基定量粪便免疫化学检测的结直肠肿瘤风险评估模型构建与验证

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Construction and validation colorectal cancer risk assessment model based on quantitative fecal immunochemical testingHu Xiaotong"，Yu Quan，Zhang Xuezhou.* ，

【Abstract】 ObjectiveTo construct and validate a colorectal cancer risk assessment model based on quantitative fecal immunochemical assay（FIT），and toimprove theearlyscreening efficiencycolorectal cancer andadvanced adenoma.MethodsData 228 patients who underwent colonoscopy at the digestive endoscopy Center our hospital from January 2022 to December 2023werecollected.All patientsunderwent colonoscopy andFIT test，anddemographicand medical history information were collected.According tocolonoscopyand pathological results，thepatients were divided into normal group，non-advancedadenomagroup，advanced adenoma groupand colorectal cancer group.Multivariate Logisticregression analysis was used toconstruct acolorectal cancer risk assessment model based on FIT，and receiver operating characteristic curve （ROC）was used to evaluate the effectiveness the model.Stratified random sampling took 70% samples as the modeling set and 30% samplesasthe validationset for internal verification.ResultsOf the228 patients，92 were in the normal group，85 were in the non-advanced adenoma group，41 were in theadvanced adenoma group，and1O were in the colorectal cancer group. There were significant differences in FIT values among the four groups （ F =118.576， P< （204号 0.001），showing an increasing trend.Multivariate analysis identified age ≥6O years old，male，FIT ⩾ 100 μg/L history colorectal cancer in first-degree relatives，andsmokingas independent risk factors.Therisk assessment model had an area under the curve （AUC）（95%CI） 0.903 （0.865，0.941），sensitivity 85.3% ，specificity 82.5% and accuracy 83.2% ，which was better than that FIT alone （AUC=O.851）.In the validation set，the （204号 AUC（95%CI） the model was 0.886 （0.819， 0.953）， the sensitivity was 83.6%， the specificity was 80.5% ，and the accuracy was 81.5% .Conclusion FIT-based colorectal cancer risk assessment model has good diagnostic efficacy， cansignificantly improve the screening eficiency colorectal cancer and advanced adenoma，and provide a powerful tool for early clinical detection and intervention.

【Key words】Quantitative fecal immunochemical detection;Colorectal neoplasms;Adenoma; Risk evaluation and mitigation;Pro concept study

结直肠癌是全球发病率和死亡率较高的恶性肿瘤之一，根据全球癌症统计数据显示，2022年结直肠癌在全球恶性肿瘤发病率中居第3位，死亡率居第2位，约占新发癌症病例的 9.6% ，死亡病例约占所有癌症致死病例的 9.3%[1] 。（剩余10028字）