{"title":"使用阿司匹林可提高粪便免疫化学试验腺瘤检出率和阳性预测值。","authors":"Zhongxue Han, Ruchen Zhou, Yueyue Li, Yanqing Li","doi":"10.1111/jgh.16949","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background and Aim</h3>\n \n <p>We aim to evaluate the effect of aspirin on fecal immunochemical test (FIT) performance for advanced colorectal neoplasia (ACRN) including advanced adenoma (AA) and colorectal cancer (CRC).</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A multicenter study involved 4887 individuals who were asked to complete a quantitative FIT and subsequent colonoscopy. Aspirin users and nonusers were matched for age and sex. The primary outcome was the positive predictive value (PPV) of FIT compared between users and matched nonusers. Univariable and multivariable logistic regression analyses were also conducted in the entire cohort and expressed as odds ratio (OR) with 95% confidence interval (CI).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>For AA, the PPV of FIT was 25.30% in users vs. 14.71% in nonusers (<i>p</i> = 0.005), and the detection rate was 8.28% in users vs. 4.44% in nonusers (<i>p</i> = 0.003). The multivariable OR after adjusting age and sex was 1.52 (95% CI, 1.02–2.22, <i>p</i> = 0.036) for PPV and 1.41 (95% CI, 0.99–1.99, <i>p</i> = 0.052) for the detection rate compared between users and nonusers. Aspirin did not affect the sensitivity and specificity of FIT for AA. Additionally, no significant difference in FIT performance for ACRN and CRC was observed.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The use of aspirin increased detection rate and PPV of FIT for AA, without impact on FIT performance for ACRN and CRC. Given the risk of cardiovascular events and influence on participation rate of FIT screening, aspirin withdrawal before FIT is unnecessary.</p>\n </section>\n </div>","PeriodicalId":15877,"journal":{"name":"Journal of Gastroenterology and Hepatology","volume":"40 6","pages":"1461-1471"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Use of Aspirin Increased the Adenoma Detection Rate and Positive Predictive Value of Fecal Immunochemical Test\",\"authors\":\"Zhongxue Han, Ruchen Zhou, Yueyue Li, Yanqing Li\",\"doi\":\"10.1111/jgh.16949\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background and Aim</h3>\\n \\n <p>We aim to evaluate the effect of aspirin on fecal immunochemical test (FIT) performance for advanced colorectal neoplasia (ACRN) including advanced adenoma (AA) and colorectal cancer (CRC).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>A multicenter study involved 4887 individuals who were asked to complete a quantitative FIT and subsequent colonoscopy. Aspirin users and nonusers were matched for age and sex. The primary outcome was the positive predictive value (PPV) of FIT compared between users and matched nonusers. Univariable and multivariable logistic regression analyses were also conducted in the entire cohort and expressed as odds ratio (OR) with 95% confidence interval (CI).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>For AA, the PPV of FIT was 25.30% in users vs. 14.71% in nonusers (<i>p</i> = 0.005), and the detection rate was 8.28% in users vs. 4.44% in nonusers (<i>p</i> = 0.003). The multivariable OR after adjusting age and sex was 1.52 (95% CI, 1.02–2.22, <i>p</i> = 0.036) for PPV and 1.41 (95% CI, 0.99–1.99, <i>p</i> = 0.052) for the detection rate compared between users and nonusers. Aspirin did not affect the sensitivity and specificity of FIT for AA. Additionally, no significant difference in FIT performance for ACRN and CRC was observed.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>The use of aspirin increased detection rate and PPV of FIT for AA, without impact on FIT performance for ACRN and CRC. Given the risk of cardiovascular events and influence on participation rate of FIT screening, aspirin withdrawal before FIT is unnecessary.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15877,\"journal\":{\"name\":\"Journal of Gastroenterology and Hepatology\",\"volume\":\"40 6\",\"pages\":\"1461-1471\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Gastroenterology and Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jgh.16949\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology and Hepatology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jgh.16949","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景与目的：本研究旨在评价阿司匹林对晚期结直肠肿瘤（ACRN）包括晚期腺瘤（AA）和结直肠癌（CRC）患者粪便免疫化学试验（FIT）表现的影响。方法：一项涉及4887人的多中心研究，他们被要求完成定量FIT和随后的结肠镜检查。阿司匹林服用者和非服用者的年龄和性别相匹配。主要结果是使用者和匹配的非使用者之间FIT阳性预测值（PPV）的比较。对整个队列进行单变量和多变量logistic回归分析，并以95%置信区间（CI）的优势比（OR）表示。结果：AA使用者的FIT PPV为25.30%，非使用者为14.71% (p = 0.005)，使用者的FIT检出率为8.28%，非使用者为4.44% （p = 0.003）。调整年龄和性别后PPV检出率的多变量OR为1.52 (95% CI, 1.02-2.22, p = 0.036)，使用者和非使用者检出率的多变量OR为1.41 （95% CI, 0.99-1.99, p = 0.052）。阿司匹林不影响FIT对AA的敏感性和特异性。此外，ACRN和CRC的FIT表现无显著差异。结论：阿司匹林的使用提高了AA的FIT检出率和PPV，对ACRN和CRC的FIT性能无影响。考虑到心血管事件的风险和对FIT筛查参与率的影响，FIT前停药是不必要的。
Use of Aspirin Increased the Adenoma Detection Rate and Positive Predictive Value of Fecal Immunochemical Test
Background and Aim
We aim to evaluate the effect of aspirin on fecal immunochemical test (FIT) performance for advanced colorectal neoplasia (ACRN) including advanced adenoma (AA) and colorectal cancer (CRC).
Methods
A multicenter study involved 4887 individuals who were asked to complete a quantitative FIT and subsequent colonoscopy. Aspirin users and nonusers were matched for age and sex. The primary outcome was the positive predictive value (PPV) of FIT compared between users and matched nonusers. Univariable and multivariable logistic regression analyses were also conducted in the entire cohort and expressed as odds ratio (OR) with 95% confidence interval (CI).
Results
For AA, the PPV of FIT was 25.30% in users vs. 14.71% in nonusers (p = 0.005), and the detection rate was 8.28% in users vs. 4.44% in nonusers (p = 0.003). The multivariable OR after adjusting age and sex was 1.52 (95% CI, 1.02–2.22, p = 0.036) for PPV and 1.41 (95% CI, 0.99–1.99, p = 0.052) for the detection rate compared between users and nonusers. Aspirin did not affect the sensitivity and specificity of FIT for AA. Additionally, no significant difference in FIT performance for ACRN and CRC was observed.
Conclusions
The use of aspirin increased detection rate and PPV of FIT for AA, without impact on FIT performance for ACRN and CRC. Given the risk of cardiovascular events and influence on participation rate of FIT screening, aspirin withdrawal before FIT is unnecessary.
期刊介绍：
Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.
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