结肠癌英文文献抄读.pptVIP

Background Colorectal cancer arises from accumulated genetic and epigenetic alterations the stage of CRC was determined with the use of the AJCC staging system. The advanced precancerous lesions, including advanced adenomas (high-grade dysplasia or with ≥25% villous histologic features or measuring ≥1 cm in the greatest dimension and sessile serrated polyps measuring 1 cm or more in diameter * This picture show us the Laboratory Procedures: Details of stool collection and processing for DNA testing. The multitarget stool DNA test consists of molecular assays for aberrantly methylated BMP3 and NDRG4promoter regions, mutant KRAS, and β-actin (a reference gene for human DNA quantity), as well as an immunochemical assay for human hemoglobin. Quantitative measurements of each marker were incorporated into logistic-regression algorithm. FIT was performed according to the manufacturer’s instructions * * So come to the result part. More than 12,000 people were enrolled at 90 sites; nearly 10,000 people had results that could be fully evaluated .A total of 65 people were found to have colorectal cancer on colonoscopy (prevalence, 0.7%). A total of 757 people had advanced precancerous lesions (prevalence, 7.6%) Table 1.show the Sensitivity and Specificity of the two kinds of tests. Multitarget stool DNA testing identified 60 of 65 people with cancer, including 56 of the 60 people with screening-relevant cancers, sensitivities are more than 90% . Among 757 people with advanced precancerous lesions, DNA testing detected 321. these findings were all significantly superior to FIT . We also can find that the specificity of FIT was,more than 90% ,so the specificity values were superior to those of the DNA test (Table 1). * * this is Subgroup analysis. Sensitivity did not vary significantly according to cancer stage (Fig. 2A) The sensitivity of the DNA test was higher for distal advanced precancerous lesions than for proximal lesions (Fig. 2B); From (Fig. 2C) we can se