Gynecologic screening in hereditary nonpolyposis colorectal cancer
Gynecologic screening in hereditary nonpolyposis colorectal cancer
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DOI：
10.1016/s0090-8258(03)00371-8
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发表时间：
2003-10-01
影响因子：
4.7
通讯作者：
van der Zee, AGJ
中科院分区：
文献类型：
--
作者：
Rijcken, FEM;Mourits, MJE;van der Zee, AGJ
Objective.在遗传性非息肉病性结直肠癌（HNPCC）中，具有错配修复（MMR）基因突变的女性患子宫内膜癌的累积终生风险为25-50%，患卵巢癌的累积终生风险为8-12%。因此，HNPCC家庭的女性成员每年都要接受妇科和经阴道超声（TVU）检查和血清CA 125水平分析。本研究的目的是评估我们10年的经验，这种筛查程序。从我们的HNPCC数据库中确定了MMR基因突变携带者或符合阿姆斯特丹标准的妇女。从患者档案中回顾性收集有关筛查程序的信息。41名妇女，35名绝经前和6名绝经后，入组该计划，中位随访时间为5年（范围5个月-11年）。在197例高危患者年中，179例TVU中有17例给出了子宫内膜取样的原因。三个癌前病变，复杂的不典型增生，被发现。一个周期的子宫内膜癌被发现作为临床症状的结果。CA 125水平无异常，未检出卵巢癌。这些结果表明，妇科筛查可以检测子宫内膜的癌前病变，但也说明了妇女自己的临床症状的识别和报告是至关重要的。(C)2003年爱思唯尔公司All rights reserved.
Objective. In hereditary nonpolyposis colorectal cancer (HNPCC), women with a mismatch repair (MMR) gene mutation have a cumulative lifetime risk of 25-50% for endometrial cancer and 8-12% for ovarian cancer. Therefore, female members of HNPCC families are offered an annual gynecologic and transvaginal ultrasound (TVU) examination and serum level CA 125 analysis. The aim of the present study was to evaluate our 10-year experience with this screening program.Methods. Women who are MMR gene mutation carriers or who fulfil the Amsterdam criteria were identified from our HNPCC database. Information concerning the screening program was retrospectively collected from patient files.Results. Forty-one women, 35 premenopausal and 6 postmenopausal, were enrolled in the program with a median follow-up of 5 years (range 5 months-11 years). In 197 patient years at risk, 17 of 179 TVUs gave reason for endometrial sampling. Three premalignant lesions, with complex atypical hyperplasia, were discovered. One interval endometrial cancer was detected as a result of clinical symptoms. No abnormal CA 125 levels were measured and no ovarian cancers were detected.Conclusion. These results demonstrate that gynecologic screening allows the detection of premalignant lesions of the endometrium but also illustrate that recognition and reporting of clinical symptoms by the women themselves is of utmost importance. (C) 2003 Elsevier Inc. All rights reserved.