Characteristics of Adenomas Detected by Fecal Immunochemical Test in Colorectal Cancer Screening

被引:15
作者
Cubiella, Joaquin [1 ]
Castro, Ines [1 ]
Hernandez, Vicent [2 ,3 ]
Gonzalez-Mao, Carmen [3 ,4 ]
Rivera, Concepcion [1 ]
Iglesias, Felipe [2 ]
Cid, Lucia [2 ,3 ]
Soto, Santiago [1 ]
de-Castro, Luisa [2 ,3 ]
Vega, Pablo [1 ]
Antonio Hermo, Jose [2 ]
Macenlle, Ramiro [1 ]
Martinez, Alfonso [2 ,3 ]
Martinez-Ares, David [2 ,3 ]
Estevez, Pamela [2 ,3 ]
Cid, Estela [1 ]
Herreros-Villanueva, Marta [5 ]
Portillo, Isabel [6 ]
Bujanda, Luis [5 ]
Fernandez-Seara, Javier [1 ]
机构
[1] Univ Ourense, Dept Gastroenterol, Complexo Hosp, Orense 32005, Spain
[2] Univ Vigo, Complexo Hosp, Dept Gastroenterol, Vigo 36310, Spain
[3] IBIV Inst Biomed Res Vigo, Vigo, Spain
[4] Univ Vigo, Complexo Hosp, Dept Clin Anal, Vigo 36310, Spain
[5] Univ Basque Country UPV EHU, CIBERehd, Biodonostia Inst, Donostia Hosp, San Sebastian, Spain
[6] Serv Vasco Salud, Programa Cribado Canc Colorrectal, Pais Vasco, Spain
关键词
SOCIETY-TASK-FORCE; COLONOSCOPY; NEOPLASIA; QUALITY; RISK; SURVEILLANCE; SENSITIVITY; GUIDELINES; POLYPS;
D O I
10.1158/1055-9965.EPI-13-1346
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Fecal immunochemical test (FIT) diagnostic accuracy for colorectal adenoma detection in colorectal cancer screening is limited. Methods: We analyzed 474 asymptomatic subjects with adenomas detected on colonoscopy in two blinded diagnostic tests studies designed to assess FIT diagnostic accuracy. We determined the characteristics of adenomas (number, size, histology, morphology, and location) and the risk of metachronous lesions (according to European guidelines). Finally, we performed a logistic regression to identify those variables independently associated with a positive result. Results: Advanced adenomas were found in 145 patients (75.6% distal and 24.3% only proximal to splenic flexure). Patients were classified as low (59.5%), intermediate (30.2%), and high risk (10.3%) according to European guidelines. At a 100-ng/mL threshold, FIT was positive in 61 patients (12.8%). Patients with advanced adenomas [odds ratio (OR), 8.8; 95% confidence interval (CI), 4.76-16.25], distal advanced adenomas (OR, 6.7; 95% CI, 1.9-8.8), high risk (OR, 20.1; 95% CI, 8.8-45.8), or intermediate risk lesions (OR, 6; 95% CI, 2.9-12.4) had more probabilities to have a positive test. The characteristics of adenomas independently associated were number of adenomas (OR, 1.22; 95% CI, 1.04-1.42), distal flat adenomas (OR, 0.44; 95% CI, 0.21-0.96), pedunculated adenomas (OR, 2.28; 95% CI, 1.48-3.5), and maximum size of distal adenomas (mm; OR, 1.24; 95% CI, 1.16-1.32). Conclusions: European guidelines classification and adenoma location correlates with the likelihood of a positive FIT result. Impact: This information allows us to understand the FIT impact in colorectal cancer prevention. Likewise, it should be taken into account in the development of new colorectal adenomas biomarkers. (C) 2014 AACR.
引用
收藏
页码:1884 / 1892
页数:9
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