结直肠癌筛查中的效果比较

doi:10.3877/cma.j.issn.2095-7157.2024.01.008

目的

比较多靶点粪便DNA检测与噗噗管法FIT在体检人群结直肠癌筛查中的应用价值。

方法

选择2020年1～12月在中国航天科工集团七三一医院体检中心进行健康体检的无症状人群，同时采用多靶点粪便DNA检测和噗噗管法FIT进行初筛，阳性者完善结肠镜检查，并对筛查结果进行分析和总结。

结果

共660例受试者均完成多靶点粪便DNA检测与噗噗管法FIT，其中42例多靶点粪便DNA检测为阳性，55例噗噗管检测阳性，多靶点粪便DNA检测阳性者对结直肠癌及进展期腺瘤检出率为1.36%，阳性预测值为32.14%；噗噗管法FIT检测阳性者对结直肠癌及进展期腺瘤检出率为0.30%，阳性预测值为7.69%，多靶点粪便DNA检测对结直肠癌及进展期腺瘤的检出率及阳性预测值均高于噗噗管法FIT检测法，差异具有统计学意义(P<0.05)。

结论

在体检人群中，与噗噗管FIT相比，多靶点粪便DNA检测技术对结直肠癌与进展期腺瘤检出率和阳性预测值高，对结直肠癌具有更高的筛查价值。

关键词: 多靶点粪便DNA检测, 噗噗管法, 结直肠癌, 进展期腺瘤, 体检人群

Objective

To compare the value of multi-target fecal DNA detection and PuPu Tube self-administered fecal immunochemical test (PuPu tube FIT) in colorectal cancer screening in physical examination population.

Methods

From January 2020 to December 2020, asymptomatic people who underwent physical examination in the Physical Examination Center of China Aerospace Science and Industry Corporation 731 Hospital were selected.Multi-target fecal DNA detection and PuPu tube FIT were used for primary screening.Colonoscopy was performed for those who were positive, and the screening results were analyzed and summarized.

Results

A total of 660 subjects completed multi-target fecal DNA detection andPuPu tube FIT, of which 42 cases were positive for multi-target fecal DNA detection, 55 cases were positive for PuPu tube FIT detection.The detection rate of colorectal cancer and advanced adenoma was 1.36% and the positive predictive value was 32.14% for those with positive multi-target fecal DNA detection. The detection rate of colorectal cancer and advanced adenoma was 0.30% and the positive predictive value was 7.69% for those with positive PuPu tube FIT detection, and the detection rate and positive predictive value of colorectal cancer and advanced adenoma by multi-target fecal DNA detection were higher than those by PuPu tube FIT, and the differences were statistically significant (P<0.05).

Conclusion

Compared with PuPu tube FIT, multi- target fecal DNA detection has higher detection rate and positive predictive value for colorectal cancer and advanced adenoma. Therefore, multi-target fecal DNA detection has a higher screening value for colorectal cancer in physical examination population.

Key words: Multi-target fecal DNA detection, PuPu Tube FIT, Colorectal cancer, Advanced adenomas, Physical examination population

表1 多靶点粪便DNA检测和噗噗管法FIT对结肠癌及管状腺瘤检出率及阳性预测值的比较[例(%)]

项目	阳性例数	癌与进展期腺瘤例数(检出率%)	癌与进展期腺瘤阳性预测值(%)	非进展期腺瘤例数(检出率%)	非进展期腺瘤阳性预测值(%)
MT-sDNA(n＝28)	42	9 (1.36)	32.14	7 (1.06)	25.00
噗噗管法FIT (n＝26)	55	2 (0.30)	7.69	6 (0.91)	23.08
χ 2值		4.492	4.969	0.078	2.908
P值		0.034	0.026	0.781	0.088

表1 多靶点粪便DNA检测和噗噗管法FIT对结肠癌及管状腺瘤检出率及阳性预测值的比较[例(%)]

项目	阳性例数	癌与进展期腺瘤例数(检出率%)	癌与进展期腺瘤阳性预测值(%)	非进展期腺瘤例数(检出率%)	非进展期腺瘤阳性预测值(%)
MT-sDNA(n＝28)	42	9 (1.36)	32.14	7 (1.06)	25.00
噗噗管法FIT (n＝26)	55	2 (0.30)	7.69	6 (0.91)	23.08
χ 2值		4.492	4.969	0.078	2.908
P值		0.034	0.026	0.781	0.088

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Comparison to multi-target fecal DNA testing and PuPu tube self-administered fecal immunochemical test in colorectal cancer screening in physical examination population

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Comparison to multi-target fecal DNA testing and PuPu tube self-administered fecal immunochemical test in colorectal cancer screening in physical examination population