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【JAMA】服用阿司匹林增隐血便检查结肠癌确诊率
德国癌症研究中心12月8日发表公报说，其研究证实，长期服用阿司匹林能够提高粪便隐血检查发现早期结肠癌的确诊率。
目前常见的结肠癌早期检查有结肠镜检查、粪便隐血检查等几种，其中以结肠镜检查的准确性最高，但其操作也最为复杂。比较方便的粪便隐血检查则准确率不够高，但德国癌症研究中心发现服用阿司匹林能够提高粪便隐血检查的准确率。
研究人员在最新一期《美国医学会杂志》（JAMA）上报告说，他们对近2000人进行了检查，其中233人为了预防心肌梗塞和中风等疾病而长期服用小剂量的阿司匹林。所有人都在2005年到2009年间做过预防结肠癌的结肠镜检查，其中有10%左右的人确诊患有早期结肠癌。研究人员为这些患者做了结肠癌粪便隐血检查，并观察服用阿司匹林对检查结果的影响。
结果显示，以结肠镜检查的结果为基准，服用阿司匹林的小组成员中通过粪便隐血检查发现早期结肠癌的确诊率达70.8%，而没有服用阿司匹林的确诊率只有35.9%。
研究人员说，他们原以为阿司匹林对早期结肠癌检查是“双刃剑”，可能影响粪便隐血检查的准确性。因为，一方面阿司匹林有增加肠胃出血几率等副作用，令医生无法判断隐血是来自结肠癌还是普通肠胃出血。另一方面，它会令结肠癌病变位置更容易出血，从而提高发现病灶的几率。而这项新研究结果证实阿司匹林对于确诊早期结肠癌的益处远大于其缺点。
研究人员目前正研究在粪便隐血检查前短期服用阿司匹林是否也能够提高该检查的准确性。（来源：新华网 周谷风） Low-Dose Aspirin Use and Performance of Immunochemical Fecal Occult Blood Tests
Context Immunochemical fecal occult blood tests (iFOBTs) are potentially promising tools for colorectal cancer screening. Low-dose aspirin use, which increases the likelihood of gastrointestinal bleeding, is common in the target population for colorectal cancer screening.
Objective To assess the association of low-dose aspirin use with the performance of 2 quantitative iFOBTs in a large sample of patients undergoing colorectal cancer screening.
Design, Setting, and Participants Diagnostic study conducted from 2005 through 2009 at internal medicine and gastroenterology practices in southern Germany including 1979 patients (mean age, 62.1 years): 233 regular users of low-dose aspirin (167 men, 67 women) and 1746 who never used low-dose aspirin (809 men, 937 women).
Main Outcome Measures Sensitivity, specificity, positive and negative predictive values, and area under receiver operating characteristic (ROC) curves in detecting advanced colorectal neoplasms (colorectal cancer or advanced adenoma) with 2 quantitative iFOBTs.
Results Advanced neoplasms were found in 24 users (10.3%) and 181 nonusers (10.4%) of low-dose aspirin. At the cut point recommended by the manufacturer, sensitivities of the 2 tests were 70.8% (95% confidence interval [CI], 48.9%-87.4%) for users compared with 35.9% (95% CI, 28.9%-43.4%) for nonusers and 58.3% (95% CI, 36.6%-77.9%) for users compared with 32.0% (95% CI, 25.3%-39.4%) for nonusers (P = .001 and P = .01, respectively). Specificities were 85.7% (95% CI, 80.2%-90.1%) for users compared with 89.2% (95% CI, 87.6%-90.7%) for nonusers and 85.7% (95% CI, 80.2%-90.1%) for users compared with 91.1% (95% CI, 89.5%-92.4%) for nonusers (P = .13 and P = .01, respectively). The areas under the ROC curve were 0.79 (95% CI, 0.68-0.90) for users compared with 0.67 (95% CI, 0.62-0.71) for nonusers and 0.73 (95% CI, 0.62-0.85) for users compared with 0.65 (95% CI, 0.61-0.69) for nonusers (P = .05 and P = .17, respectively). Among men, who composed the majority of low-dose aspirin users, the areas under the ROC curve were 0.87 (95% CI, 0.76-0.98) for users compared with 0.68 (95% CI, 0.63-0.74) for nonusers and 0.81 (95% CI, 0.68-0.93) for users compared with 0.67 (95% CI, 0.61-0.72) for nonusers (P = .003 and P = .04, respectively).
Conclusion For 2 iFOBTs, use of low-dose aspirin compared with no aspirin was associated with a markedly higher sensitivity for detecting advanced colorectal neoplasms, with only a slightly lower specificity.
http://jama.ama-assn.org/content/304/22/2513.abstract?sid=827fd3fa-756d-48d2-ba59-d9544dd08856 国外产业动态-业界动态-生物医药产业-生物谷根据生物医学数据库MedTRACK和生命科学分析公司公布的数据显示,该行业在2010年的... 长期服用阿司匹林能够提高粪便隐血检查发现早期结肠癌的确诊率.目前常见的结肠癌早...www.bioon.com/...ist_420.shtml-2010-12-13-快照-动态-业界动态-生物医药产业-生物谷"[标签:content2]
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作者:admin@医学,生命科学 2011-01-29 00:58
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