Brewer M A, Mitchell M F, Bast R C
University of Texas-Houston, Gynecologic Oncology Service Department of Obstetrics, Houston 77030, USA.
In Vivo. 1999 Jan-Feb;13(1):99-106.
Chemoprevention trials with OCP and retinoids will be important to determine if these drugs are effective in selected populations. Further work will be critical to understanding the mechanism of action of OCP in preventing ovarian cancer and if this protective effect will be upheld in the high-risk population. Initial results in the Milan study are promising for the retinoids in prevention of ovarian cancer and will be used in chemoprevention trials both alone and in combination with OCP's to determine if there might be an additive effect with these drugs. As yet, little is known about preinvasive changes in the ovary to predict which women are at risk for developing ovarian cancer. We can now identify high-risk women by genetic counseling and testing, yet ultrasound and serum markers are the only modality available to evaluate these women. Research is focusing on developing ways of evaluating women, particularly those at high risk for ovarian cancer, to better understand the neoplastic process in the ovary and thus identify these women prior to their developing advanced ovarian cancer. Research is also focusing on understanding chemoprevention for ovarian cancer so that women can receive the optimal chemopreventive agent when diagnosed as high risk. Prognosis with advanced disease is so poor that early diagnosis and chemoprevention are the only methods at the current time to significantly improve survival in epithelial ovarian cancer.
使用口服避孕药(OCP)和维甲酸进行化学预防试验对于确定这些药物在特定人群中是否有效至关重要。进一步的研究对于理解OCP预防卵巢癌的作用机制以及这种保护作用在高危人群中是否依然成立至关重要。米兰研究的初步结果显示维甲酸在预防卵巢癌方面很有前景,将用于单独及与OCP联合的化学预防试验,以确定这些药物是否可能存在相加作用。目前,对于卵巢的癌前变化了解甚少,难以预测哪些女性有患卵巢癌的风险。我们现在可以通过遗传咨询和检测来识别高危女性,但超声和血清标志物是评估这些女性的唯一可用方法。研究重点在于开发评估女性的方法,尤其是那些卵巢癌高危女性,以便更好地了解卵巢的肿瘤形成过程,从而在她们发展为晚期卵巢癌之前识别出这些女性。研究还集中在了解卵巢癌的化学预防,以便女性在被诊断为高危时能够接受最佳的化学预防药物。晚期疾病的预后很差,因此早期诊断和化学预防是目前显著提高上皮性卵巢癌生存率的唯一方法。