INTESTINE Vol.23 No.5(5-1)


特集名 FIT陰性癌の特徴
題名 FIT陽性癌 vs. FIT陰性癌 (1) 一般検診の立場から
発刊年月 2019年 09月
著者 満崎 克彦 済生会熊本病院予防医療センター
著者 野村 美緒子 済生会熊本病院予防医療センター
著者 福永 久美 済生会熊本病院予防医療センター
著者 菅 守隆 済生会熊本病院予防医療センター
【 要旨 】 免疫便潜血検査(fecal immunochemical test;FIT)を用いた偽陰性癌と陽性癌の臨床病理学的特徴を後ろ向きに比較検討した.偽陰性早期癌は,腫瘍径が小さく,深達度が浅い癌が多く,表面型腫瘍も偽陰性になりやすい.偽陰性進行癌は女性に多く右側結腸(とくに盲腸)に発生しやすい.偽陰性対策として,偽陰性癌の特徴を理解すると同時に,精度管理を十分に行うことが重要である.また,FITの弱点を補強するため大腸内視鏡検査や大腸CT検査を介入させることも偽陰性対策になりうると考えられた.
Theme Clinical characteristics of fecal immunochemical test (FIT) negative colorectal cancer
Title Clinical histopathologic characteristics of colorectal cancer that tested as false negative on a fecal immunochemical occult-blood test: viewpoint of colorectal cancer screening
Author Katsuhiko Mitsuzaki Center for Preventive Medicine, Saiseikai Kumamoto Hospital
Author Mioko Nomura Center for Preventive Medicine, Saiseikai Kumamoto Hospital
Author Kumi Fukunaga Center for Preventive Medicine, Saiseikai Kumamoto Hospital
Author Moritaka Suga Center for Preventive Medicine, Saiseikai Kumamoto Hospital
[ Summary ] We retrospectively compared the clinical histopathologic characteristics of colorectal cancers that tested as positive and false negative on a fecal immunochemical test (FIT). Early-stage cancers that test as false negative on a FIT are often small in diameter and shallow in depth of invasion; superficial tumors are also likely to be false negative. Advanced cancers that test as false negative are more common in women, and are more likely to develop in the right side of the colon (especially the cecum). As a countermeasure to identify false-negative results, it is important to perform sufficient quality control while understanding the features of FIT false-negative cancers. In addition, colonoscopy and CT colonography are considered countermeasures to compensate for this weakness of FIT.
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