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Assessment of disease activity by fecal immunochemical test in ulcerative colitis

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World Journal of Gastroenterology 2016年第48期22卷 10617-10624页

作者： Dae Gon Ryu Hyung Wook Kim Su Bum Park Dae Hwan Kang Cheol Woong Choi Su Jin Kim Hyeong Seok Nam Department of Internal Medicine Pusan National University School of Medicine and Research Institute for Convergence of Biomedical Science and Technology Pusan National University Yangsan Hospital

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 *** All of 21 patients with MES 0 had negative FIT( 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

关键词： Ulcerative colitis Fecal immunochemical test Mayo endoscopic subscore Biomarker Disease activity

High-risk symptoms and quantitative faecal immunochemical test accuracy: Systematic review and meta-analysis

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World Journal of Gastroenterology 2019年第19期25卷 2383-2401页

作者： Noel Pin Vieito Sara Zarraqui?os Joaquín Cubiella Department of Gastroenterology Complexo Hospitalario Universitario de Ourense Instituto de Investigación Sanitaria Galicia Sur Department of Biochemistry Genetics and Immunology Faculty of Biology University of Vigo

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 ***, it is unknown whether FIT′s accuracy remains stable throughout the broad spectrum of possible *** To perform a systematic review and meta-analysis to assess FIT accuracy for CRC detection in different clinical *** 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 *** 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.

关键词： Bowel disease Colorectal cancer Diagnostic accuracy Faecal haemoglobin Faecal immunochemical test Faecal occult blood test Inflammatory bowel disease Significant colonic lesion

Academic hospital staff compliance with a fecal immunochemical test-based colorectal cancer screening program

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World Journal of Gastrointestinal Oncology 2016年第8期8卷 629-634页

作者： Georgia Vlachonikolou Paraskevas Gkolfakis 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 Hepatogastroenterology Unit Second Department of Internal Medicine and Research Institute Attikon University General Hospital Medical School University of Athens

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 ***: 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 ***: 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.

关键词： Colorectal cancer Screening Academic hospital staff Fecal immunochemical test Compliance

Systematic review of colorectal cancer screening guidelines for average-risk adults: Summarizing the current global recommendations

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World Journal of Gastroenterology 2018年第1期24卷 124-138页

作者： Florence Bénard Alan N Barkun Myriam Martel Daniel von Renteln Department of Medicine University of Montreal (UdeM )and University of Montreal Hospital Research Center (CRCHUM) Division of Gastroenterology McGill University Health Center McGill University Department of Medicine Division of Gastroenterology University of Montreal Hospital (CHUM)University of Montreal Hospital Research Center (CRCHUM)

AIM To summarize and compare worldwide colorectal cancer(CRC) screening recommendations in order to identify similarities and *** 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.

关键词： Guidelines Systematic review fecal occult blood test Fecal immunochemical test Colonoscopy Colorectal cancer Screening Flexible sigmoidoscopy

Colorectal cancer screening: Opportunities to improve uptake, outcomes, and disparities

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World Journal of Gastrointestinal Endoscopy 2016年第20期8卷 733-740页

作者： Neal Shahidi Winson Y Cheung Division of Gastroenterology Department of Medicine University of British Columbia Vancouver BC V6Z 2K5 Canada Division of Medical Oncology Department of Medicine University of British Columbia Vancouver BC V5Z 4E6 Canada British Columbia Cancer Agency VancouverBC V5Z 4E6 Canada

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 *** 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 *** both opportunistic and programmatic colorectal cancer screening,poor participant uptake remains an ongoing ***,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 endoscopic *** latter poses the risk of adverse events,such as perforation and post-polypectomy bleeding,as well as financial impacts to the healthcare ***,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 *** 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.

关键词： Fecal occult blood test Fecal immunochemical test Colonoscopy Neoplasia Polyp

Quantitative Analysis of Fecal Hemoglobin Concentration in Colorectal Cancer Patients-The Values in the Screening and Diagnosis of Colorectal Cancer

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Proceedings of Anticancer Research 2020年第1期4卷 19-22页

作者： Manqun Wu Jianping Hu Shaoqi Yang The First People's Hospital of Yinchuan Yinchuan City 750001Ningxia ProvinceChina Affiliated Hospital of Ningxia Medical University Yinchuan City 750004Ningxia ProvinceChina

Objective:To use immunochemical detection of fecal hemoglobin amount as a technical method,to perform a fecal immunochemical test(FIT)on the fecal specimens of research subjects who were going to undergo *** recorded results are compared and analyzed,and the sensitivity and specificity of the detection method in the diagnosis of colorectal cancer were ***:Three hundred of individuals who were going to undergo colonoscopy were tested for GFOBT and FIT in feces in advance,and 20μg/g was used as the threshold for determining positive FIT *** results were analyzed and compared with the results of ***:The sensitivity of FIT to the diagnosis of colorectal cancer was 80.95%,and the specificity was 86.54%.The positive predictive values of FIT test in colorectal cancer screening were 53.1%and 81.77%,***:FIT is more sensitive and specific for detecting colorectal cancer and *** fecal occult blood test(FOBT)is stronger,and FIT test detection is more valuable in colon cancer screening.

关键词： Colonoscopy Fecal immunochemical test Colorectal cancer screening

Quantitative Analysis of Fecal Hemoglobin Concentration in Colorectal Cancer Patients-The Values in the Screening and Diagnosis of Colorectal Cancer

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Proceedings of Anticancer Research 2019年第5期3卷 4-6页

作者： Manqun Wu Department of Gastroenterology The First People's Hospital of YinchuanYinchuan City 750001Ningxia Province

关键词： Colonoscopy Fecal immunochemical test Colorectal cancer screening

Application of quantitative estimates of fecal hemoglobin concentration for risk prediction of colorectal neoplasia

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World Journal of Gastroenterology 2013年第45期19卷 8366-8372页

作者： Chao-Sheng Liao Yu-Min Lin Hung-Chuen Chang Yu-Hung Chen Lee-Won Chong Chun-Hao Chen Yueh-Shih Lin Kuo-Ching Yang Chia-Hui Shih Division of Gastroenterology Department of Internal Medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan School of Medicine Fu Jen Catholic University New Taipei City 24205 Taiwan Department of Family Medicine Shin Kong Wu Ho-Su Memorial Hospital Taipei 111 Taiwan Health Management Center Shin Kong Wu HoSu Memorial Hospital Taipei 111 Taiwan Chang Gung Institute of Technology School of Nursing Tao-Yuan 333 Taiwan

AIM:To determine the role of the fecal immunochemical test(FIT),used to evaluate fecal hemoglobin concentration,in the prediction of histological grade and risk of colorectal ***:We enrolled 17881 individuals who attended the two-step colorectal cancer screening program in a single hospital between January 2010 and October *** was recommended to the participants with an FIT of≥12 ngHb/mL *** classified colorectal lesions as cancer(C),advanced adenoma(AA),adenoma(A),and others(O)by their colonoscopic and histological *** linear regression analysis adjusted for age and gender was used to determine the association between the FIT results and colorectal tumor *** risk of adenomatous neoplasia was estimated by calculating the positive predictive values for different FIT ***:The positive rate of the FIT was 10.9%(1948/17881).The attendance rate for colonoscopy was 63.1%(1229/1948).The number of false positive results was *** these 1229 cases,the numbers of O,A,AA,and C were 759,221,201,and 48,*** analysis revealed a positive association between histological grade and FIT concentration(β=0.088,P0.95,P<0.001).CONCLUSION:Higher FIT concentrations are associated with more advanced histological *** prediction for colorectal neoplasia based on individual FIT concentrations is significant and may help to improve the performance of screening programs.

关键词： Colorectal cancer Fecal immunochemical test Screening Risk prediction Performance