Diagnostic Performance of Faecal Immunochemical Testing (FIT) in Patients with Lynch Syndrome Scheduled for Colonoscopic Surveillance.

IF 3 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Diagnostics Pub Date : 2024-10-30 DOI:10.3390/diagnostics14212431

Adam D Gerrard, Yasuko Maeda, Judith Strachan, Doug Speake, Malcolm G Dunlop, Farhat V N Din

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引用次数: 0

Abstract

Background and aims: Lynch syndrome (LS) carries a substantial lifetime risk of colorectal cancer which is currently mitigated by biennial colonoscopy surveillance. Paramount to the surveillance programme is the removal of adenomas before malignant transformation but there is an associated service burden and morbidity of repeated endoscopy. We investigated if faecal immunochemical testing (FIT) for faecal haemoglobin has the diagnostic performance to replace colonoscopy.

Methods: In this retrospective cohort study, patients due to undergo planned surveillance for LS between November 2020 and April 2022 were sent two FIT kits prior to colonoscopy. Test diagnostic performance of colorectal cancer (CRC), advanced and non-advanced adenoma detection was calculated for single and double FIT strategies. A faecal-Hb of 10 µg Hb/g was considered positive.

Results: In total, 78 patients, with 45 (57.7%) female, median age 52 years (IQR 41-63), completed at least one FIT and colonoscopy. The median time from FIT to colonoscopy was 47 days. A single FIT was positive in 7/30 cases of adenoma (2/3 advanced, 5/27 non-advanced). A total of 64 (82.1% of FIT1T returners) completed a second FIT. Using the greatest of the two FITs (FIT2TMAX) 8/26 (2/3 advanced, 4/23 non-advanced), patients with adenomas were identified. There were no cases of CRC. The sensitivity for adenoma detection was 23.3% and 23.1%, respectively.

Conclusions: In patients with LS awaiting colonoscopy, FIT has a low sensitivity for detecting adenomas and advanced adenomas. This is not improved by the addition of a second FIT test.

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计划进行结肠镜监测的林奇综合征患者粪便免疫化学检验 (FIT) 的诊断性能。

背景和目的：林奇综合征（LS）患者一生中罹患结直肠癌的风险很高，目前通过每两年一次的结肠镜检查来降低这一风险。监测计划的首要任务是在腺瘤恶变前将其切除，但重复内镜检查会带来相关的服务负担和发病率。我们研究了粪便血红蛋白免疫化学检验（FIT）是否具有取代结肠镜检查的诊断性能：在这项回顾性队列研究中，2020 年 11 月至 2022 年 4 月期间计划接受 LS 监测的患者在结肠镜检查前会收到两个 FIT 套件。计算了单FIT和双FIT策略对结直肠癌（CRC）、晚期和非晚期腺瘤检测的诊断性能。粪便中 Hb 含量达到 10 µg Hb/g 即为阳性：共有 78 名患者完成了至少一次 FIT 和结肠镜检查，其中女性 45 人（57.7%），中位年龄 52 岁（IQR 41-63）。从 FIT 到结肠镜检查的中位时间为 47 天。7/30 例腺瘤（2/3 例晚期，5/27 例非晚期）的单次 FIT 结果呈阳性。共有 64 人（占 FIT1T 返回者的 82.1%）完成了第二次 FIT。使用两次 FIT 的最大值（FIT2TMAX），确定了 8/26 例腺瘤患者（2/3 例晚期，4/23 例非晚期）。没有发现癌症病例。腺瘤检测灵敏度分别为 23.3% 和 23.1%：结论：在等待结肠镜检查的 LS 患者中，FIT 检测腺瘤和晚期腺瘤的灵敏度较低。增加第二次 FIT 检测并不能改善这种情况。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diagnostics Biochemistry, Genetics and Molecular Biology-Clinical Biochemistry

CiteScore

4.70

自引率

8.30%

发文量

2699

审稿时长

19.64 days

期刊介绍： Diagnostics (ISSN 2075-4418) is an international scholarly open access journal on medical diagnostics. It publishes original research articles, reviews, communications and short notes on the research and development of medical diagnostics. There is no restriction on the length of the papers. Our aim is to encourage scientists to publish their experimental and theoretical research in as much detail as possible. Full experimental and/or methodological details must be provided for research articles.