Identifying the best cutoff value of the fecal occult blood immunochemical test in the detection of advanced and neoplastic colorectal lesions.

Patricia Gaggero, Eduardo Fenocchi, Cecilia Silva, Juan C López-Alvarenga, Natalia Lambert, Fabián Batista, Sergio Sobrino-Cossío, Jonathan R White, Adolfo Parra-Blanco
{"title":"Identifying the best cutoff value of the fecal occult blood immunochemical test in the detection of advanced and neoplastic colorectal lesions.","authors":"Patricia Gaggero, Eduardo Fenocchi, Cecilia Silva, Juan C López-Alvarenga, Natalia Lambert, Fabián Batista, Sergio Sobrino-Cossío, Jonathan R White, Adolfo Parra-Blanco","doi":"10.24875/CIRU.23000651","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.</p><p><strong>Methods: </strong>This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/mL) referred for colonoscopy (2012-2015) at a tertiary center in Uruguay.</p><p><strong>Results: </strong>Colorectal lesions were detected in 35.3% (516/1461) of cases, with a mean age of 62.8 ± 8.3 years. About 53.2% were men and 65.1% of the tumors were located in the left side of the colon. The size of the lesion and FIT values (p = 0.001) were positively correlated. Laterally spreading tumors predominated in the right colon (586 ng Hb/mL; 95% Confidence interval [CI] 443.4-760). One hundred and thirty-five (26%) lesions were advanced adenomas (15 ± 6.7 mm); 694.6 ng/mL; 95% CI 632.4-756.9). The highest diagnostic yield (0.5112) for advanced adenomas was at a FIT level of 400 ng Hb/mL (accuracy 88.6%). There were significant differences in FIT values early and advanced CRC (927 ng/mL; [95% CI: 637-1082] vs. 1453 [95% CI: 1352-1594; p = 0.001]).</p><p><strong>Conclusion: </strong>A FIT value of 400 ng Hb/mL was the best diagnostic yield to detect advanced adenomas and CRC. This value is useful during the COVID-19 pandemic as it allows prioritization of colonoscopy to those most at risk of significant disease, thus reducing risks to both patients and healthcare workers.</p>","PeriodicalId":93936,"journal":{"name":"Cirugia y cirujanos","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cirugia y cirujanos","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.24875/CIRU.23000651","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: Screening is an effective tool for detecting colorectal lesions in asymptomatic subjects. There is a positive correlation between fecal immunochemical test (FIT) values and the size of tumors. Despite the efficacy of screening, the detection of colorectal cancer (CRC) remains low. The primary objective was to evaluate the best FIT cutoff value for detecting advanced adenomas and CRC among individuals at average risk in a country with a high incidence and morbidity from CRC.

Methods: This observational and prospective study analyzed consecutive cases in 1461 asymptomatic subjects with a positive FIT (≥ 100 ng hemoglobin [Hb]/mL) referred for colonoscopy (2012-2015) at a tertiary center in Uruguay.

Results: Colorectal lesions were detected in 35.3% (516/1461) of cases, with a mean age of 62.8 ± 8.3 years. About 53.2% were men and 65.1% of the tumors were located in the left side of the colon. The size of the lesion and FIT values (p = 0.001) were positively correlated. Laterally spreading tumors predominated in the right colon (586 ng Hb/mL; 95% Confidence interval [CI] 443.4-760). One hundred and thirty-five (26%) lesions were advanced adenomas (15 ± 6.7 mm); 694.6 ng/mL; 95% CI 632.4-756.9). The highest diagnostic yield (0.5112) for advanced adenomas was at a FIT level of 400 ng Hb/mL (accuracy 88.6%). There were significant differences in FIT values early and advanced CRC (927 ng/mL; [95% CI: 637-1082] vs. 1453 [95% CI: 1352-1594; p = 0.001]).

Conclusion: A FIT value of 400 ng Hb/mL was the best diagnostic yield to detect advanced adenomas and CRC. This value is useful during the COVID-19 pandemic as it allows prioritization of colonoscopy to those most at risk of significant disease, thus reducing risks to both patients and healthcare workers.

确定粪便潜血免疫化学检验在检测晚期和肿瘤性结直肠病变中的最佳临界值。
目的:筛查是检测无症状人群结直肠病变的有效工具。粪便免疫化学检验(FIT)值与肿瘤大小呈正相关。尽管筛查很有效,但大肠癌(CRC)的检出率仍然很低。这项研究的主要目的是评估在一个 CRC 发病率和发病率较高的国家中,检测平均风险人群中晚期腺瘤和 CRC 的最佳 FIT 临界值:这项前瞻性观察研究分析了乌拉圭一家三级中心转诊接受结肠镜检查的1461名FIT阳性(血红蛋白[Hb]≥100 ng/mL)无症状受检者的连续病例(2012-2015年):35.3%的病例(516/1461)发现结肠直肠病变,平均年龄为 62.8 ± 8.3 岁。约 53.2% 为男性,65.1% 的肿瘤位于左侧结肠。病变大小与 FIT 值(P = 0.001)呈正相关。侧向扩散的肿瘤主要位于右侧结肠(586 ng Hb/mL;95% 置信区间 [CI] 443.4-760)。135个病灶(26%)为晚期腺瘤(15 ± 6.7 mm);694.6 纳克/毫升;95% 置信区间 [CI] 632.4-756.9)。FIT 值为 400 纳克血红蛋白/毫升时,晚期腺瘤的诊断率最高(0.5112)(准确率为 88.6%)。早期和晚期 CRC 的 FIT 值有明显差异(927 ng/mL;[95% CI:637-1082] vs. 1453 [95% CI:1352-1594;p = 0.001]):结论:400 ng Hb/mL 的 FIT 值是检测晚期腺瘤和 CRC 的最佳诊断率。在 COVID-19 大流行期间,该值非常有用,因为它能让结肠镜检查优先考虑那些最有可能患重大疾病的人,从而降低患者和医护人员的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信