Startseite Clinical utility of one versus two faecal immunochemical test samples in the detection of advanced colorectal neoplasia in symptomatic patients
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Clinical utility of one versus two faecal immunochemical test samples in the detection of advanced colorectal neoplasia in symptomatic patients

  • Josep Maria Auge EMAIL logo , Callum G. Fraser , Cristina Rodriguez , Alba Roset , Maria Lopez-Ceron , Jaume Grau , Antoni Castells und Wladimiro Jimenez
Veröffentlicht/Copyright: 27. Juni 2015
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 54 Heft 1

Abstract

Background: The utility of faecal immunochemical tests (FIT) in assessment of symptomatic patients with lower gastrointestinal symptoms has not been well explored. The aims of this study were to evaluate the diagnostic yield for advanced colorectal neoplasia (ACRN) in symptomatic patients using the first of two FIT samples (FIT/1) and the higher concentration of two FIT samples (FIT/max).

Methods: Samples from two consecutive bowel motions from 208 symptomatic patients who required colonoscopy were analysed using the HM-JACKarc analyser (Kyowa Medex Co., Ltd., Tokyo, Japan). Patients were categorised into two groups: patients with any ACRN and individuals with other diagnoses or normal colonoscopy.

Results: Colonoscopy detected ACRN in 29 patients. In these patients, FIT/1 and FIT/max were significantly higher than in patients with low-risk adenoma (p=0.006 and p=0.024), other findings (p=0.002 and p=0.002) and normal colonoscopy (p<0.001 and p<0.001). The areas under the curves (AUC) of FIT/1 and FIT/max were 0.71 and 0.69, respectively. Undetectable FIT/1 rules out 96.6% of ACRN and the specificity was 10.6%. Increasing the FIT/1 cut-off to 10 μg Hb/g faeces, sensitivity and specificity were 34.5% and 87.2%, respectively. Similar results were obtained using FIT/max with 20 μg Hb/g faeces cut-off, providing a sensitivity and specificity of 34.5% and 85.6%, respectively.

Conclusions: Undetectable FIT is a good strategy to rule-out ACRN in symptomatic patients. The diagnostic yield of collecting two samples for FIT can be achieved with one sample, but a lower faecal haemoglobin concentrations (f-Hb) cut-off is required.

Keywords: advanced colorectal neoplasia; colorectal cancer; diagnostic yield; faecal haemoglobin; faecal immunochemical test; symptomatic patients
Corresponding author: Josep Maria Auge, MD, Biochemistry and Molecular Genetics Department, Hospital Clinic, Villarroel, 170, 08036 Barcelona, Spain, E-mail:

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: Menarini Diagnósticos, S.A., provided instruments, reagents and technical support. Grants received: J.M. Auge (Menarini Diagnósticos, S.A.).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organisation(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2015-4-23
Accepted: 2015-6-4
Published Online: 2015-6-27
Published in Print: 2016-1-1

©2016 by De Gruyter

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  35. Acknowledgment
  36. Letter to the Editors
  37. Glypican-1 as a highly sensitive and specific pancreatic cancer biomarker
  38. Platelet microRNAs are not modulated by systemic heparin in acute coronary syndromes
  39. Concomitant appearance of two false positive peaks with a true monoclonal one in a patient with plasma cell myeloma
  40. Anti-streptavidin interferences in Roche thyroid immunoassays: a case report
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https://doi.org/10.1515/cclm-2015-0388
Schlagwörter für diesen Artikel
advanced colorectal neoplasia; colorectal cancer; diagnostic yield; faecal haemoglobin; faecal immunochemical test; symptomatic patients

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Building a bridge to safe diagnosis in health care. The role of the clinical laboratory
  4. Capillary electrophoresis for the screening and diagnosis of inherited hemoglobin disorders. Ready for prime time?
  5. Reviews
  6. Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis
  7. Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings
  8. Mini Review
  9. Clinical relevance of sST2 in cardiac diseases
  10. General Clinical Chemistry and Laboratory Medicine
  11. Preservation of urine free catecholamines and their free O-methylated metabolites with citric acid as an alternative to hydrochloric acid for LC-MS/MS-based analyses
  12. Performance characteristics of the VIDAS® 25-OH Vitamin D Total assay – comparison with four immunoassays and two liquid chromatography-tandem mass spectrometry methods in a multicentric study
  13. Differentiation of acute pyelonephritis from other febrile states in children using urinary neutrophil gelatinase-associated lipocalin (uNGAL)
  14. Early postoperative C-terminal agrin fragment (CAF) serum levels predict graft loss and proteinuria in renal transplant recipients
  15. Homocitrulline: a new marker for differentiating acute from chronic renal failure
  16. Hematology and Coagulation
  17. Development of hemoglobin typing control materials for laboratory investigation of thalassemia and hemoglobinopathies
  18. Comparison of capillary electrophoresis and high performance liquid chromatography for detection and quantification of hemoglobin New York
  19. Prevalence of hemostatic alterations in patients with recurrent spontaneous subconjunctival hemorrhage
  20. Reference Values and Biological Variations
  21. Reference intervals for 24 laboratory parameters determined in 24-hour urine collections
  22. First trimester PAPP-A2, PAPP-A and hCGβ in small-for-gestational-age pregnancies
  23. Cancer Diagnostics
  24. Clinical utility of one versus two faecal immunochemical test samples in the detection of advanced colorectal neoplasia in symptomatic patients
  25. Cardiovascular Diseases
  26. Time from symptom onset influences high-sensitivity troponin T diagnostic accuracy for the diagnosis of acute myocardial infarction
  27. Prognostic significance of serum albumin level changes in acute ischemic stroke: the role of biological and analytical variation
  28. Correlates of serum hepcidin levels and its association with cardiovascular disease in an elderly general population
  29. Infectious Diseases
  30. Usefulness of several biomarkers in the management of septic patients: C-reactive protein, procalcitonin, presepsin and mid-regional pro-adrenomedullin
  31. Diabetes
  32. Performance of strip-based glucose meters and cassette-based blood gas analyzer for monitoring glucose levels in a surgical intensive care setting
  33. Accuracy and precision assessment of a new blood glucose monitoring system
  34. Acknowledgment
  35. Acknowledgment
  36. Letter to the Editors
  37. Glypican-1 as a highly sensitive and specific pancreatic cancer biomarker
  38. Platelet microRNAs are not modulated by systemic heparin in acute coronary syndromes
  39. Concomitant appearance of two false positive peaks with a true monoclonal one in a patient with plasma cell myeloma
  40. Anti-streptavidin interferences in Roche thyroid immunoassays: a case report
  41. Evaluation of the new Methotrexate CMIA assay on the Architect i2000SR
  42. Liposomal interference on Sysmex XN-series body fluid mode
  43. Development of an immunomagnetic beads-based test and its application in influenza surveillance
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