Analysis Report On Early Screening Of Colorectal Cancer In Tibet Plateau

Objective In this study,stool samples were collected and colonoscopy and histopathology were taken as the "gold standard".All samples were tested by fecal immunochemical test(FIT).Compared with the results of colonoscopy and histopathology.To predict the sensitivity and specificity of FIT in colorectal cancer(CRC)and advanced colorectal adenoma screening in Tibet plateau,to evaluate the clinical value of this new screening method.Methods This study collected fecal samples of Tibetan patients who were hospitalized in the Department of Gastroenterology and General surgery of the people’s Hospital of Tibet Autonomous region from July 2021 to August 2022 and planned to undergo colonoscopy or histopathological examination of the lesion site.A total of 98 stool samples were collected,including 13 cases of CRC,17 cases of colorectal adenoma,16 cases of colorectal polyps and 52 cases of normal colonoscopy.Colorectal adenomas can be divided into advanced colorectal adenomas and non-progressive colorectal adenomas,respectively.At the same time,the clinical data of the patients were collected.The sensitivity,specificity and area under curve(AUC)of chemical fecal occult blood test(CFOBT),carcinoembryonic antigen(CEA)and FIT for CRC detection were evaluated by receiver operating characteristic(ROC)curve,and the sensitivity,specificity and AUC of FIT for CRC and colorectal adenoma were predicted by ROC curve.Results In this study,98 samples were divided into 4 groups: CRC group,colorectal adenoma group,colorectal polyp group and normal colonoscopy group(normal control group).Cases were included in CRC group,17 cases in colorectal adenoma group(11 cases in advanced colorectal adenoma,6 cases in non-advanced colorectal adenoma),16 cases in colorectal polyp group and 52 cases in normal colonoscopy group.They are all Tibetans living in Tibet,including 60 males(61.20%)and 38 females(38.80%),with a ratio of 1.6: 1,Age between 18-83 years old,with an average age of 50.27±16.09 years and a median living altitude of 3,824.20 meters(3,657.10,4004.50).CFOBT to CRC detecting accuracy of 72.31%,the sensitivity of 61.50%,specificity of 75.00%,AUC for 0.683.The CEA for CRC detection rate was86.15%,sensitivity 46.20%,specificity of 96.20%,AUC for 0.712.FIT for CRC screening measure accuracy was 86.15%,sensitivity was 84.60%,specificity of 86.50%,AUC for 0.856.The sensitivity of FIT for detecting colorectal adenoma is 35.30%,the sensitivity for detecting advanced adenoma is 54.54%,the specificity for detecting non-advanced adenoma is 100.00%,the specificity for detecting colorectal polyp is 93.75%,and the specificity for detecting normal colonoscopy is 86.54%.Based on the above results,98 subjects were divided into two groups,with 24 cases of CRC and advanced colorectal adenoma as one group and 74 cases as the other group.Using ROC curve to predict the FIT of CRC and progress in colorectal adenoma detection sensitivity of 70.80%,specificity of89.20%,AUC for 0.800.Conclusion Compared with traditional detection methods,FIT is more sensitive to detect CRC and advanced colorectal adenoma in Tibet plateau,which can improve the accuracy of screening CRC and its precancerous lesions.It has high specificity for detecting non-advanced colorectal adenoma,colorectal polyp and normal people,and can exclude many diseases that are not CRC and precancerous lesions.Compared with colonoscopy,FIT can be used for clinical screening of CRC and its precancerous lesions,and it is a simple and noninvasive screening method.