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High-risk symptoms and quantitative faecal immunochemical test accuracy: Systematic review and meta-analysis 预览
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作者 Noel Pin Vieito Sara Zarraquinos Joaquín Cubiella 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2383-2401,共19页
BACKGROUND The quantitative faecal immunochemical test for haemoglobin (FIT) has been revealed to be highly accurate for colorectal cancer (CRC) detection not only in a screening setting, but also in the assessment of... BACKGROUND The quantitative faecal immunochemical test for haemoglobin (FIT) has been revealed to be highly accurate for colorectal cancer (CRC) detection not only in a screening setting, but also in the assessment of patients presenting lower bowel symptoms. Therefore, the National Institute for Health and Care Excellence has recommended the adoption of FIT in primary care to guide referral for suspected CRC in low-risk symptomatic patients using a 10 μg Hb/g faeces threshold. Nevertheless, it is unknown whether FIT′s accuracy remains stable throughout the broad spectrum of possible symptoms. AIM To perform a systematic review and meta-analysis to assess FIT accuracy for CRC detection in different clinical settings. METHODS A systematic literature search was performed using MEDLINE and EMBASE databases from inception to May 2018 to conduct a meta-analysis of prospective studies including symptomatic patients that evaluated the diagnostic accuracy of quantitative FIT for CRC detection. Studies were classified on the basis of brand, threshold of faecal haemoglobin concentration for a positive test result, percentage of reported symptoms (solely symptomatic, mixed cohorts) and CRC prevalence (< 2.5%,≥ 2.5%) to limit heterogeneity and perform subgroup analysis to assess the influence of clinical spectrum on FIT′s accuracy to detect CRC. RESULTS Fifteen cohorts including 13073 patients (CRC prevalence 0.4% to 16.8%) were identified. Pooled estimates of sensitivity for studies using OC-Sensor at 10 μg Hb/g faeces threshold (n = 10400) was 89.6%[95% confidence interval (CI): 82.7% to 94.0%). However, pooled estimates of sensitivity for studies formed solely by symptomatic patients (n = 4035) and mixed cohorts (n = 6365) were 94.1%(95%CI: 90.0% to 96.6%) and 85.5%(95%CI: 76.5% to 91.4%) respectively (P < 0.01), while there were no statistically significant differences between pooled sensitivity of studies with CRC prevalence < 2.5%(84.9%, 95%CI: 73.4% to 92.0%) and ≥ 2.5%(91.7%, 95%CI: 83.3% to 96.1%)(P = 0.25 展开更多
关键词 BOWEL DISEASE Colorectal cancer Diagnostic ACCURACY FAECAL HAEMOGLOBIN FAECAL immunochemical TEST FAECAL occult blood TEST Inflammatory BOWEL DISEASE Significant colonic lesion
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Systematic review of colorectal cancer screening guidelines for average-risk adults:Summarizing the current global recommendations 预览
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作者 Florence Bénard Alan N Barkun +1 位作者 Myriam Martel Daniel von Renteln 《世界胃肠病学杂志:英文版》 SCIE CAS 2018年第1期124-138,共15页
AIM To summarize and compare worldwide colorectal cancer(CRC)screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE,EMBASE,Scopus... AIM To summarize and compare worldwide colorectal cancer(CRC)screening recommendations in order to identify similarities and disparities.METHODS A systematic literature search was performed using MEDLINE,EMBASE,Scopus,CENTRAL and ISI Web of knowledge identifying all average-risk CRC screening guideline publications within the last ten years and/or position statements published in the last 2 years.In addition,a hand-search of the webpages of National Gastroenterology Society websites,the National Guideline Clearinghouse,the BMJ Clinical Evidence website,Google and Google Scholar was performed.RESULTS Fifteen guidelines were identified.Six guidelines were published in North America,four in Europe,four in Asia and one from the World Gastroenterology Organization.The majority of guidelines recommend screening average-risk individuals between ages 50 and 75 using colonoscopy(every 10 years),or flexible sigmoidoscopy(FS,every 5 years)or fecal occult blood test(FOBT,mainly the Fecal Immunochemical Test,annually or biennially).Disparities throughout the different guidelines are found relating to the use of colonoscopy,rank order between test,screening intervals and optimal age ranges for screening.CONCLUSION Average risk individuals between 50 and 75 years should undergo CRC screening.Recommendations for optimal surveillance intervals,preferred tests/test cascade as well as the optimal timing when to start and stop screening differ regionally and should be considered for clinical decision making.Furthermore,local resource availability and patient preferences are important to increase CRC screening uptake,as any screening is better than none. 展开更多
关键词 Guidelines Systematic review FECAL OCCULT blood TEST FECAL immunochemical TEST COLONOSCOPY Colorectal cancer Screening Flexible SIGMOIDOSCOPY
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免疫法便隐血检测结果和结直肠病变关联研究 预览
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作者 卞之凌 沈立松 《临床医药文献杂志(电子版)》 2018年第19期4-6,9共4页
目的评估免疫法便隐血试验在结直肠病变诊断过程中的临床意义。方法回顾分析新华医院994例年龄在50~74岁全结肠镜检查对象的免疫法便隐血检测结果,以病理诊断为金标准,比较不同性别、年龄和结直肠病变的便隐血阳性率差异。结果994例研... 目的评估免疫法便隐血试验在结直肠病变诊断过程中的临床意义。方法回顾分析新华医院994例年龄在50~74岁全结肠镜检查对象的免疫法便隐血检测结果,以病理诊断为金标准,比较不同性别、年龄和结直肠病变的便隐血阳性率差异。结果994例研究对象中,男性便隐血阳性率为63.95%,女性便隐血阳性率为67.57%,多因素回归分析结果显示女性便隐血阳性率高于男性(OR=1.331,95%CI=1.012~1.751),差异有统计学意义(P<0.05),普通良性病变对象便隐血阳性率高于正常对象(OR=1.552,95%CI=1.112~2.166),差异有统计学意义(P<0.05)。结论免疫法便隐血检测对于结直肠良恶性病变有一定的辅助诊断价值,尤其是特定人群应引起重视,及时进行诊断性检查。 展开更多
关键词 便隐血 免疫法 结直肠
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Assessment of disease activity by fecal immunochemical test in ulcerative colitis 预览
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作者 Dae Gon Ryu Hyung Wook Kim +4 位作者 Su Bum Park Dae Hwan Kang Cheol Woong Choi Su Jin Kim Hyeong Seok Nam 《世界胃肠病学杂志:英文版》 SCIE CAS 2016年第48期10617-10624,共8页
AIM To evaluate the efficacy of quantitative fecal immunochemical test(FIT) as biomarker of disease activity in ulcerative colitis(UC).METHODS Between February 2013 and November 2014, a total of 82 FIT results, obtain... AIM To evaluate the efficacy of quantitative fecal immunochemical test(FIT) as biomarker of disease activity in ulcerative colitis(UC).METHODS Between February 2013 and November 2014, a total of 82 FIT results, obtained in conjunction with colonoscopies, were retrospectivelyevaluated for 63 patients with UC. The efficacy of FIT for evaluation of disease activity was compared to colonoscopic findings. Quantitative fecal blood with automated equipment examined from collected feces. Endoscopic disease severity were assessed using the Mayo endoscopic subscore(MES) classification. The extent of disease were classified by proctitis(E1), left sided colitis(E2), and extensive colitis(E3). Clinical activity were subgrouped by remission or active.RESULTS All of 21 patients with MES 0 had negative FIT(< 7 ng/mL), but 22 patients with MES 2 or 3 had a mean FIT of > 134.89 ng/m L. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV) and accuracy of negative FIT about mucosal healing were 73.33%, 81.82%, 91.49%, 51.43% and 73.17%, respectively. The sensitivity, specificity, PPV, NPV and accuracy of predictive value of positive FIT(cutoff value > 100 ng/mL) about active disease status were 45.45%, 93.33%, 71.43%, 82.35%and 26.83%, respectively. Among patients with clinical remission, FIT was negative in 31(81.6%) of 38 cases, with a mean fecal hemoglobin concentration of 6.12 ng/mL(range, negative to 80.9 ng/mL) for this group of patients. Among patients with clinical active disease, FIT was negative in 16(36.4%) out of 44 cases, with a mean fecal hemoglobin concentration > 167.4 ng/mL for this group of patients. FIT was positively correlated with endoscopic activity(r = 0.626, P < 0.01) and clinical activity(r = 0.496, P < 0.01). But, FIT did not correlate with the extent of disease(r =-0.047, P = 0.676)CONCLUSION Quantitative FIT can be a non-invasive and effective biomarker for evaluation of clinical and endoscopic activity in UC, but not predict the extent of disease. 展开更多
关键词 ULCERATIVE COLITIS FECAL immunochemical TEST MAYO endoscopic subscore Biomarker Disease activity
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TRAIL在乳腺癌组织中的表达 预览
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作者 杨雷 孔焕育 曹莹 《现代肿瘤医学》 CAS 2013年第4期776-778,共3页
目的:研究肿瘤坏死因子相关凋亡诱导配体(TRAIL)在乳腺癌组织中的表达。方法:免疫组化法检测TRAIL在乳腺癌组织中的表达。结果:TRAIL在乳腺不典型增生和腺癌中的表达无统计学差异。TRAIL的阳性表达水平与乳腺癌组织的分化程度呈正... 目的:研究肿瘤坏死因子相关凋亡诱导配体(TRAIL)在乳腺癌组织中的表达。方法:免疫组化法检测TRAIL在乳腺癌组织中的表达。结果:TRAIL在乳腺不典型增生和腺癌中的表达无统计学差异。TRAIL的阳性表达水平与乳腺癌组织的分化程度呈正相关,即分化程度愈高,TRAIL表达水平愈高。TRAIL在不同临床分期乳腺癌组织中的表达无统计学差异,与有无淋巴结转移无统计学差异。结论:本实验从凋亡调节因子方面支持了不典型增生为癌前病变的观点,TRAIL蛋白的表达可能与乳腺癌组织的恶性程度有关,与肿瘤的生物学行为无关。 展开更多
关键词 乳腺癌 肿瘤坏死因子相关凋亡诱导配体 免疫组化
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AT1R拮抗剂对膀胱癌细胞株生物学行为的影响及其机制研究 被引量:2
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作者 李国灏 李运柱 +2 位作者 李文洲 陈琳 胡卫锋 《临床泌尿外科杂志》 北大核心 2011年第3期224-227,230共5页
探讨血管紧张素Ⅱ1型受体(ATlR)拮抗剂坎地沙坦对膀胱癌BIU-87细胞株的生物学行为的影响。方法:采用免疫组织化学SABC法检测膀胱癌BIU-87细胞株ATIR的表达,用MMT法检测用坎地沙坦处理后的BIU-87细胞株的生长情况,同时检测BIU-87细... 探讨血管紧张素Ⅱ1型受体(ATlR)拮抗剂坎地沙坦对膀胱癌BIU-87细胞株的生物学行为的影响。方法:采用免疫组织化学SABC法检测膀胱癌BIU-87细胞株ATIR的表达,用MMT法检测用坎地沙坦处理后的BIU-87细胞株的生长情况,同时检测BIU-87细胞株的侵袭能力和黏附能力,用ELISA法检测血管内皮细胞生长因子和白细胞介素-8的表达水平。结果:ATIR拮抗剂坎地沙坦不影响BIU-87细胞株的生长,但能降低其侵袭能力和黏附能力,也能抑制血管内皮细胞生长因子和白细胞介素-8的表达。结论:ATIR拮抗剂通过降低肿瘤细胞的侵袭黏附能力和抑制血管生成而达到抗癌作用,ATlR拮抗剂将来可能会成为一种抗癌治疗的新方法。 展开更多
关键词 膀胱癌 BIU-87细胞株 坎地沙坦 免疫组织化学
醛酮还原酶1C2和组织蛋白酶D在膀胱移行细胞癌中的超表达及意义 被引量:1
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作者 熊飞 杨为民 +2 位作者 章慧平 周四维 叶章群 《临床泌尿外科杂志》 北大核心 2009年第2期145-147,共3页
目的:探讨醛酮还原酶1C2(AKR1C2)和组织蛋白酶D(cathepsinD)在膀胱移行细胞癌中的表达及其与膀胱癌病理分级、临床分期的关系。方法:应用免疫组织化学的方法检测AKR1C2和cathepsinD在40例膀胱癌组织和5例正常膀胱组织中的表达,... 目的:探讨醛酮还原酶1C2(AKR1C2)和组织蛋白酶D(cathepsinD)在膀胱移行细胞癌中的表达及其与膀胱癌病理分级、临床分期的关系。方法:应用免疫组织化学的方法检测AKR1C2和cathepsinD在40例膀胱癌组织和5例正常膀胱组织中的表达,并对比两者表达相关性。结果:40例膀胱癌中AKR1C2阳性表达率为80%,cathepsinD阳性表达率为90%,cathepsinD蛋白表达与膀胱癌病理分级、临床分期呈正相关(r=0.308).AKR1C2蛋白表达在不同膀胱癌病理分级中差异有统计学意义(P〈0.05)。AKR1C2蛋白在不同临床分期之间表达差异无统计学意义。结论:结论:AKR1C2和cathepsinD表达特征可以作为膀胱移行细胞癌的诊断和判断预后的参考指标。 展开更多
关键词 膀胱移行细胞癌 醛酮还原酶1C2 组织蛋白酶D 免疫组织化学
膀胱移行细胞癌组织中p16、p53和PCNA的表达及其意义 预览 被引量:1
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作者 卢童 杨为民 叶章群 《临床泌尿外科杂志》 2008年第1期 58-60,共3页
目的:探讨p16、p53蛋白及PCNA在膀胱移行细胞癌的表达及其与病理分级和临床分期关系。方法:采用免疫组化SABC法并结合图像分析方法检测40例膀胱移行细胞癌中p16、p53蛋白及PCNA的表达。结果:3种蛋白在膀胱肿瘤中的表达与正常膀胱组... 目的:探讨p16、p53蛋白及PCNA在膀胱移行细胞癌的表达及其与病理分级和临床分期关系。方法:采用免疫组化SABC法并结合图像分析方法检测40例膀胱移行细胞癌中p16、p53蛋白及PCNA的表达。结果:3种蛋白在膀胱肿瘤中的表达与正常膀胱组织均有显著差异。p16与病理分级及临床分期呈负相关。p53、PCNA与病理分级呈正相关。结论:p16与p53可作为膀胱移行细胞癌分化程度和预后判断的参考指标。而PCNA可作为预后判断辅助指标。 展开更多
关键词 膀胱肿瘤 肿瘤标志物 免疫组织化学
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粪便DNA检测技术在结直肠癌筛查中的应用现状及展望
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作者 马晨曦 关旭 +3 位作者 王松 刘正 姜争 王锡山 《中华胃肠外科杂志》 CAS CSCD 北大核心 2019年第5期491-494,共4页
有效的早期筛查和一级预防是降低我国结直肠癌发病率和死亡率的主要措施之一。粪便DNA检测作为一种近几年兴起的非侵入性结直肠肿瘤筛查方法,是通过检测粪便中脱落的肠道细胞中的变异基因来判断结直肠肿瘤,其中多靶点粪便DNA检测技术是... 有效的早期筛查和一级预防是降低我国结直肠癌发病率和死亡率的主要措施之一。粪便DNA检测作为一种近几年兴起的非侵入性结直肠肿瘤筛查方法,是通过检测粪便中脱落的肠道细胞中的变异基因来判断结直肠肿瘤,其中多靶点粪便DNA检测技术是应用最广泛的一种检测手段。国外针对这一新兴技术开展的多项研究均表明,多靶点粪便DNA检测具有较高的灵敏度,且其随着技术的不断完善与发展逐渐应用于临床。而在国内,多靶点粪便DNA检测尚处于起步阶段,有待更多来自中国人群的试验验证。与传统的结直肠癌筛查方法相比,粪便DNA检测技术兼具无创无痛、安全方便等优势,但该检测方法同样存在费用高昂、特异性较差等问题。多靶点粪便DNA检测符合精准医学诊疗模式,能够很大程度上弥补传统肠癌筛查手段的不足,对肠癌筛查手段的整体提升起到了重要的推动作用。本文通过概括国内外相关研究,总结粪便DNA检测技术的优缺点并探讨其应用价值。 展开更多
关键词 结直肠肿瘤 粪便 多靶点粪便DNA 筛查 粪便潜血试验
17种免疫法粪便潜血试验检测性能评估 预览
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作者 李佩 诸佩超 +1 位作者 宋荣维 陶沙 《检验医学》 CAS 2019年第2期152-158,共7页
目的通过对17种常用免疫法粪便潜血试验(FIT)的检测性能进行评估,探讨结直肠癌筛查假阳性率较高的原因。方法以模拟粪便为样本,配制14个不同浓度的检测样本。采用17种FIT对模拟粪便样本进行检测,编号1~15为定性FIT,编号16~17为定量FIT。... 目的通过对17种常用免疫法粪便潜血试验(FIT)的检测性能进行评估,探讨结直肠癌筛查假阳性率较高的原因。方法以模拟粪便为样本,配制14个不同浓度的检测样本。采用17种FIT对模拟粪便样本进行检测,编号1~15为定性FIT,编号16~17为定量FIT。由7名操作人员进行检测,并记录结果。2种定量FIT由其中2名操作人员采用Luminex200多功能流式点阵仪与OC-Sensor全自动便潜血分析仪进行检测,并记录结果。结果共收集1666份样本进行检测,11种定性FIT试剂阳性率高于理论阳性率(P<0.005),16、17号定量FIT试剂阳性率与理论阳性率差异无统计学意义(P16=0.43,P17=0.21),其粪便样本血红蛋白水平与理论浓度呈高度相关(r16=0.88,P<0.0001;r17=0.92,P<0.0001)。定性FIT的敏感性可达100.00%,且11种定性FIT的Kappa值均<0.40。16、17号定量FIT的敏感性均为86.21%,特异性分别为88.24%和97.06%,Kappa值分别为0.73、0.80。结论定性FIT成本低且操作方便,但缺乏对粪便取样量及稀释液的统一标准,实际阳性判断值低于预设阳性判断值,特异性低。定量FIT成本较高,但不易受人为主观判断影响,特异性相对较高。 展开更多
关键词 免疫法粪便潜血试验 结直肠癌 阳性判断值 敏感性 特异性
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醋酸戈舍瑞林缓释植入剂对妇科肿瘤术后化疗患者卵巢功能影响的临床研究 预览
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作者 张晓凤 《中国医学创新》 CAS 2018年第21期5-9,共5页
目的:探讨醋酸戈舍瑞林缓释植入剂在妇科肿瘤术后化疗患者中的应用效果及对卵巢功能的影响。方法:选择2014年8月-2015年7月本科室收治的妇科肿瘤术后化疗患者152例,按照随机数字表法分为对照组(n=76例)和观察组(n=76例)。对照组... 目的:探讨醋酸戈舍瑞林缓释植入剂在妇科肿瘤术后化疗患者中的应用效果及对卵巢功能的影响。方法:选择2014年8月-2015年7月本科室收治的妇科肿瘤术后化疗患者152例,按照随机数字表法分为对照组(n=76例)和观察组(n=76例)。对照组采用常规方法化疗,观察组在对照组基础上联合醋酸戈舍瑞林缓释植入剂治疗。采用免疫化学发光法测定两组手术前后卵泡雌激素(FSH)、雌二醇(E_2)及黄体生成素水平;采用彩色多普勒超声诊断仪对两组治疗前、后卵巢动脉血流指标PI、RI及S/D水平进行测定,记录并统计两组化疗后月经生育及绝经相关症状;记录并统计两组治疗后潮热出汗、易激动、失眠及性交痛发生率,比较两组临床疗效及对卵巢功能的影响。结果:观察组治疗6周期后FSH、E2及LH水平,均低于治疗前(P〈0.05);对照组治疗6周期后FSH和LH水平,均高于治疗前(P〈0.05);对照组治疗6周期后E_2水平,低于治疗前(P〈0.05);观察组治疗6周期后FSH、E_2及LH水平,均低于对照组(P〈0.05);观察组治疗6周期后卵巢血流学参数PI、RI及S/D水平,均低于对照组(P〈0.05);观察治疗6周期后月经复潮天数为(35.41±7.25)d,短于对照组的(102.53±4.28)d(P〈0.05)。观察组治疗6周期后月经稀发、经量减少及闭经发生率,均低于对照组(P〈0.05);观察组治疗6周期后潮热出汗、易激动、失眠及性交痛发生率,均低于对照组(P〈0.05);观察组与对照组均对保留生育功能者进行随访观察,观察组治疗后2~3年足月娩出率高于对照组(P〈0.05);观察组治疗后2~3年自然流产率、异位妊娠率,均低于对照组(P〈0.05)。结论:在常规化疗基础上联合醋酸戈舍瑞林缓释植入剂用于妇科肿瘤术后化疗患者中效果理想,有助于改善患者卵巢功能,能降低更年期相关症状,提高化疗后患者的妊娠率,值得 展开更多
关键词 醋酸戈舍瑞林缓释植入剂 妇科肿瘤 术后化疗 卵巢功能 彩色多普勒超声诊断仪 免疫化学发光法
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脑脊液细胞学检查联合细胞免疫化学染色在脑膜癌病诊断中的价值
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作者 姜宇 周仁华 +3 位作者 王娟 沈骏 鞠强国 袁颖 《中国医师进修杂志:综合版》 2018年第4期308-310,共3页
目的 探讨脑脊液细胞学检查联合细胞免疫化学染色方法在临床追踪脑膜癌病(MC)中的诊断价值.方法 患者脑脊液采用StatSpin Cytofuge 12离心机离心沉淀,MGG染色和SP法细胞免疫化学染色,对确诊为脑膜癌病的16例患者临床资料进行回顾性分... 目的 探讨脑脊液细胞学检查联合细胞免疫化学染色方法在临床追踪脑膜癌病(MC)中的诊断价值.方法 患者脑脊液采用StatSpin Cytofuge 12离心机离心沉淀,MGG染色和SP法细胞免疫化学染色,对确诊为脑膜癌病的16例患者临床资料进行回顾性分析.结果 16例患者中11例通过脑脊液细胞学检查联合细胞免疫化学染色确诊MC先于影像学发现脑膜病变;脑脊液细胞学检查光镜下观察癌细胞异型性明显,细胞免疫学检查清晰分辨MC的组织来源分类.结论 脑脊液细胞学检查联合细胞免疫化学染色方法是追踪颅内转移性恶性肿瘤的重要临床手段之一. 展开更多
关键词 脑膜癌病 硬膜下积液 细胞学技术 细胞免疫化学染色
检后随访在粪便隐血阳性人群中筛查结直肠癌的体会与教训 预览
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作者 鲍艳英 李凤 +4 位作者 费秀霞 周琳 张梦千 宋文军 沈振海 《中华保健医学杂志》 2018年第4期307-309,共3页
目的探讨在健康体检人群中应用粪便隐血免疫化学检测法(FIT)筛查结直肠癌(CRC)的有效路径。方法回顾性分析太湖疗养院2012~2016年应用FIT检测的健康体检人群159 614例,应用排除和复查标准,复测FIT,两次阳性病例推荐内窥镜检查,恶... 目的探讨在健康体检人群中应用粪便隐血免疫化学检测法(FIT)筛查结直肠癌(CRC)的有效路径。方法回顾性分析太湖疗养院2012~2016年应用FIT检测的健康体检人群159 614例,应用排除和复查标准,复测FIT,两次阳性病例推荐内窥镜检查,恶性肿瘤疑似病例推荐专科就诊。结果 FIT阳性人群10 931例病理诊断恶性肿瘤16例(CRC 13例、胃癌3例)。CRC在FIT检测人群中的不完全检出率8.15/10万,在FIT阳性人群中的不完全检出率118.93/10万。结论检后随访FIT结果、内窥镜检是体检中心筛查CRC的有效路径,其中提高内窥镜检依从性是关键。 展开更多
关键词 检后随访 结直肠癌 大便隐血
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Clinical importance of colonoscopy in patients with gastric neoplasm undergoing endoscopic submucosal dissection 预览
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作者 Chieko Tsuchida Naoto Yoshitake +9 位作者 Hitoshi Kino Yoshihito Kaneko Masakazu Nakano Kohei Tsuchida Keiichi Tominaga Takako Sasai Hironori Masuyama Hidetsugu Yamagishi Yasuo Imai Hideyuki Hiraishi 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第23期4262-4269,共8页
AIM To evaluate the usefulness of total colonoscopy(TCS) for patients undergoing gastric endoscopic submucosal dissection(ESD) and to assess risk factors for colorectal neoplasms.METHODS Of the 263 patients who underw... AIM To evaluate the usefulness of total colonoscopy(TCS) for patients undergoing gastric endoscopic submucosal dissection(ESD) and to assess risk factors for colorectal neoplasms.METHODS Of the 263 patients who underwent ESD at our department between May 2010 and December 2013, 172 patients undergoing TCS during a one-year period before and after ESD were targeted. After excluding patients with a history of surgery or endoscopic therapy for colorectal neoplasms, 158 patients were analyzed. Of the 868 asymptomatic patients who underwent TCS during the same period because of positive fecal immunochemical test(FIT) results, 158 patients with no history of either surgery or endoscopic therapy for colorectal neoplasms who were matched for age and sex served as the control group for comparison.RESULTS TCS revealed adenoma less than 10 mm in 53 patients(33.6%), advanced adenoma in 17(10.8%), early colorectal cancer in 5(3.2%), and advanced colorectalcancer in 4(2.5%). When the presence or absence of adenoma less than 10 mm, advanced adenoma, and colorectal cancer and the number of adenomas were compared between patients undergoing ESD and FITpositive patients, there were no statistically significant differences in any of the parameters assessed. The patients undergoing ESD appeared to have the same risk of colorectal neoplasms as the FIT-positive patients. Colorectal neoplasms were clearly more common in men than in women(P = 0.031). Advanced adenoma and cancer were significantly more frequent in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus(P = 0.019).CONCLUSION In patients undergoing gastric ESD, TCS appears to be important for detecting synchronous double neoplasms. Advanced adenoma and cancer were more common in patients with at least two of the following conditions: hypertension, dyslipidemia, and diabetes mellitus. Caution is therefore especially warranted in patients with these risk factors. 展开更多
关键词 COLONOSCOPY Colorectal 胃的瘤 内视镜的 submucosal 解剖 烘便的免疫化学的测试
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Colorectal cancer population screening programs worldwide in 2016: An update 预览
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作者 Mercedes Navarro Andrea Nicolas +1 位作者 Angel Ferrandez Angel Lanas 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第20期3632-3642,共11页
Colorectal cancer(CRC)is the third most commonly diagnosed cancer in the world.The incidence and mortality show wide geographical variations.Screening is recommended to reduce both incidence and mortality.However,ther... Colorectal cancer(CRC)is the third most commonly diagnosed cancer in the world.The incidence and mortality show wide geographical variations.Screening is recommended to reduce both incidence and mortality.However,there are significant differences among studies in implementation strategies and detection.This review aimed to present the results and strategies of different screening programs worldwide.We reviewed the literature on national and international screening programs published in Pub Med,on web pages,and in clinical guidelines.CRC Screening programs are currently underway in most European countries,Canada,specific regions in North and South America,Asia,and Oceania.The most extensive screening strategies were based on fecal occult blood testing,and more recently,the fecal immunochemical test(FIT).Participation in screening has varied greatly among different programs.The Netherlands showed the highest participation rate(68.2%)and some areas of Canada showed the lowest(16%).Participation rates were highest among women and in programs that used the FIT test.Men exhibited the greatest number of positive results.The FIT test has been the most widely used screening program worldwide.The advent of this test has increased participation rates and the detection of positive results. 展开更多
关键词 Colorectal 癌症 屏蔽的 Colorectal 癌症 烘便的秘密验血 烘便的免疫化学的测试 COLONOSCOPY
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粪便隐血序贯结肠镜对消化科门诊结直肠肿瘤机会性筛查的价值 被引量:2
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作者 丁晗玥 吴东 +1 位作者 周炜洵 李景南 《中华全科医师杂志》 2017年第5期356-360,共5页
目的 评估单次或多次粪便免疫化学试验(FIT)序贯结肠镜检查或直接结肠镜检查对结直肠肿瘤的筛查效力.方法 回顾性分析2013年1月至2015年12月北京协和医院消化科门诊行结肠镜筛查的6 193例患者的临床资料,按照不同筛查方式将其分为4组... 目的 评估单次或多次粪便免疫化学试验(FIT)序贯结肠镜检查或直接结肠镜检查对结直肠肿瘤的筛查效力.方法 回顾性分析2013年1月至2015年12月北京协和医院消化科门诊行结肠镜筛查的6 193例患者的临床资料,按照不同筛查方式将其分为4组并比较其筛查效力:①直接镜检组:不做FIT而直接行结肠镜检查;②1次隐血加镜检组:完成1次FIT后序贯结肠镜;③2次隐血加镜检组:2次FIT后序贯结肠镜;④3次隐血加镜检组:3次FIT后序贯结肠镜.结果 4组分别纳入3 812、1 244、341和796例患者,共检出结直肠癌 97例(1.6%),腺瘤1 038例(16.8%).对于结直肠癌,3次FIT至少1次(+)、至少2次(+)和3次均(+)者的阳性预测值分别为4.53%、5.62%和8.94%,优于直接镜检组(1.52%);其中3次FIT至少1次(+)者的受试者曲线下面积最大(0.743).对于结直肠腺瘤,直接镜检组的检出率(17 581.25/10万)高于所有FIT序贯结肠镜的方案(3 732.30/10万~13 127.41/10万).结论 单次或多次FIT序贯结肠镜与直接结肠镜检查的筛查效力不同.3次FIT至少获1次阳性结果后再行结肠镜检查,是筛查结直肠癌的最优方案;而直接结肠镜检查则有利于结直肠腺瘤的检出. 展开更多
关键词 结直肠肿瘤 筛查 结肠镜检查 粪便隐血试验 粪便免疫化学试验
不同性别和年龄段人群粪便隐血试验序贯结肠镜筛查结直肠癌的成本效果分析 被引量:3
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作者 丁晗玥 吴东 +1 位作者 周炜洵 李景南 《中华消化内镜杂志》 CSCD 北大核心 2017年第10期699-703,共5页
目的探讨不同性别和年龄段人群结直肠癌(CRC)直接结肠镜或粪便免疫化学试验(FIT)序贯结肠镜筛查的合理化方案。方法回顾性分析北京协和医院消化科门诊接受CRC机会性筛查的6193例患者,按筛查策略分为4组,直接结肠镜检查组及结肠镜... 目的探讨不同性别和年龄段人群结直肠癌(CRC)直接结肠镜或粪便免疫化学试验(FIT)序贯结肠镜筛查的合理化方案。方法回顾性分析北京协和医院消化科门诊接受CRC机会性筛查的6193例患者,按筛查策略分为4组,直接结肠镜检查组及结肠镜检查前1、2、3次FIT序贯组,总结分析不同性别及年龄段患者的CRC筛查成本效果比。结果共检出CRC97例(1.6%),结直肠腺瘤1038例(16.8%)。年龄≤40岁的人群,不论男女,1~3次FIT方案的CRC筛查成本效果比均优于直接结肠镜检查;〉40—60岁的人群,男性患者3次FIT中1次及2次阳性的CRC筛查成本效果比均优于直接结肠镜检查,女性患者3次FIT中1次阳性的CRC筛查成本效果比优于直接结肠镜检查;〉60岁的人群,男性患者直接结肠镜检查的CRC筛查成本效果比优于1—3次FIT方案,女性进行2次FIT中1次阳性的CRC筛查成本效果优于直接结肠镜。结论不同性别和年龄段人群应采取不同的CRC结肠镜筛查策略,超过60岁的男性建议直接行结肠镜检查,而女性及其他年龄的男性建议在获得FIT阳性结果后再行结肠镜检查,以便实现最优成本效果。 展开更多
关键词 恶性肿瘤 结肠 直肠 结肠镜检查 粪便免疫化学试验 成本效果分析
Colorectal and interval cancers of the Colorectal Cancer Screening Program in the Basque Country (Spain) 预览
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作者 Isabel Portillo Eunate Arana-Arri +4 位作者 Isabel Idigoras Isabel Bilbao Lorea Martínez-Indart Luis Bujanda I?aki Gutierrez-Ibarluzea 《世界胃肠病学杂志:英文版》 SCIE CAS 2017年第15期2731-2742,共12页
AIM To assess proportions, related conditions and survival of interval cancer(IC).METHODS The programme has a linkage with different clinical databases and cancer registers to allow suitable evaluation. This evaluatio... AIM To assess proportions, related conditions and survival of interval cancer(IC).METHODS The programme has a linkage with different clinical databases and cancer registers to allow suitable evaluation. This evaluation involves the detection of ICs after a negative faecal inmunochemical test(FIT), interval cancer FIT(IC-FIT) prior to a subsequent invitation, and the detection of ICs after a positive FIT and confirmatory diagnosis without colorectal cancer(CRC) detected and before the following recommended c o l o n o s c o p y, I C-c o l o n o s c o p y. W e c o n d u c t e d a retrospective observational study analyzing from January 2009 to December 2015 1193602 invited people onto the Programme(participation rate of 68.6%).RESULTS Two thousand five hundred and eighteen cancers were diagnosed through the programme, 18 cases of IC-colonoscopy were found before the recommended follow-up(43542 colonoscopies performed) and 186 IC-FIT were identified before the following invitation of the 769200 negative FITs. There was no statistically significant relation between the predictor variables of ICs with sex, age and deprivation index, but there was relation between location and stage. Additionally, it was observed that there was less risk when the location was distal rather than proximal(OR = 0.28, 95%CI: 0.20-0.40, P < 0.0001), with no statistical significance when the location was in the rectum as opposed to proximal. When comparing the screen-detected cancers(SCs) with ICs, significant differences in survival were found(P < 0.001); being the 5-years survival for SCs 91.6% and IC-FIT 77.8%.CONCLUSION These findings in a Population Based CRC Screening Programme indicate the need of population-based studies that continue analyzing related factors to improve their detection and reducing harm. 展开更多
关键词 Colorectal 癌症 人口屏蔽计划 间隔癌症 排泄物的免疫化学的测试 COLONOSCOPY 诊断 死亡 幸存
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Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program 预览
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作者 Georgia Vlachonikolou Paraskevas Gkolfakis +10 位作者 Athanasios D Sioulas Ioannis S Papanikolaou Anastasia Melissaratou Giannis-Aimant Moustafa Eleni Xanthopoulou Gerasimos Tsilimidos Ioanna Tsironi Paraskevas Filippidis Chrysoula Malli George D Dimitriadis Konstantinos Triantafyllou 《世界胃肠肿瘤学杂志:英文版(电子版)》 CAS 2016年第8期629-634,共6页
AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of 'Attikon' University General Hospital... AIM: To measure the compliance of an Academic Hospital staff with a colorectal cancer(CRC) screening program using fecal immunochemical test(FIT).METHODS: All employees of 'Attikon' University General Hospital aged over 50 years were thoroughly informed by a team of physicians and medical students about the study aims and they were invited to undergo CRC screening using two rounds of FIT(DyoniFOB~ Combo H, DyonMed SA, Athens, Greece). The tests were provided for free and subjects tested positive were subsequently referred for colonoscopy. One year after completing the two rounds, participants were asked to be re-screened by means of the same test.RESULTS: Among our target population consisted of 211 employees, 59(27.9%) consented to participate, but only 41(19.4%) and 24(11.4%) completed the first and the second FIT round, respectively. Female gender was significantly associated with higher initial participation(P = 0.005) and test completion- first and second round-(P = 0.004 and P = 0.05) rates, respectively. Phy sician’s(13.5% vs 70.2%, P < 0.0001) participation and test completion rates(7.5% vs 57.6%, P < 0.0001 for the first and 2.3% vs 34%, P < 0.0001 for the second round) were significantly lower compared to those of the administrative/technical staff. Similarly, nurses participated(25.8% vs 70.2%, P = 0.0002) and completed the first test round(19.3% vs 57.6%, P = 0.004) in a significant lower rate than the administrative/technical staff. One test proved false positive. No participant repeated the test one year later.CONCLUSION: Despite the well-organized, guided and supervised provision of the service, the compliance of the Academic Hospital personnel with a FIT-based CRC screening program was suboptimal, especially among physicians. 展开更多
关键词 Colorectal cancer Screening ACADEMIC hospital STAFF FECAL immunochemical TEST COMPLIANCE
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Colorectal cancer screening: Opportunities to improve uptake, outcomes, and disparities 预览
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作者 Neal Shahidi Winson Y Cheung 《世界胃肠内镜杂志:英文版(电子版)》 2016年第20期733-740,共8页
Colorectal cancer screening has become a standard of care in industrialized nations for those 50 to 75 years of age, along with selected high-risk populations. While colorectal cancer screening has been shown to reduc... Colorectal cancer screening has become a standard of care in industrialized nations for those 50 to 75 years of age, along with selected high-risk populations. While colorectal cancer screening has been shown to reduce both the incidence and mortality of colorectal cancer, it is a complex multi-disciplinary process with a number of important steps that require optimization before tangible improvements in outcomes are possible. For both opportunistic and programmatic colorectal cancer screening, poor participant uptake remains an ongoing concern. Furthermore, current screening modalities(such as the guaiac based fecal occult blood test,fecal immunochemical test and colonoscopy) may be used or performed suboptimally, which can lead to missed neoplastic lesions and unnecessary endoscopicevaluations. The latter poses the risk of adverse events,such as perforation and post-polypectomy bleeding,as well as financial impacts to the healthcare system.Moreover, ongoing disparities in colorectal cancer screening persist among marginalized populations, including specific ethnic minorities (African Americans, Hispanics, Asians, Indigenous groups), immigrants, and those who are economically disenfranchised. Given this context, we aimed to review the current literature on these important areas pertaining to colorectal cancer screening, particularly focusing on the guaiac based fecal occult blood test, the fecal immunochemical test and colonoscopy. 展开更多
关键词 FECAL OCCULT blood TEST FECAL immunochemical TEST Colonoscopy NEOPLASIA POLYP
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