A Point-of-Care Faecal Test Combining Four Biomarkers Allows Avoidance of Normal Colonoscopies and Prioritizes Symptomatic Patients with a High Risk of Colorectal Cancer

Hijos-Mallada, Gonzalo (Universidad de Zaragoza) ; Saura, Nuria ; Lué, Alberto (Universidad de Zaragoza) ; Velamazan, Raúl ; Nieto, Rocío ; Navarro, Mercedes ; Arechavaleta, Samantha ; Chueca, Eduardo ; Gomollon, Fernando (Universidad de Zaragoza) ; Lanas, Angel (Universidad de Zaragoza) ; Sostres, Carlos

Resumen: Most colonoscopies performed to evaluate gastrointestinal symptoms detect only non-relevant pathologies. We aimed to evaluate the diagnostic accuracy of a qualitative point-of-care (POC) test combining four biomarkers (haemoglobin, transferrin, calprotectin, and lactoferrin), a quantitative faecal immunochemical test (FIT) for haemoglobin, and a quantitative faecal calprotectin (FC) test in symptomatic patients prospectively recruited. Colorectal cancer (CRC), adenoma requiring surveillance, inflammatory bowel disease (IBD), microscopic colitis, and angiodysplasia were considered significant pathologies. A total of 571 patients were included. Significant pathology was diagnosed in 118 (20.7%), including 30 CRC cases (5.3%). The POC test yielded the highest negative predictive values: 94.8% for a significant pathology and 100% for CRC or IBD if the four markers turned negative (36.8% of the patients). Negative predictive values of FIT, FC, and its combination for diagnosis of a significant pathology were 88.4%, 87.6%, and 90.8%, respectively. Moreover, the positive predictive value using the POC test was 82.3% for significant pathology when all biomarkers tested positive (6% of the patients), with 70.6% of these patients diagnosed with CRC or IBD. The AUC of the POC test was 0.801 (95%CI 0.754-0.848) for the diagnosis of a significant pathology. Therefore, this POC faecal test allows the avoidance of unnecessary colonoscopies and prioritizes high risk symptomatic patients.

Idioma: Inglés

DOI: 10.3390/cancers15030721

Año: 2023

Publicado en: Cancers 15, 3 (2023), 721 [14 pp.]
ISSN: 2072-6694

Factor impacto JCR: 4.5 (2023)

Categ. JCR: ONCOLOGY rank: 78 / 322 = 0.242 (2023) - Q1 - T1

Factor impacto CITESCORE: 8.0 - Oncology (Q1) - Cancer Research (Q2)

Factor impacto SCIMAGO: 1.391 - Oncology (Q1) - Cancer Research (Q2)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)