Subtypes of Ovarian Cancer and Ovarian Cancer Screening.
Subtypes of Ovarian Cancer and Ovarian Cancer Screening.
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DOI：
10.3390/diagnostics7010012
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发表时间：
2017-03-02
期刊：
影响因子：
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通讯作者：
Konishi I
中科院分区：
文献类型：
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作者：
Koshiyama M;Matsumura N;Konishi I
卵巢癌是发达国家妇科癌症死亡的首要原因，因为它通常在晚期被诊断出来。在本文中，我们讨论了当前的问题，与卵巢癌筛查的有效性和问题，并比较卵巢癌亚型的特点。有两种类型的卵巢癌：I型癌，这是一种生长缓慢的惰性肿瘤，被认为是由前驱病变引起的，在亚洲相对常见; II型癌，这是一种临床上侵袭性的肿瘤，可以从浆液性输卵管上皮内癌（STIC）和/或卵巢表面上皮从头发展，在欧洲和美国常见。关于这个问题的一项最著名的研究报告说，在美国，每年使用CA 125/经阴道超声（TVS）进行筛查并没有降低卵巢癌的死亡率。相比之下，英国最近的一项研究显示，筛查组的总体平均死亡率降低了20%。另外两项研究进一步报告称，筛查与检测时分期降低相关。从理论上讲，每年使用CA 125/TVS筛查可以很容易地发现前驱病变，在亚洲可能比欧洲和美国更有效。II型卵巢癌的早期检测仍然是一个悬而未决的问题。单独使用CA 125或TVS筛查的分辨率不太可能成功解决STIC。需要开发用于早期检测II型癌如STIC的生物标志物。
Ovarian cancer is the foremost cause of gynecological cancer death in the developed world, as it is usually diagnosed at an advanced stage. In this paper we discuss current issues, the efficacy and problems associated with ovarian cancer screening, and compare the characteristics of ovarian cancer subtypes. There are two types of ovarian cancer: Type I carcinomas, which are slow-growing, indolent neoplasms thought to arise from a precursor lesion, which are relatively common in Asia; and Type II carcinomas, which are clinically aggressive neoplasms that can develop de novo from serous tubal intraepithelial carcinomas (STIC) and/or ovarian surface epithelium and are common in Europe and the USA. One of the most famous studies on the subject reported that annual screening using CA125/transvaginal sonography (TVS) did not reduce the ovarian cancer mortality rate in the USA. In contrast, a recent study in the UK showed an overall average mortality reduction of 20% in the screening group. Another two studies further reported that the screening was associated with decreased stage at detection. Theoretically, annual screening using CA125/TVS could easily detect precursor lesions and could be more effective in Asia than in Europe and the USA. The detection of Type II ovarian carcinoma at an early stage remains an unresolved issue. The resolving power of CA125 or TVS screening alone is unlikely to be successful at resolving STICs. Biomarkers for the early detection of Type II carcinomas such as STICs need to be developed.