结肠标志 AI 工具与粪便免疫化学检验相结合在下消化道癌症急诊患者中的诊断应用

IF 3.3 Q2 GASTROENTEROLOGY & HEPATOLOGY
Ruth M Ayling, Finbarr Cotter
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引用次数: 0

摘要

目标 大肠癌(CRC)是英国第四大常见癌症。有症状提示 CRC 的患者应转诊接受紧急检查。然而,胃肠道症状往往不是特异性的,因此需要合适的分诊工具来确定检查的优先次序。在本研究中,我们对粪便免疫化学检验(FIT)、贫血和人工智能算法 ColonFlag 的性能进行了回顾性检查,并评估了它们对紧急转诊的下消化道癌症患者的潜在临床益处。设计 纳入所有在 12 个月内转诊的 40 岁以上患者。6 个月后,对临床结果进行测定,并对分流测试的性能进行评估。结果 共有 3822 名患者完成检查并获得诊断。其中 143 人患有癌症,126 人患有高危腺瘤 (HRA)。ColonFlag会漏检27例CRC和29例HRA。以 10 µg/g 为临界值的粪便血红蛋白 (f-Hb) 会漏检 10 例 CRC 和 26 例 HRA;粪便血红蛋白与贫血相结合会漏检 2 例 CRC 和 14 例 HRA。将 f-Hb 与 ColonFlag 结合使用只会漏诊 1 例 CRC 和 5 例 HRA,并会减少 400 多名患者的紧急转诊需求。结论 ColonFlag 有助于检测 CRC 和 HRA,在没有粪便样本的情况下可单独使用,与 FIT 结合使用可减少紧急转诊的需求。如有合理要求,可提供相关数据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diagnostic application of the ColonFlag AI tool in combination with faecal immunochemical test in patients on an urgent lower gastrointestinal cancer pathway
Objective Colorectal cancer (CRC) is the fourth most common cancer in the UK. Patients with symptoms suggestive of CRC should be referred for urgent investigation. However, gastrointestinal symptoms are often non-specific and there is a need for suitable triage tools to enable prioritisation of investigations. In this study, the performance of the faecal immunochemical test (FIT), anaemia and the artificial intelligence algorithm ColonFlag were retrospectively examined and evaluated for their potential clinical benefits in patients who had been referred on an urgent lower gastrointestinal cancer pathway. Design All patients aged over 40 years referred in a 12-month period were included. After 6 months, clinical outcomes were determined and the performance of the triage tests was evaluated. Results A total of 3822 patients completed investigations and received a diagnosis. 143 had CRC, 126 high-risk adenomas (HRA). ColonFlag would have missed 27 CRC and 29 HRA. Faecal haemoglobin (f-Hb) at a cut-off of 10 µg/g would have missed 10 CRC and 26 HRA; f-Hb in combination with anaemia would have missed 2 CRC and 14 HRA. Using f-Hb in combination with ColonFlag would have missed only 1 CRC and 5 HRA and would have reduced the need for urgent referral by over 400 patients. Conclusion ColonFlag has potential to assist detection of CRC and HRA, alone where no faecal sample is present and in combination with FIT and to reduce the need for urgent referral. Data are available on reasonable request.
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来源期刊
BMJ Open Gastroenterology
BMJ Open Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.90
自引率
3.20%
发文量
68
审稿时长
2 weeks
期刊介绍: BMJ Open Gastroenterology is an online-only, peer-reviewed, open access gastroenterology journal, dedicated to publishing high-quality medical research from all disciplines and therapeutic areas of gastroenterology. It is the open access companion journal of Gut and is co-owned by the British Society of Gastroenterology. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around continuous publication, publishing research online as soon as the article is ready.
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