| [Background] as one of the common malignant tumors in the elderly,colorectal cancer has a high morbidity and mortality in China.Because of its slow natural course and definite precancerous lesions,it has been listed as one of the most suitable cancers for early screening and prevention by the World Health Organization.At present,the incidence of colorectal cancer in China is increasing year by year,and because of the differences in medical level between regions and urban and rural areas,the work of early screening for colorectal cancer has a long way to go.Single use of fecal occult blood screening will lead to a high false positive rate and a waste of medical resources;while enteroscopy has low compliance and requires a lot of manpower,material and financial resources;at present,a method with high screening efficiency and high compliance is needed to improve the early screening system.[Objective] to evaluate the effect of combined detection of multi-target fecal FIT-DNA in early screening of colorectal cancer in Inner Mongolia Autonomous region and further analyze its application prospect.[Methods] the subjects selected the people who were treated in the affiliated Hospital of Inner Mongolia Medical University,and each subject was examined by multi-target fecal FIT-DNA combined detection technique and enteroscopy.the results of multi-target fecal FIT-DNA detection technique were taken as the experimental group,and the results of self-enteroscopy as the control group,and the pathological results were taken as the gold standard to evaluate the effect of the new fecal molecular detection technique in colorectal cancer screening.The positive people screened out were given timely intervention.Finally,the serum tumor markers of some participants were analyzed and compared.[Results] Of the 403 people who participated in outpatient screening,335 preferred multi-target fecal FIT-DNA detection,107 people were positive,and the positive rate was 31.9%(107/335).70 patients with positive initial screening underwent follow-up colonoscopy,and the rate of follow-up enteroscopy was 65.4%(70/107).Among the128 participants who used the two screening methods,the sensitivity of multi-target fecal FIT-DNA test for colorectal cancer screening was 89.9%(62/69),and the specificity was86.4%(51/59).The sensitivity of colonoscopy was 97.1%(67/69),and the specificity was84.7%(50/59).In addition,the sensitivity and specificity of serum tumor markers in 115 patients were retrospectively analyzed.The sensitivity and specificity of serum tumor markers were 63.2%(43/68)and 74.5%(35/47),respectively,while the sensitivity and specificity of multi-target fecal FIT-DNA combined detection were 89.7%(61/68)and87.2%(41/47),respectively.[Conclusion] the sensitivity and specificity of combined detection of multi-target fecal FIT-DNA is better than that of serum tumor markers,and it has obvious advantages in non-invasive screening,although it is not as good as enteroscopy,but it is simpler than enteroscopy and can be tested at home;express mail does not rely on the hospital;non-invasive detection has higher compliance.It brings another option for people who are not willing to endure the pain of colonoscopy;for areas like our region,where the population is sparsely populated,the medical treatment is relatively backward and the level is uneven,and the facilities are unevenly distributed,the use of this technology makes it possible to make early screening for a wide range of colorectal cancer.This experiment is not a well-organized large-scale population screening,it is still limited to high-risk groups in outpatient clinics of regional hospitals,and belongs to opportunistic screening,but in practical application,the screening effectiveness of this technique for colorectal cancer was tested.It provides some data support for the further promotion of this new early screening technique,but a large number of clinical experimental data are still needed to verify its value. |
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