对有家族易感性的女性进行经阴道超声检查和血清CA125检测以筛查卵巢癌：一项前瞻性队列研究。
Screening for ovarian cancer by transvaginal ultrasound and serum CA125 measurement in women with a familial predisposition: a prospective cohort study.
作者信息
Bosse Kristin, Rhiem Kerstin, Wappenschmidt Barbara, Hellmich Martin, Madeja Martin, Ortmann Monika, Mallmann Peter, Schmutzler Rita
机构信息
Division of Molecular Gyneco-Oncology, Department for Obstetrics and Gynecology, University of Cologne, Germany.
出版信息
Gynecol Oncol. 2006 Dec;103(3):1077-82. doi: 10.1016/j.ygyno.2006.06.032. Epub 2006 Aug 9.
OBJECTIVE
This study evaluates the accuracy of transvaginal ultrasound (TVUS) in combination with CA125 to detect ovarian cancer in women at hereditary risk for ovarian cancer.
METHODS
A semi-annual surveillance protocol comprising CA125 measurement and TVUS was offered to 676 women including 85 BRCA mutation carriers. Surgical intervention was performed if TVUS revealed a suspicious cyst or if elevated CA125 levels or cystic lesions persisted in two consecutive examinations.
RESULTS
Ten women underwent histological verification that revealed one serous cystadenocarcinoma stage Ic. No interval ovarian cancer occurred. The specificity of surgical intervention reached 98.7% (95% confidence interval (CI): 97.5% to 99.3%) and a positive predictive value (PPV) of 10% (95% CI: 1.8% to 40.4%).
CONCLUSION
The low PPV is due to the unexpectedly low incidence of ovarian cancer. Large scale investigations including details on potential confounders and modifiers are needed to further evaluate accuracy and effectiveness of ovarian cancer screening for women at high risk.
目的
本研究评估经阴道超声（TVUS）联合CA125检测遗传性卵巢癌风险女性卵巢癌的准确性。
方法
为676名女性（包括85名BRCA突变携带者）提供了一项包括CA125检测和TVUS的半年期监测方案。如果TVUS显示有可疑囊肿，或者CA125水平升高或囊性病变在连续两次检查中持续存在，则进行手术干预。
结果
10名女性接受了组织学验证，其中发现1例Ic期浆液性囊腺癌。未发生间隔期卵巢癌。手术干预的特异性达到98.7%（95%置信区间（CI）：97.5%至99.3%），阳性预测值（PPV）为10%（95%CI：1.8%至40.4%）。
结论
PPV较低是由于卵巢癌的发病率出乎意料地低。需要进行大规模调查，包括潜在混杂因素和修饰因素的详细信息，以进一步评估高危女性卵巢癌筛查的准确性和有效性。
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