Blood粪便潜血试验和结肠镜检查对在慢

AbstractApositivefecaloccultbloodtest(FOBT)isoccasionallyobservedinsomechronicmyeloidleukemia(CML)patientstreatedwithatyrosinekinaseinhibitor(TKI),andhemorrhagiccolitisinpatientstreatedwithdasatinibhasbeenreported.ToclarifythefrequencyofTKI-inducedhemorrhagiccolitisandthescreeningefficacyofanFOBTfollowedbyacolonoscopy,weprospectivelyenrolledCMLpatientstreatedwithaTKI.FOBTswereperformedinallpatientsandcolonoscopywasperformedinpatientswithpositiveFOBTs.WhenTKI-inducedhemorrhagiccolitiswaspathologicallyidentified,theTKIwasinterrupted,andtheFOBTswerereevaluated.ThefirstFOBTwaspositivein10of30patients.AllpatientswithpositiveFOBTsweretreatedwithdasatinibanddevelopednosymptoms.Dasatinib-inducedhemorrhagiccolitiswasconfirmedin6of18patientstreatedwithdasatinib(33%).Itsendoscopicfeaturewasaredflareand/orerosion.ImmunohistologicalanalysesshowedCD3+,CD8+,CD56+,andGranzymeB+cytotoxicTlymphocyteinfiltration.Afterdasatinibdiscontinuation,theFOBTsbecamenegativeinallbutonepatientwhohadconcurrentcolorectalpolyps.Dasatinib-inducedhemorrhagiccolitiswasobservedinonethirdofasymptomaticpatientstreatedwithdasatinib.AnFOBTfollowedbyacolonoscopycanbeausefulstrategytodetectthedisease.摘要音频摘要偶尔会在一些接受酪氨酸激酶抑制剂（TKI）治疗的慢性髓细胞白血病（CML）患者中观察到粪便潜血实验（FOBT）呈阳性，且已有报道称使用达沙替尼治疗患者出现出血性结肠炎。为了阐明TKI诱导的出血性结肠炎的频率和FOBT之后结合结肠镜检查的筛查效果，本研究前瞻性地招募接受TKI治疗的CML患者。所有患者均进行FOBT，其中的FOBT检测阳性者进行结肠镜检查。当从病理学上鉴定TKI诱导出血性结肠炎，中止使用TKI，并再次评估FOBT的效果。30位患者中有10人首次FOBT呈阳性。所有FOBT阳性的患者均服用达沙替尼并无临床症状。在服用达沙替尼治疗的18名患者中有6名（33%）证实了达沙替尼引起出血性结肠炎。其内窥镜特征是有红斑和/或糜烂。免疫组化分析显示了CD3+，CD8+，CD56+和颗粒蛋白酶B+的细胞毒性T淋巴细胞浸润。除一名并发有结肠息肉的患者，其余患者在停止服用达沙替尼后，FOBT均变为阴性。用达沙替尼治疗的无临床症状患者中的1/3观察到达沙替尼诱导的出血性结肠炎。FOBT之后结合结肠镜检查可以成为检测该疾病的一种有用策略。译自：张永惠矫正自：谷淑华原文出处NishiwakiS,MaedaM,YamadaM,etal.Clinicalefficacyoffecaloccultbloodtestandcolonoscopyfordasatinib-inducedhemorrhagiccolitisinCMLpatients[J].Blood,,(1):-.万康源医学前沿万康源（天津）基因科技有限公司邮箱：wankangyuan

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