ادغام آزمون خون مخفی مدفوع گایاک و آزمون ایمونوشیمیایی مدفوع برای غربالگری سرطان کولورکتال

نوع مقاله : مقاله مروری

نویسندگان

1 استاد، گروه آسیب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استادیار، گروه آسیب‌شناسی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 پزشک عمومی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

4 کارشناس پرستاری، بیمارستان چمران، اصفهان، ایران

5 کارشناس بهداشت عمومی، دانشکده‌ی بهداشت، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

6 پزشک عمومی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

7 پزشک عمومی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران.

10.48305/jims.v43.i814.0495

چکیده

مقاله مروری




مقدمه: سرطان کولورکتال (Colorectal Cancer) CRC سهم قابل توجهی در مرگ و میر در سراسر جهان دارد و تشخیص زودهنگام از طریق غربالگری حیاتی است. آزمون‌های ایمونوشیمیایی مدفوع FIT (Fecal Immunochemical Tests) و آزمون‌های خون مخفی مدفوع گایاک (gFOBT) روش‌های غیرتهاجمی تشخیص خون در نمونه‌های مدفوع هستند. ادغام FIT و gFOBT  می‌تواند دقت تشخیصی برای غربالگری CRC را افزایش دهد.
روش‌ها: جستجوی متون در پایگاه‌های داده PubMed/MEDLINE،Scopus  و Google Scholar با استفاده از کلمات کلیدی مرتبط برای شناسایی مطالعات انسانی مرتبط انجام شد. هدف اصلی، فرضیه‌سازی در مورد این موضوع بود که آیا ادغام FIT و gFOBT می‌تواند اثربخشی تشخیصی و غربالگری را برای تشخیص CRC یا آدنوم‌ها افزایش دهد یا خیر.
یافته‌ها: هیچ مطالعه‌ای به طور خاص ادغام FIT و gFOBT را در مقایسه با استفاده از هر آزمون به صورت جداگانه یا کولونوسکوپی بررسی نکرده بود. با این حال، چندین مطالعه که هر دو آزمون را در یک جمعیت مشابه بررسی کردند، نشان دادند که علی‌رغم حساسیت پایین‌تر gFOBT، نتایج مثبت gFOBT می‌تواند در مواردی با نتایج منفی FIT رخ دهد. ادغام FIT و gFOBT می‌تواند در مقایسه با آزمون‌های منفرد حساسیت، ویژگی و مقرون‌به‌صرفه‌بودن را بهبود بخشد.
نتیجه‌گیری: ادغام FIT و gFOBT رویکردی امیدوارکننده برای افزایش اثربخشی غربالگری CRC از طریق مکانیسم‌های تشخیص مکمل، مدیریت بهتر الگوهای خونریزی متناوب و تشخیص بهبودیافته ضایعات پروگزیمال ارائه می‌دهد. اگرچه این فرضیه چالش‌ها و محدودیت‌های مختلفی را به همراه دارد، اعتبارسنجی اولیه می‌تواند با استفاده از داده‌های موجود از مطالعات قبلی انجام شود. تحقیقات بیشتر برای بررسی این رویکرد ضروری است.

تازه های تحقیق

آذر برادران:  Google Scholar 

بهنوش محمدی جزی:  Google Scholar 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

A Comprehensive Analysis of Integrating Guaiac Fecal Occult Blood Test and Fecal Immunochemical Test for Colorectal Cancer Screening

نویسندگان [English]

  • Azar Baradaran 1
  • Behnoosh Mohammadi Jazi 2
  • Mohadese Nekookhoo 3
  • Zeynab Sabokrooh 4
  • Elena Malekpour 5
  • Farzad Safari 6
  • Ali Abesi 7
  • Ali Noursina 3
1 Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 MD, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
4 Nurse, Chamran Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
5 Public Health Specialist, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
6 MD, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
7 MD, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Colorectal cancer (CRC) accounts for a significant share of cancer mortality globally, highlighting the critical importance of early detection through screening. Non-invasive methods such as fecal immunochemical tests (FIT) and guaiac-based fecal occult blood tests (gFOBT) are established to identify occult blood in stool specimens. Integrating FIT and gFOBT may improve diagnostic accuracy for CRC screening.
Methods: A comprehensive literature review was conducted across PubMed/MEDLINE, Scopus, and Google Scholar, utilizing targeted keywords to identify relevant human studies. The primary aim was to explore whether combining FIT and gFOBT could yield improved diagnostic performance and screening efficacy for CRC and adenomatous lesions.
Findings: A review of the literature revealed no studies explicitly assessing the integration of FIT and gFOBT compared to each test individually or to colonoscopy.  Nevertheless, several investigations assessing both modalities in comparable cohorts indicated that, despite the lower overall sensitivity of gFOBT, positive results from gFOBT can emerge even when FIT results are negative. The proposed integration of these tests holds the potential to enhance sensitivity, specificity, and cost-effectiveness in CRC screening.
Conclusion: Integrating FIT and gFOBT offers a promising approach to enhancing the effectiveness of CRC screening through complementary detection mechanisms, better management of intermittent bleeding patterns, and improved detection of proximal lesions. While this hypothesis presents several challenges and limitations, preliminary validation could be performed using existing data from previous studies. Further research is necessary to evaluate this integrative approach rigorously.

کلیدواژه‌ها [English]

  • Colorectal Neoplasms
  • Early Detection of Cancer
  • Mass Screening
  • Occult Blood
  • Sensitivity and Specificity
  • Colonoscopy

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مجله دانشکده پزشکی اصفهان
دوره 43، شماره 814
هفته 2، تیر
خرداد و تیر 1404
صفحه 495-502

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سابقه مقاله

  • تاریخ دریافت: 01 بهمن 1403
  • تاریخ پذیرش: 25 مرداد 1404

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