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有效的早期筛查和一级预防是降低我国结直肠癌发病率和死亡率的主要措施之一.粪便DNA检测作为一种近几年兴起的非侵入性结直肠肿瘤筛查方法,是通过检测粪便中脱落的肠道细胞中的变异基因来判断结直肠肿瘤,其中多靶点粪便DNA检测技术是应用最广泛的一种检测手段.国外针对这一新兴技术开展的多项研究均表明,多靶点粪便DNA检测具有较高的灵敏度,且其随着技术的不断完善与发展逐渐应用于临床.而在国内,多靶点粪便DNA检测尚处于起步阶段,有待更多来自中国人群的试验验证.与传统的结直肠癌筛查方法相比,粪便DNA检测技术兼具无创无痛、安全方便等优势,但该检测方法同样存在费用高昂、特异性较差等问题.多靶点粪便DNA检测符合精准医学诊疗模式,能够很大程度上弥补传统肠癌筛查手段的不足,对肠癌筛查手段的整体提升起到了重要的推动作用.本文通过概括国内外相关研究,总结粪便DNA检测技术的优缺点并探讨其应用价值.

Effective early screening and primary prevention is one of the major initiatives to decrease the morbidity and mortality of colorectal cancer in China. As a new non-invasive screening method for colorectal cancer in recent years, fecal DNA test detects colorectal cancer by analyzing gene mutations from intestinal tumor cells in the feces. The most widely used method among fecal DNA test is multi?target stoolDNA test (MT?sDNA). Many studies abroad on this emerging technique have been carried out to verify its high sensitivity, and it is gradually used in the clinic with continuous improvement and development of technology. Meanwhile, domestic MT?sDNA is still in the prototype stage, and more researches from Chinese population are needed. Compared with traditional screening methods, MT?sDNA technology has the advantages of non?invasiveness, painlessness and convenience. But its defects exist, such as high cost and low specificity. MT?sDNAis in accordance with precision medicine, and can largely make up for the shortcomings of traditional screening methods for colorectal cancer. It also holds a great promise for promoting the screening for colorectal cancer. This paper is aimed to discuss the application value of fecal DNA test by introducing its related researches at home and abroad, and summarizing its merits and demerits.