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

[1]	Siegel RL，Miller KD，Jemal A．Cancer statistics，2019[J]．CA Cancer J Clin，2019, 69(1): 7-34.
[2]	孙可欣，郑荣寿，张思维，等.2015年中国分地区恶性肿瘤发病和死亡分析[J]．中国肿瘤，2019，28(1): 1-11.
[3]	Biller LH，Schrag D．Diagnosis and Treatment of Metastatic Colorectal Cancer: A Review[J]．JAMA，2021，325(7): 669-685.
[4]	Bibbins-Domingo K，Grossman DC，Curry SJ，et al.Screening for Colorectal Cancer：US Preventive Services Task Force Recommendation Statement[J]．JAMA，2016，315(23): 2564-2575.
[5]	中国抗癌协会大肠癌专业委员会中国结直肠肿瘤早诊筛查策略制订专家组．中国结直肠肿瘤早诊筛查策略专家共识[J]．中华胃肠外科杂志，2018, 21(10): 1081-1086.
[6]	Young GP，Rabeneck L，Winawer SJ.The Global Paradigm Shift in Screening for Colorectal Cancer[J]．Gastroenterology，2019，156(4): 843-851.e2.
[7]	Imperiale TF，Gruber RN，Stump TE，et al.Performance Characteristics of Fecal Immunochemical Tests for Colorectal Cancer and Advanced Adenomatous Polyps：A Systematic Review and Meta-analysis[J]．Ann Intern Med，2019，170(5): 319-329.
[8]	翟爱军，武斌，张续乾，等．在体检人群中应用自测型免疫化学法粪便潜血试验筛查结直肠癌的结果分析[J/CD]．肿瘤综合治疗电子杂志，2020, 6(4): 53-56.
[9]	Kaminski MF，Robertson DJ，Senore C，et al.Optimizing the Quality of Colorectal Cancer Screening Worldwide[J]．Gastroenterology, 2020，158(2): 404-417.
[10]	陈燕，李兆申，蔡全才，等．粪便脱落细胞检测应用于大肠癌筛查的研究进展[J]．第二军医大学学报，2007，28(10): 1120-1122.
[11]	Houshmand M，Abbaszadegan MR，Kerachian MA.Assessment of Bone Morphogenetic Protein 3 Methylation in Iranian Patients with Colorectal Cancer[J]．Middle East J Dig Dis，2017，9(3): 158-163.
[12]	Melotte V，Lentjes MH，van den Bosch SM，et al.N-Myc downstream-regulated gene 4 (NDRG4)：a candidate tumor suppressor gene and potential biomarker for colorectal cancer[J]．J Natl Cancer Inst，2009，101(13): 916-927.
[13]	Ahlquist DA，Skoletsky JE，Boynton KA，et al.Colorectal cancer screening by detection of altered human DNA in fecal: feasibility of a multitarget assay panel[J]．Gastroenterology，2000, 119(5): 1219-1227.
[14]	王小军，曹晖，陶元生，等．粪便多配体聚糖2基因甲基化在结直肠恶性肿瘤进展的相关性[J]．中华实验外科杂志，2021，38(2): 249-252.
[15]	Han YD，Oh TJ，Chung TH，et al.Early detection of colorectal cancer based on presence of methylated syndecan-2 (SDC2) in fecal DNA[J]．Clin Epigenetics，2019，11(1): 51-61.
[16]	Imperiale TF，Ransohoff DF，Itzkowitz SH，et al.Multitarget fecal DNA testing for colorectal-cancer screening[J]．N Engl J Med，2014，370(14): 1287-1297.
[17]	Mu J，Huang Y，Cai S，et al.Plausibility of an extensive use of fecal DNA test for screening advanced colorectal neoplasia[J]. Clin Chim Acta，2020，501(2): 42-47.
[18]	李怡玲，关旭，窦利州，等．粪便多靶点DNA与粪便潜血联合检测技术对结直肠癌早诊早筛的诊断价值分析[J]．中华医学杂志，2022，102(33): 2607-2613.
[19]	Xu J, Rong L, Gu F, et al. Asia-Pacific Colorectal Screening Score Combined With Stool DNA Test Improves the Detection Rate for Colorectal Advanced Neoplasms[J]．Clin Gastroenterol Hepatol, 2023, 21(6): 1627-1636，e4.
[20]	Zhu Y，Li X，Hu Y，et al.Nonadherence to Referral Colonoscopy After Positive Fecal Immunochemical Test Results Increases the Risk of Distal Colorectal Cancer Mortality[J]．Gastroenterology, 2023，165(6): 1558-1560，e4.

[1]	朱兴墅, 郑师尧, 王庆惠, 陈力, 刘旺武, 纪辉涛, 王瑜, 赵虎, 方永超. 蛋白磷酸酶-1催化亚基β在结直肠癌诊断、预后及免疫浸润中的生物信息学分析[J]. 中华细胞与干细胞杂志(电子版), 2023, 13(06): 321-330.
[2]	卓长华, 叶韵斌, 陈昌江, 简锦亮, 王志纬. 林奇综合征相关性异时性结直肠癌的治疗[J]. 中华结直肠疾病电子杂志, 2024, 13(01): 32-37.
[3]	陈园园, 颜宏利. 遗传性结直肠癌的基因阻断[J]. 中华结直肠疾病电子杂志, 2024, 13(01): 1-5.
[4]	朱菡, 卓士超, 吴迪, 朱雅楠, 韩佳欣. 术前血浆纤维蛋白原、血脂水平及MMR表达与结直肠癌病理特点及预后的相关性[J]. 中华消化病与影像杂志(电子版), 2024, 14(02): 141-145.
[5]	焦莉莉, 周芊池, 凌梦芸, 魏红玲, 徐缨. 血清SAA、CA19-9结合超声内镜对结直肠癌术前分期的诊断价值[J]. 中华消化病与影像杂志(电子版), 2024, 14(02): 146-150.
[6]	张朋伟, 杨朝凤, 李杨. 结直肠癌肝转移介入治疗的研究进展[J]. 中华消化病与影像杂志(电子版), 2024, 14(02): 177-182.
[7]	蒲丹, 龙煊, 周玉龙, 李甘霖. 血清外泌体miR-224对结直肠癌肝转移患者射频消融治疗后复发的预测价值[J]. 中华消化病与影像杂志(电子版), 2024, 14(01): 45-52.
[8]	黄霓, 张仕勇, 兰茜琳, 周奕, 明兵. 双源CT与MRI在结直肠癌术前分期中的临床价值分析[J]. 中华消化病与影像杂志(电子版), 2024, 14(01): 57-61.
[9]	梁文龙, 曹杰, 黄庆, 林泳, 黄红丽, 杨平, 李冠炜, 胡鹤. 信迪利单抗联合瑞戈非尼治疗晚期结直肠癌的疗效与安全性分析[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 409-413.
[10]	王小娜, 谭微, 李悦, 姜文艳. 预测性护理对结直肠癌根治术患者围手术期生活质量、情绪及并发症的影响[J]. 中华消化病与影像杂志(电子版), 2023, 13(06): 525-529.
[11]	段福孝, 王鑫宇, 孙爽, 于知宇, 张成. 结直肠癌患者周围神经侵犯预测模型的建立与评价[J]. 中华临床医师杂志(电子版), 2023, 17(11): 1154-1162.
[12]	李永胜, 孙家和, 郭书伟, 卢义康, 刘洪洲. 高龄结直肠癌患者根治术后短期并发症及其影响因素[J]. 中华临床医师杂志(电子版), 2023, 17(09): 962-967.
[13]	王飞飞, 王光林, 孟泽松, 李保坤, 曹龙飞, 张娟, 周超熙, 丁源一, 王贵英. 敲低IMPDH1对结肠癌SW480、HT29细胞生物功能的影响[J]. 中华临床医师杂志(电子版), 2023, 17(08): 884-890.
[14]	孔凡彪, 杨建荣. 肝脏基础疾病与结直肠癌肝转移之间关系的研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(07): 818-822.
[15]	王亚丹, 吴静, 黄博洋, 王苗苗, 郭春梅, 宿慧, 王沧海, 王静, 丁鹏鹏, 刘红. 白光内镜下结直肠肿瘤性质预测模型的构建与验证[J]. 中华临床医师杂志(电子版), 2023, 17(06): 655-661.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

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

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

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