Faecal haemoglobin: Measurement, applications, and future potential

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Callum G. Fraser
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Abstract

Faecal hemoglobin concentrations (f-Hb) can be quantitated using faecal immunochemical test for haemoglobin (FIT) analytical systems. FIT are of proven value and widely used in colorectal cancer (CRC) screening. Several factors affect f-Hb including sex, age, deprivation, geographical region, and FIT system. Thus, FIT data may not be transferable. Women are disadvantaged in programmes using a single f-Hb threshold for all participants, but risk scoring or sex stratified thresholds could be used to minimise this problem. In addition, low but detectable f-Hb, below the threshold, implies future risk of CRC. In several countries, where colonoscopy resources are constrained, FIT are now accepted as of added value in assessment of patients presenting in primary or secondary care with symptoms, although some serious colorectal disease is missed. Elevated f-Hb in the absence of any discernible colorectal lesions is common and has been found in several diseases with a systemic inflammatory component, including circulatory, respiratory, digestive, neuropsychological, blood and endocrine diseases, and others. There is growing evidence for the value of f-Hb in post-polypectomy surveillance, potentially saving costs and colonoscopy. There may be a role for FIT systems which have lower limits of detection than currently available methods. The faecal material remaining in FIT specimen collection devices could be used for further studies, including assessment of the microbiome. The estimation of f-Hb is now a mature investigative tool but further research will undoubtedly expand applications of value.

粪便血红蛋白:测量、应用和未来潜力。
粪便血红蛋白浓度(f-Hb)可以使用血红蛋白(FIT)分析系统的粪便免疫化学测试进行定量。FIT已被证明有价值,并广泛应用于癌症(CRC)筛查。影响f-Hb的几个因素包括性别、年龄、贫困、地理区域和FIT系统。因此,FIT数据可能不可转让。在对所有参与者使用单一f-Hb阈值的项目中,女性处于不利地位,但可以使用风险评分或性别分层阈值来最大限度地减少这一问题。此外,低但可检测的f-Hb低于阈值,意味着未来CRC的风险。在结肠镜检查资源有限的几个国家,FIT现在被认为是评估有症状的初级或二级护理患者的附加值,尽管遗漏了一些严重的结肠直肠疾病。在没有任何可辨别的结直肠病变的情况下,f-Hb升高是常见的,并且已经在几种具有全身炎症成分的疾病中发现,包括循环系统、呼吸系统、消化系统、神经心理学、血液和内分泌疾病等。越来越多的证据表明f-Hb在息肉切除术后监测中的价值,有可能节省成本和结肠镜检查。FIT系统的检测极限可能低于目前可用的方法。FIT标本采集装置中残留的粪便物质可用于进一步研究,包括评估微生物组。f-Hb的估计现在是一种成熟的研究工具,但进一步的研究无疑将扩大其应用价值。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
23
审稿时长
69 days
期刊介绍: Each topic-based issue of Best Practice & Research Clinical Gastroenterology will provide a comprehensive review of current clinical practice and thinking within the specialty of gastroenterology.
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