CA125 and Ovarian Cancer: A Comprehensive Review.
CA125 and Ovarian Cancer: A Comprehensive Review.
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DOI：
10.3390/cancers12123730
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发表时间：
2020-12-11
期刊：
影响因子：
5.2
通讯作者：
Akbari MR
中科院分区：
文献类型：
--
作者：
Charkhchi P;Cybulski C;Gronwald J;Wong FO;Narod SA;Akbari MR
CA 125已成为筛查卵巢癌最有前途的生物标志物，但在基于人群的卵巢癌筛查中仍不具有可接受的准确性。本文就CA 125在卵巢癌的诊断、疗效评价及预后判断中的作用进行综述，并对进一步提高CA 125在卵巢癌早期诊断中的临床应用提出建议。这些措施包括使用CA 125来筛选有症状的人寻求医疗护理，而不是筛选一般人群，提高血浆中CA 125水平的临界点，并在护理点进行测试，而不是实验室测试。通过这些策略，我们将在肿瘤可以通过手术完全切除的阶段检测到更具侵袭性的卵巢癌患者，这是降低复发率和提高卵巢癌患者生存率的最重要因素。卵巢癌是第二大致命的妇科恶性肿瘤。肿瘤生物标志物CA 125在过去的四十年中一直被用作卵巢癌的主要标志物。使用CA 125作为诊断生物标志物诊断I期和II期卵巢癌的重点并没有提高患者的生存率。因此，任何专业协会都不建议对平均风险的无症状妇女进行CA 125筛查。卵巢癌致癌的二元模型表明，II型肿瘤是卵巢癌死亡率的主要原因。然而，II型肿瘤很少在I期和II期被诊断出来。最近的重点转移到诊断低容量II型卵巢癌在其早期阶段的演变提供了一个新的和有价值的筛选目标。II型卵巢癌通常在晚期被诊断出来，并且具有比I型肿瘤显著更高的CA 125水平。在IIIa/B期检测到低体积II型癌与最佳细胞减灭的可能性较高相关，这是卵巢癌患者最可靠的预后指标。通过在初级保健设施中使用床旁CA 125检测，使用更高的临界点而不是传统上使用的35 U/mL，可以诊断III期早期子阶段的CA 125 II型卵巢癌。快速床旁检测也有可能在治疗期间和治疗后对卵巢癌患者进行有效的纵向筛查和快速监测。本文综述了CA 125在卵巢癌诊断和治疗中的作用，并探讨了CA 125的新的和更有效的筛查策略。
CA125 has been the most promising biomarker for screening ovarian cancer; however, it still does not have an acceptable accuracy in population-based screening for ovarian cancer. In this review article, we have discussed the role of CA125 in diagnosis, evaluating response to treatment and prognosis of ovarian cancer and provided some suggestions in improving the clinical utility of this biomarker in the early diagnosis of aggressive ovarian cancers. These include using CA125 to screen individuals with symptoms who seek medical care rather than screening the general population, increasing the cutoff point for the CA125 level in the plasma and performing the test at point-of-care rather than laboratory testing. By these strategies, we would detect more aggressive ovarian cancer patients in stages that the tumour can be completely removed by surgery, which is the most important factor in redusing recurrence rate and improving the survival of the patients with ovarian cancer. Ovarian cancer is the second most lethal gynecological malignancy. The tumour biomarker CA125 has been used as the primary ovarian cancer marker for the past four decades. The focus on diagnosing ovarian cancer in stages I and II using CA125 as a diagnostic biomarker has not improved patients’ survival. Therefore, screening average-risk asymptomatic women with CA125 is not recommended by any professional society. The dualistic model of ovarian cancer carcinogenesis suggests that type II tumours are responsible for the majority of ovarian cancer mortality. However, type II tumours are rarely diagnosed in stages I and II. The recent shift of focus to the diagnosis of low volume type II ovarian cancer in its early stages of evolution provides a new and valuable target for screening. Type II ovarian cancers are usually diagnosed in advanced stages and have significantly higher CA125 levels than type I tumours. The detection of low volume type II carcinomas in stage IIIa/b is associated with a higher likelihood for optimal cytoreduction, the most robust prognostic indicator for ovarian cancer patients. The diagnosis of type II ovarian cancer in the early substages of stage III with CA125 may be possible using a higher cutoff point rather than the traditionally used 35 U/mL through the use of point-of-care CA125 assays in primary care facilities. Rapid point-of-care testing also has the potential for effective longitudinal screening and quick monitoring of ovarian cancer patients during and after treatment. This review covers the role of CA125 in the diagnosis and management of ovarian cancer and explores novel and more effective screening strategies with CA125.
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DOI：
10.1097/igc.0b013e31828f7a24
发表时间：
2013-06
期刊：
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
影响因子：
--
作者：
Chen X;Zhang J;Cheng W;Chang DY;Huang J;Wang X;Jia L;Rosen DG;Zhang W;Yang D;Gershenson DM;Sood AK;Bast RC Jr;Liu J
通讯作者：
Liu J
影响因子：
6.2
作者：
Bast, Robert C., Jr.
通讯作者：
Bast, Robert C., Jr.
DOI：
10.1093/jnci/djp438
发表时间：
2010-01-06
期刊：
Journal of the National Cancer Institute
影响因子：
--
作者：
Anderson GL;McIntosh M;Wu L;Barnett M;Goodman G;Thorpe JD;Bergan L;Thornquist MD;Scholler N;Kim N;O'Briant K;Drescher C;Urban N
通讯作者：
Urban N
影响因子：
2
作者：
Bast, RC;Xu, FJ;Mills, GB
通讯作者：
Mills, GB
影响因子：
4.7
作者：
Chi, Dennis S.;Musa, Fernanda;Barakat, Richard R.
通讯作者：
Barakat, Richard R.