Recent progress in the diagnosis and treatment of ovarian cancer.
Recent progress in the diagnosis and treatment of ovarian cancer.
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DOI：
10.3322/caac.20113
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发表时间：
2011-05
期刊：
影响因子：
--
通讯作者：
Armstrong DK
中科院分区：
文献类型：
--
作者：
Jelovac D;Armstrong DK
上皮性卵巢癌是最致命的妇科恶性肿瘤，主要是由于大多数患者在诊断时处于晚期。目前正在研究使用超声和癌抗原（CA）125肿瘤标记物的筛查策略，可能会降低诊断时的分期，但尚未显示出改善生存率。在BRCA 1或BRCA 2基因中遗传有害突变的女性和患有Lynch综合征（遗传性非息肉病性结直肠癌）的女性患卵巢癌的风险最高，但仅占该疾病患者的约10%。其他不太常见和不太明确的遗传综合征可能会增加卵巢癌的风险，但它们对遗传风险的贡献很小。散发性卵巢癌的明确病因尚未确定，但风险受到生殖和激素因素的影响。手术在卵巢癌中具有独特的作用，因为它不仅用于诊断和分期，而且还用于治疗，即使是广泛传播的晚期疾病患者。卵巢癌对化疗药物，特别是铂类药物高度敏感，大多数患者在初始治疗后会获得缓解。最近的进展，使用腹腔内途径化疗的交付进一步提高了生存后的初始治疗。虽然大多数卵巢癌患者对初始化疗有反应，但大多数患者最终会出现疾病复发。复发性疾病的化疗包括以铂为基础的多药方案，用于完成初始治疗后疾病复发超过6至12个月的女性，以及用于疾病复发较早的女性的序贯单药治疗。新的靶向生物制剂，特别是那些涉及血管内皮生长因子途径和那些靶向聚（ADP-核糖）聚合酶（PARP）酶的生物制剂，为改善卵巢癌的预后带来了巨大的希望。
Epithelial ovarian cancer is the most lethal of the gynecologic malignancies, largely due to the advanced stage at diagnosis in most patients. Screening strategies using ultrasound and the cancer antigen (CA) 125 tumor marker are currently under study and may lower stage at diagnosis but have not yet been shown to improve survival. Women who have inherited a deleterious mutation in the BRCA1 or BRCA2 gene and those with the Lynch syndrome (hereditary nonpolyposis colorectal cancer) have the highest risk of developing ovarian cancer but account for only approximately 10% of those with the disease. Other less common and less well-defined genetic syndromes may increase the risk of ovarian cancer, but their contribution to genetic risk is small. A clear etiology for sporadic ovarian cancer has not been identified, but risk is affected by reproductive and hormonal factors. Surgery has a unique role in ovarian cancer, as it is used not only for diagnosis and staging but also therapeutically, even in patients with widely disseminated, advanced disease. Ovarian cancer is highly sensitive to chemotherapy drugs, particularly the platinum agents, and most patients will attain a remission with initial treatment. Recent advances in the delivery of chemotherapy using the intraperitoneal route have further improved survival after initial therapy. Although the majority of ovarian cancer patients will respond to initial chemotherapy, most will ultimately develop disease recurrence. Chemotherapy for recurrent disease includes platinum-based, multiagent regimens for women whose disease recurs more than 6 to 12 months after the completion of initial therapy and sequential single agents for those whose disease recurs earlier. New targeted biologic agents, particularly those involved with the vascular endothelial growth factor pathway and those targeting the poly (ADP-ribose) polymerase (PARP) enzyme, hold great promise for improving the outcome of ovarian cancer.
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影响因子：
158.5
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