| Objective:To evaluate the performance of fecal latent blood test and SDC2 gene methylation detection in comparison with Nanchang city and colonoscopy.Methods:In January 2021 to April 2022,Nanchang university affiliated hospital and physical examination population,through the form of colorectal cancer risk factors questionnaire,signed the relevant informed consent after the fecal blood test combined SDC2 gene testing project,the subjects for colorectal cancer screening,in principle,all subjects to improve colonoscopy,finally the three stool test results and compare with colonoscopy results to evaluate the joint detection technology in Nanchang city colorectal cancer screening performance and value.Results:Seventy-four of the 131 subjects involved in the screening completed the combined fecal g FOBT-FIT-DNA testing,Overall detection rate was 4.1%(3/74),The colonoscopy detection rate was 22.85%(16/70),The colonoscopy rate was 94.59%(70 /74);Its sensitivity is 37.5%,Speciality is 100%,Positive prediction rate of 100%,Negative predictive rate was 90.39%,Enteroscopy with a sensitivity of 100%,Speciality: 82.98%,Positive prediction rate of 50%,Negative prediction rate of 100%;One hundred and six individuals completed combined fecal FIT-DNA testing,Overall detection rate was 16.9%(18/106),The colonoscopy detection rate was 21.51%(20 /93),The enteroscopy rate was 87.74%(93/106);Its sensitivity is 100%,Speciality:89.86%,The positive prediction rate was 58.82%,Negative predictive rate of 100%,Enteroscopy with a sensitivity of 100%,Speciality: 85.48%,The positive prediction rate was 52.63%,Negative prediction rate of 100%;With 122 individuals completed combined stool DNA testing,Overall detection rate was 22.13%(27/122),The colonoscopy detection rate was 21.28%(20/94),Enteroscopy rate was 77.05%(94/122);Its sensitivity is 100%,Speciality: 71.08%,The positive prediction rate was41.67%,Negative predictive rate of 100%,Enteroscopy with a sensitivity of 100%,Speciality: 86.3%,Positive prediction rate of 50%,Negative prediction rate was100%.Conclusion:The overall detection rate and sensitivity of g FOBT-FIT-DNA detection is at a large disadvantage compared with the other three screening modalities,Patients still need to perfect their colonoscopy after being positive,Therefore,the preferred choice is not recommended among the three methods,However,its specificity and positive predictive rate have advantages,Negative results can be used as an adjuvant indicator for the exclusion of colorectal cancer,And to some extent,improve the compliance of patient colonoscopy,Fool genetic testing has no advantage over other screening modalities,However,the positive rate of colorectal cancer screening in subjects is more than 75 years of age,Perhaps suitable for areas with more places for primary screening of colorectal cancer,Such as nursing homes,elderly communities,elderly groups for the primary screening of colorectal cancer,Use alone is not recommended,The combined fecal FIT-DNA detection method is comparable to colonoscopy in terms of overall detection performance(sensitivity,specificity,positive predictive rate,negative predictive rate),Better than a single fecal DNA detection,With the advantages of good sensitivity,easy carrying,rapid reporting of results,and no side reactions,Under the circumstances that the family cannot afford the cost of colonoscopy,has no endoscopic equipment or endoscopist in their residence,and cannot tolerate colonoscopy due to their own intestinal tract,psychological sensitivity or advanced age,Combined fecal FIT-DNA testing method may be preferred for a non-invasive screening population for colorectal cancer,Given that this study was only conducted within the hospital visit and physical examination population of the Affiliated Hospital of Nanchang University,Combined with the overall number of cases and compliance,The reliability of the results needs to be confirmed by more participants and a wider range of screening data. |
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