结肠癌英文文献抄读

Methods


Excluded
personal history : colorectal neoplasia,
digestive cancer, or inflammatory bowel disease

previous colonoscopy , barium enema, CT ,sigmoidoscopy positive results on fecal blood testing, rectal bleeding
mutant KRAS
immunoche mical assay for human hemoglobin
12776
Results
0.7% 7.6%
Results
Results
Results
Figure 3.Receiver Operating Characteristic (ROC) Curves Comparing DNA Testing and FIT for the Detection of Colorectal Cancer and Advanced Colorectal Neoplasia.
measure ≥1cm in the greatest dimension
Sessile serrated polyps measuring 1 cm or more in diameter
FIT
Multitarget stool DNA test
aberrantly methylated BMP3 and NDRG4promoter regions
Results

Multitarget DNA testing detected clinically significant lesions more efficiently than FIT.
Conclusions

A stool test combining altered human DNA and fecal hemoglobin showed higher sensitivity than a commercial FIT for both CRC and advanced precancerous lesions, although with lower specificity.


People at average risk for colorectal cancer
An easy-to-use screening test 599$


DNA test VS
Methods


Study Population:
2011.6-2012.11 90 sites
• Asymptomatic persons
• Ages of 50 to 84 at average risk for CRC
• Scheduled to undergo screeningcolonoscopy


undergone colorectal resection
fa百度文库ily history
Methods


Primary and Secondary Outcomes
CRC, stage determined with the use of the AJCC staging system Advanced precancerous lesions: Advanced adenomas high-grade dysplasia with ≥25% villous histologic features
Translational Research


Aug. 12, 2014
FDA Approves Cologuard First and Only Stool DNA Noninvasive Colorectal Cancer Screening Test Received a proposed coverage memorandum from the Centers for Medicare and Medicaid Services (CMS)
Background

Processes of colorectal carcinogenesis lend themselves to screening
Background

A substantial never tested!
proportion
28%

Screening for CRC is costeffective
Multitarget Stool DNA Testing for Colorectal-Cancer Screening
IF:54.42
N Engl J Med. 2014 Apr 3;370(14):1287-97
Background

CRC: major cause of death and disease

A simple, noninvasive test might improve clinical outcomes
Background

Colorectal cancer arises from accumulated genetic and epigenetic alterations
Aim
Evaluate the multitarget stool DNA test as a tool for screening
Aim
Primary aim: DNA test in the detection of CRC
Secondary aims: DNA test in the detection of advanced precancerous lesions and to compare it with a commercially available fecal immunochemical test (FIT)