对高危和一般风险女性进行CA125和经阴道超声的卵巢癌年度监测是无效的。

Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective.

作者信息

Woodward E R, Sleightholme H V, Considine A M, Williamson S, McHugo J M, Cruger D G

机构信息

West Midlands Regional Genetics Service, Birmingham Women's Hospital, Edgbaston, Birmingham, UK.

出版信息

BJOG. 2007 Dec;114(12):1500-9. doi: 10.1111/j.1471-0528.2007.01499.x. Epub 2007 Sep 27.

DOI:10.1111/j.1471-0528.2007.01499.x

PMID:17903229

Abstract

OBJECTIVE

To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer.

DESIGN

Retrospective audit.

SETTING

NHS Trust.

POPULATION

Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high-risk group (>10% lifetime risk of developing ovarian cancer), 77 in a moderate risk group (4-10% lifetime risk of developing ovarian cancer) and 71 in a near population risk group (<4% lifetime risk).

METHODS

Retrospective audit of case records, laboratory CA125 results, radiology reports, histology records and local cancer registry data.

MAIN OUTCOME MEASURES

Ovarian cancers occurring in study population. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of TVU, and CA125 as a screening tool for ovarian cancer.

RESULTS

Four ovarian cancers and one endometrial cancer occurred. One ovarian cancer was detected at surveillance, three occurred in women who presented symptomatically between screenings. Thirty women underwent exploratory surgery because of abnormal findings at surveillance. Two women had cancer (PPV = 6.7%); one had ovarian cancer and the other endometrial cancer. Twenty-eight women (93.3%) had no malignancy. Sensitivity, specificity, PPV and NPV for TVU in the whole cohort were 33.3, 85.8, 0.6 and 99.8%, respectively. For high-risk individuals, the figures for TVU were 33.3, 84.5, 1.1 and 99.6, respectively. Combining both modalities for the whole cohort, the sensitivity, specificity, PPV and NPV were 66.7, 82.9, 1.5 and 99.8% and 50.0, 82.8, 1.3 and 99.7%, respectively, for the high-risk group alone.

CONCLUSIONS

Ovarian screening by annual TVU and CA125 is inefficient at detecting early-stage ovarian cancers.

摘要

目的

评估每年进行CA125检测和经阴道超声（TVU）扫描作为卵巢癌监测手段的疗效。

设计

回顾性审计。

机构

国民保健服务信托基金。

研究对象

341名参加卵巢癌筛查的无症状女性：179名属于高危组（终生患卵巢癌风险>10%），77名属于中度风险组（终生患卵巢癌风险4 - 10%），71名属于接近一般人群风险组（终生患卵巢癌风险<4%）。

方法

回顾性审计病例记录、实验室CA125检测结果、放射学报告、组织学记录和当地癌症登记数据。

主要观察指标

研究人群中发生的卵巢癌。TVU以及CA125作为卵巢癌筛查工具的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。

结果

发生了4例卵巢癌和1例子宫内膜癌。1例卵巢癌在监测时被检测到，3例发生在筛查期间有症状就诊的女性中。30名女性因监测时发现异常而接受了 exploratory 手术。2名女性患有癌症（PPV = 6.7%）；1名患有卵巢癌，另1名患有子宫内膜癌。28名女性（93.3%）没有恶性肿瘤。整个队列中TVU的敏感性、特异性、PPV和NPV分别为33.3%、85.8%、0.6%和99.8%。对于高危个体，TVU的相应数值分别为33.3%、84.5%、1.1%和99.6%。对于整个队列，将两种方法结合使用时，敏感性、特异性、PPV和NPV分别为66.7%、82.9%、1.5%和99.8%；仅对于高危组，分别为50.0%、82.8%、1.3%和99.7%。