RESUMO
BACKGROUND: The Asia-Pacific Colorectal Screening (APCS) score is effective to screen high-risk groups of advanced colorectal neoplasia (ACN) patients but needs revising and can be combined with the fecal immunochemical test (FIT). This paper aimed to improve the APCS score and evaluate its use with the FIT in stratifying the risk of ACN. METHODS: This prospective and multicenter study enrolled 955 and 1201 asymptomatic Chinese participants to form the derivation and validation set, respectively. Participants received the risk factor questionnaire, colonoscopy and FIT. Multiple logistic regression was applied, and C-statistic, sensitivity and negative predictive values (NPVs) were used to compare the screening efficiency. RESULTS: A modified model was developed incorporating age, body mass index (BMI), family history, diabetes, smoking and drinking as risk factors, stratifying subjects into average risk (AR) or high risk (HR). In the validation set, the HR tier group had a 3.4-fold (95% CI 1.8-6.4) increased risk for ACN. The C-statistic for the modified score was 0.69 ± 0.04, and 0.67 ± 0.04 for the original score. The sensitivity of the modified APCS score combined with FIT for screening ACN high-risk cohorts was 76.7% compared with 36.7% of FIT alone and 70.0% of the modified APCS score alone. The NPVs of the modified score combined with FIT for ACN were 98.0% compared with 97.0% of FIT alone and 97.9% of the modified APCS score alone. CONCLUSIONS: The modified score and its use with the FIT are efficient in selecting the HR group from a Chinese asymptomatic population.
Assuntos
Colonoscopia , Neoplasias Colorretais/diagnóstico , Sangue Oculto , Fatores Etários , Consumo de Bebidas Alcoólicas , Doenças Assintomáticas , China , Neoplasias Colorretais/patologia , Diabetes Mellitus , Exercício Físico , Comportamento Alimentar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade , Valor Preditivo dos Testes , Estudos Prospectivos , Análise de Regressão , Medição de Risco , Fatores de Risco , Tamanho da Amostra , Sensibilidade e Especificidade , Fatores Sexuais , Fumar , Inquéritos e QuestionáriosRESUMO
Colorectal cancer (CRC) is one of the leading causes of cancer-related mortality worldwide. Cancer screening is known to decrease mortality from CRC. One important test for CRC screening is the fecal occult blood test (FOBT), which includes guaiac FOBT and fecal immunological tests. In this review we discussed the development and application of the FOBT in CRC screening.
Assuntos
Neoplasias Colorretais/diagnóstico , Detecção Precoce de Câncer/métodos , Guaiaco , Testes Imunológicos/métodos , Indicadores e Reagentes , Sangue Oculto , HumanosRESUMO
OBJECTIVE: To investigate the performance of the quantitative immunochemical fecal occult blood test (qFIT) and to determine the association between the fecal hemoglobin (Hb) level and the location and size of adenomas and the stages of colorectal cancer (CRC). METHODS: A total of 692 participants were included in the study. Their fecal Hb level was measured using an OC-SENSA MICRO qFIT. The colonoscopy results, including the location, size, and histological features of the adenomas, as well as the relationship between the Hb level and different characteristics were analyzed. Performance of the qFIT at various thresholds of fecal Hb levels was evaluated. RESULTS: Advanced colorectal neoplasia (ACRN) was identified in 76 patients based on the colonoscopic and pathological examinations. Large adenomas (≥10 mm) had a higher fecal Hb level than small adenomas (<10 mm). Advanced adenomas located on the left side of the colon presented with a higher fecal Hb level than those on the right side (P = 0.022). Stage III-IV CRC patients had a significantly higher Hb level than stage I-II patients (P = 0.013). The sensitivity and specificity of qFIT for ACRN was 51.3% and 86.4%ï¼respectively, with the best cut-off level of 400 ng/mL. The sensitivity and specificity for CRC was 61.0% and 89.1%, with the best cut-off level of 500 ng/mL. CONCLUSIONS: qFIT has an acceptable sensitivity and specificity for ACRN detection. Furthermore, the qFIT results are associated with the location and size of adenomas as well as the grade of CRC.
Assuntos
Adenoma/diagnóstico , Neoplasias do Colo/diagnóstico , Detecção Precoce de Câncer/estatística & dados numéricos , Hemoglobinas/análise , Imunoquímica/estatística & dados numéricos , Sangue Oculto , Adenoma/patologia , Adulto , Idoso , Colo/patologia , Neoplasias do Colo/patologia , Detecção Precoce de Câncer/métodos , Fezes/química , Feminino , Humanos , Imunoquímica/métodos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias/métodos , Estadiamento de Neoplasias/estatística & dados numéricos , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
A facile synthetic approach for total synthesis of tanshinone I has been accomplished. The key precursor is a novel compound, epoxy phenanthraquinone. And this synthesis of tanshinone I is achieved in only three simple stages, which include Diels-Alder reaction, Δ(2)-Weitz-Scheffer-type epoxidation, and Feist-Bénary reaction from commercially available styrene.