To evaluate the efficacy of the Asia-Pacific colorectal screening (APCS) score combined with the quantitative fecal immunochemical test in colorectal neoplasia screening. Subjects who appointment to receive colonoscopy were recruited from August 2017 to May 2019 in the digestive endoscopy center. Before the colonoscopy, all subjects were scored by the Asia Pacific colorectal cancer screening scoring system and measured by quantitative fecal immunochemical test (QFIT). The detection rates of colorectal neoplasia were compared to evaluate the efficacy of the combined assay in colorectal neoplasia screening between APCS score and QFIT. A total of 1 420 subjects were enrolled in this study, APCS score medium-risk (MR) and high-risk (HR) groups were 847 (59.7%) and 573 (40.4%) and 26 cases (1.8%) of colorectal cancer, 196 cases (13.8%) of advanced adenoma, and 395 cases (27.8%) of non-advanced adenoma were detected. With the combination of APCS score and QFIT, participants were classified into 4 groups high-risk with positive QFIT result group G1, high-risk with negative QFIT result group G2, medium-risk with positive QFIT group G3, medium-risk negative QFIT group G4. The prevalence of colorectal neoplasia was 64.3%, 16.4%, 55.0%, and 9.8%, respectively. The prevalence of advanced neoplasia in high-risk with QFIT results was significantly higher than that in other 3 groups. HR and positive QFIT were the indicators for further colonoscopy, and MR with FIT negative group could postpone colonoscopy and conduct annual QFIT follow-up. The combination of APCS score and QFIT for colorectal neoplasia screening can reduce unnecessary colonoscopy, improve colonoscopy compliance and screening efficiency, and has important clinical significance and promotion value in colorectal tumor screening.
评估亚太结直肠癌筛查（APCS）评分系统联合定量法便潜血在结直肠肿瘤筛查的价值。选择2017年8月至 2019 年5月在解放军总医院第七医学中心消化内镜中心拟接受肠镜检查的受试者1 420例，男695例，女725例，年龄50~75岁，所有入组病例在行结肠镜检查前行APCS评分和定量便潜血检测（QFIT），比较APCS评分和QFIT各组中结直肠肿瘤检出率，以评价联合检测法在结直肠肿瘤筛查中的效能。本研究共纳入分析1 420例研究对象，其中 APCS评分中危组847例（59.7%），高危组573例（40.4%），共检出结直肠癌26例（1.8%），进展期腺瘤196例（13.8%），非进展期腺瘤395例（27.8%）；APCS 评分与QFIT联合检测可分为4组［高危组（HR）QFIT阳性G1、高危组QFIT阴性G2、中危组（MR）QFIT阳性G3、中危组QFIT阴性G4］，对结直肠肿瘤的检出率分别为64.3%、16.4%、55.0%和9.8%，APCS评分高危组QFIT阳性组进展期肿瘤检出率明显高于其他3组；HR和QFIT阳性是进一步结肠镜检查的指标，MR且QFIT阴性组可暂缓肠镜，继续年度QFIT随访。总之，APCS评分联合QFIT用于结直肠肿瘤筛查，可减少不必要的肠镜检查，提高肠镜依从性和筛查效能，在结直肠肿瘤初筛中有重要的临床意义和推广价值。.