广州试点开展多靶点粪便FIT-DNA联合检测用于大肠癌筛查的结果分析  

Detection and analysis of multitarget stool FIT-DNA test for colorectal cancer screening in Guangzhou

作　　者：张晓[1] 赵德坚[2] 李燕[3] 满善晴 陈一友 ZHANG Xiao;ZHAO Dejian;LI Yan;MAN Shanqing;CHEN Yiyou(Guangzhou Haizhu District Center for Disease Control and Prevention,Guangdong 510288,China;Guangzhou Yuexiu District Center for Disease Control and Prevention,Guangdong 510055,China;Guangzhou Municipal Center for Disease Control and Prevention,Guangdong 510440,China;Newhorizon Health Technology Co.,Ltd.,Hangzhou,Zhejiang 310052,China)

机构地区：[1]广州市海珠区疾病预防控制中心,广东广州510288 [2]广州市越秀区疾病预防控制中心,广东广州510055 [3]广州市疾病预防控制中心,广东广州510440 [4]诺辉健康科技有限公司,浙江杭州310052

出　　处：《国际检验医学杂志》2020年第S01期72-77,共6页International Journal of Laboratory Medicine

摘　　要：目的对2017年广州市在白云、越秀、海珠3区试点开展大肠癌初筛阳性人群进行多靶点粪便FIT-DNA联合检测(常卫清)筛查结果进行分析和总结,为广州市大肠癌筛查工作的进一步推进提供参考数据。方法对2015-2017年大肠癌初筛阳性[问卷评估阳性或者免疫法便隐血检测(胶体金法)大便隐血(FIT)阳性]多次动员仍未接受肠镜检查的高危人群,动员接受新型筛查技术-多靶点粪便FIT-DNA联合检测(常卫清),检测阳性者进一步建议进行肠镜检查;然后,统计分析不同地区、性别、年龄组的多靶点粪便FIT-DNA联合检测阳性率、肠镜检查依从性以及肠镜检查异常情况。结果870例初筛阳性入组,男332例,女538例。841例进行多靶点粪便FIT-DNA联合检测(常卫清),阳性率为13.91%(117/841),其中白云、越秀、海珠3个区阳性率分别为13.87%(33/238)、14.35%(31/216)、13.66%(53/387),男性和女性的阳性率分别为19.00%(61/321)和10.77%(56/520),不同年龄组<40、40~49、50~59、60~69、70~74、>74岁的阳性率分别为0.00%(0/3)、6.25%(2/32)、11.21%(25/223)、15.21%(66/434)、16.52%(19/115)、22.73%(5/22)。55例完成肠镜检查,肠镜依从率为47.01%(55/117),其中白云、越秀、海珠3个区的肠镜依从率分别为33.33%(11/33)、87.10%(27/31)、32.08%(17/53),男性和女性的肠镜依从率为45.90%(28/61)和48.21%(27/56),不同年龄组50~59、60~69、70~74岁的肠镜依从率分别为44.00%(11/25)、51.52%(34/66)、21.05%(4/19)。45例随访到肠镜结果,30例检查结果异常,病变总检出率为66.67%(30/45),其中结直肠癌3例,腺瘤11例,息肉15例,肠炎1例。结论在大肠癌的筛查策略中,建议对初筛阳性的高危人群引入多靶点粪便FIT-DNA联合检测(常卫清)进一步精筛,以提高进一步进行肠镜检查的依从性。Objective To analyze and summarize the screening results of multitarget stool FIT-DNA test(ColoClear)in the pilot positive population in preliminary screening of colorectal cancer in Baiyun,Yuexiu and Haizhu of Guangzhou in 2017,and to provide reference data for the further advancement of screening for colorectal cancer in Guangzhou.Methods High-risk population who were with positive preliminary screening of colorectal cancer in 2015-2017[positive by questionnaire evaluation or positive fecal occult blood(FIT)by immunocolloidal gold method],were given multiple mobilization and had not received colonoscopy were mobilized to accept new screening technology-multitarget stool FIT-DNA test(ColoClear),and people with positive detection were further recommended for colonoscopy.The positive rate of multitarget stool FIT-DNA test,colonoscopy compliance and colonoscopy abnormalities were statistically analyzed among different regions,gender and age groups.Results Eight hundred and seventy people with positive preliminary screening were included into the group,including 332 males and 538 females.Eight hundred and forty-one people were given multitarget stool FIT-DNA test(ColoClear),and the positive rate was 13.91%(117/841),and the positive rates in Baiyun,Yuexiu and Haizhu were 13.87%(33/238),14.35%(31/216)and 13.66%(53/387)respectively,and the positive rates of males and females were 19.00%(61/321)and 10.77%(56/520),and the positive rates of different age groups<40,40-49,50-59,60-69,70-74 and>74 were 0(0/3),6.25%(2/32),11.21%(25/223),15.21%(66/434),16.52%(19/115)and 22.73%(5/22).Fifty-five cases completed colonoscopy,and the colonoscopy compliance rate was 47.01%(55/117),33.33%(11/33)in Baiyun,87.10%(27/31)in Yuexiu and 32.08%(17/53)in Haizhu,and the colonoscopy compliance rates of males and females were 45.90%(28/61)and 48.21%(27/56),and the colonoscopy compliance rates of different age groups 50-59,60-69 and 70-74 were 44.00%(11/25),51.52%(34/66)and 21.05%(4/19)respectively.In the end,the colonoscopy results of 45 patien

关 键 词：大肠癌/结直肠癌 癌症筛查 多靶点粪便FIT-DNA联合检测(常卫清) 

分 类 号：R73[医药卫生—肿瘤]