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The Fecal Immunoassay Occult Blood Test Combined With Calprotectin Sequential Linkage Imaging Endoscopy Screening Strategy for Monitoring Tumor Changes Associated With Long-duration Ulcerative Colitis (DETECT-UCAN)

2026年7月29日 更新者：Yan Zhang, MD、Qilu Hospital of Shandong University

Diagnostic Performance of Fecal Immunochemical Test Combined With Fecal Calprotectin Sequential Linked Color Imaging Endoscopy for Surveillance of Colitis-Associated Neoplasia in Long-standing Ulcerative Colitis: A Multicenter, Prospective Cohort Study

Ulcerative colitis (UC) is a chronic inflammatory bowel disease associated with an increased risk of colorectal cancer, known as UC-associated neoplasia (UCAN). Current guidelines recommend regular colonoscopy surveillance for long-standing UC patients, but this strategy faces challenges including poor adherence and low neoplasia detection rates. This study aims to evaluate the diagnostic performance of a non-invasive pre-screening strategy combining fecal immunochemical test (FIT) and fecal calprotectin (FC), followed by linked color imaging (LCI) colonoscopy, for detecting UCAN in patients with long-standing UC.

This is a multicenter, prospective, diagnostic cohort study. Eligible patients with long-standing UC (disease duration >8 years for extensive colitis or >10 years for left-sided colitis, or with PSC) will undergo FIT and FC testing, followed by LCI colonoscopy within 4 weeks regardless of stool test results. The primary outcome is the diagnostic performance (sensitivity, specificity, PPV, NPV) of combined FIT+FC testing for UCAN, using LCI colonoscopy with histopathology as the reference standard. A total of 250 participants will be enrolled from 6 centers in China. Secondary outcomes include UCAN detection rate, feasibility indicators, patient adherence and acceptability, optimal cut-off values for FIT and FC, and 12-month miss rate.

調査の概要

状態

まだ募集していません

条件

研究の種類

観察的

入学 (推定)

250

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

サンプリング方法

非確率サンプル

調査対象母集団

Patients with long-standing ulcerative colitis at high risk for UCAN, including those with disease duration >10 years (E1/E2) or >8 years (E3), those with primary sclerosing cholangitis (PSC), those with a first-degree family history of colorectal cancer, or those with a history of colorectal neoplasia resected.

説明

Inclusion Criteria:

  • Age 18-75 years, any gender.
  • Definite diagnosis of ulcerative colitis by clinical, endoscopic, and pathological criteria.
  • Meeting at least one of the following high-risk criteria (with first onset of mucopurulent bloody stool as the starting time): E1/E2 disease duration >10 years; E3 disease duration >8 years; with primary sclerosing cholangitis (PSC); first-degree family history of colorectal cancer; history of colorectal neoplasia resected.
  • Discontinued any form of glucocorticoids for at least 4 weeks prior to enrollment.
  • In clinical remission at enrollment (stool frequency score <3, rectal bleeding score = 0).
  • Able to understand the study, voluntarily participate, and sign written informed consent.

Exclusion Criteria:

  • Presence of other gastrointestinal diseases or tumors.
  • Severe comorbidities (e.g., cardiopulmonary insufficiency, hepatic or renal failure) that may affect study results or preclude tolerance of endoscopy.
  • Currently taking antiplatelet or anticoagulant medications (aspirin, warfarin, rivaroxaban, etc.).
  • Pregnant or breastfeeding women.
  • History of total or subtotal colectomy.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

コホートと介入

グループ/コホート
Long-standing Ulcerative Colitis High-risk Cohort
Participants with long-standing UC meeting high-risk criteria (disease duration >8/10 years, PSC, family history, or prior neoplasia). All participants undergo a unified surveillance protocol: baseline data collection → fecal sample collection for FIT and FC testing → LCI colonoscopy within 4 weeks regardless of stool test results.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Diagnostic Performance of Combined FIT+FC for UCAN
時間枠：At time of colonoscopy (within 4 weeks after stool sample collection)
Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) of combined FIT+FC testing (either positive defined as positive) for detecting UCAN, using LCI colonoscopy with histopathology as the reference standard.
At time of colonoscopy (within 4 weeks after stool sample collection)

二次結果の測定

結果測定
メジャーの説明
時間枠
UCAN Detection Rate
時間枠：At time of colonoscopy
Proportion of patients with pathologically confirmed UCAN (LGD, HGD, or CRC) among all patients who complete LCI colonoscopy
At time of colonoscopy
Comprehensive completion rate of the joint screening process
時間枠：Week 4 LCI colonoscopy

Unit of measurement: Percentage (%) Detailed description

To evaluate the overall implementation quality of the "FIT+FC sequential LCI" screening strategy, this indicator was set as a composite endpoint. Summary rule (mathematical definition) : Subjects who simultaneously meet all of the following five conditions are defined as "fully compliant process participants" :

  • Fecal sample collection was successful;

    • The sample quality is qualified;

      • Both the FIT and FC laboratory tests have been completed. ④ Complete the LCI colonoscopy within 4 weeks; ⑤ The Boston Quality of Bowel Preparation Scale (BBPS) score is ≥ 6 points. The reported value of this result measurement item = (the number of fully compliant process participants/the total number of participants in the group) × 100%.

(Note: The completion rates of each individual link will be presented as baseline characteristics or descriptive data in the attached materials, and will not be separately used as result measurement items for
Week 4 LCI colonoscopy
Patient Adherence
時間枠：Within 4 weeks after stool collection
Proportion of patients completing colonoscopy within the 4-week time window
Within 4 weeks after stool collection
Patient Acceptability
時間枠：At 4-week follow-up

Patient acceptance scores for stool testing and colonoscopy, discomfort scores, willingness to repeat, assessed by standardized questionnaire.

  1. Fecal Test Acceptability Questionnaire, score range: 6 to 30 points. The meaning of the score: A higher score = better results (higher acceptance).

  2. Colonoscopy Experience Scale Score range: • Acceptance dimension (Items 1-3) : 3-15 points

    • Comfort/Discomfort dimension (Items 4-6) : 3-15 points (Note direction) Overall experience dimension (Items 7-9) : 3-15 points
    • Total score: 9-45 points Score meaning: A higher score = a better outcome (higher acceptance, less discomfort, and a better overall experience)
  3. Willingness for Repeat Examination Score range: 4 to 20 points Score meaning: A higher score = a better outcome (stronger willingness to accept again)
At 4-week follow-up
Optimal Cut-off Values
時間枠：Week 52
Optimal cut-off values for FIT and FC alone and in combination for predicting UCAN, determined by ROC curve analysis
Week 52
12-Month Miss Rate
時間枠：12 months after baseline
Proportion of new UCAN cases detected during 12-month follow-up among patients with negative baseline colonoscopy
12 months after baseline

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Qilu Hospital of Shandong University

協力者

Linyi People's Hospital
Shouguang people's Hospital
Qilu Hospital of Shandong University (Qingdao)
Zaozhuang Municipal Hospital
Weifang Traditional Chinese Medicine Hospital

捜査官

  • 主任研究者：Yanbo Yu、Qilu Hospital of Shandong University

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年7月23日

一次修了 (推定)

2029年8月31日

研究の完了 (推定)

2029年12月31日

試験登録日

最初に提出

2026年7月24日

QC基準を満たした最初の提出物

2026年7月29日

最初の投稿 (実際)

2026年8月3日

学習記録の更新

投稿された最後の更新 (実際)

2026年8月3日

QC基準を満たした最後の更新が送信されました

2026年7月29日

最終確認日

2026年7月1日

詳しくは

本研究に関する用語

追加の関連 MeSH 用語

その他の研究ID番号

  • DETECT-UCAN-2026-07

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

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米国FDA規制医薬品の研究

いいえ

米国FDA規制機器製品の研究

いいえ

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