Rosenthal A N, Jacobs I J
Gynaecology Cancer Research Unit, St. Bartholomew's Hospital, London-U.K.
Int J Biol Markers. 1998 Oct-Dec;13(4):216-20. doi: 10.1177/172460089801300408.
Ovarian cancer has the worst prognosis of any gynaecological malignancy, primarily because it tends to present at an advanced stage. The excellent survival rates of early stage disease have provided the rationale for efforts to detect ovarian cancer early by screening, in the hope that survival rates will be improved. Available data suggests that CA 125 is elevated in the majority of epithelial ovarian malignancies prior to clinical presentation. Large trials of screening for ovarian cancer indicate that using a CA 125 cutoff value of 30 U/mL has good sensitivity, but inadequate specificity for detecting preclinical disease. Use of transvaginal ultrasonography as a second-line test in women with elevated CA 125 levels improves specificity to acceptable levels, as does use of a mathematical algorithm which analyses rates of change of CA 125. Two major randomised controlled trials, investigating the effect of screening strategies incorporating CA 125 on mortality, are currently underway.
卵巢癌是所有妇科恶性肿瘤中预后最差的，主要原因是它往往在晚期才出现。早期卵巢癌出色的生存率为通过筛查早期发现卵巢癌提供了依据，以期提高生存率。现有数据表明，在大多数上皮性卵巢恶性肿瘤出现临床症状之前，CA 125水平就会升高。大规模卵巢癌筛查试验表明，将CA 125临界值设定为30 U/mL具有良好的敏感性，但检测临床前疾病的特异性不足。对于CA 125水平升高的女性，使用经阴道超声作为二线检测方法可将特异性提高到可接受水平，使用分析CA 125变化率的数学算法也能达到同样效果。目前正在进行两项主要的随机对照试验，研究纳入CA 125的筛查策略对死亡率的影响。
