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美国放射学会适宜性标准©卵巢癌筛查。

ACR appropriateness criteria© ovarian cancer screening.

作者信息

Brown Douglas L, Andreotti Rochelle F, Lee Susanna I, Dejesus Allison Sandra O, Bennett Genevieve L, Dubinsky Theodore, Glanc Phyllis, Horrow Mindy M, Lev-Toaff Anna S, Horowitz Neil S, Podrasky Ann E, Scoutt Leslie M, Zelop Carolyn M

机构信息

Mayo Clinic, Rochester, MN, USA.

出版信息

Ultrasound Q. 2010 Dec;26(4):219-23. doi: 10.1097/RUQ.0b013e3181fdd604.

Abstract

The majority of women with ovarian cancer have advanced stage disease at the time of diagnosis and a poor 5 year survival rate. Hence, screening has been investigated in the hopes of improving survival by diagnosing ovarian cancer at an earlier stage. Most screening methods thus far have included ultrasound and/or serum tumor markers. However, low prevalence of the disease, high false positive rate of current screening methods, and the probable rapid growth of most ovarian carcinomas from no defined precursor lesion, all contribute to difficulty in screening for ovarian cancer. While screening may be able to detect ovarian cancer at an earlier stage, adequate data is presently lacking on whether screening improves survival. The results of ongoing large clinical trials will be available in a few years and should provide critical information regarding the usefulness of screening. Pending results of those large clinical trials, screening is not currently recommended for women at average risk for ovarian cancer. Screening is most likely to be performed in women with an increased familial risk of ovarian cancer, but patients should be aware that even with this risk factor, there is currently insufficient evidence to know if screening is effective. New screening methods, including new or multiple serum markers and proteomics, are also being investigated.

摘要

大多数卵巢癌女性在确诊时已处于晚期,5年生存率较低。因此,人们对筛查进行了研究,希望通过早期诊断卵巢癌来提高生存率。迄今为止,大多数筛查方法包括超声检查和/或血清肿瘤标志物检测。然而,该疾病的低发病率、当前筛查方法的高假阳性率以及大多数卵巢癌可能从无明确前驱病变迅速发展,这些都导致了卵巢癌筛查的困难。虽然筛查可能能够在早期检测出卵巢癌,但目前缺乏关于筛查是否能提高生存率的充分数据。正在进行的大型临床试验结果将在几年后得出,应该会提供有关筛查有效性的关键信息。在这些大型临床试验结果出来之前,目前不建议对卵巢癌平均风险的女性进行筛查。筛查最有可能在卵巢癌家族风险增加的女性中进行,但患者应该意识到,即使有这个风险因素,目前也没有足够的证据来确定筛查是否有效。新的筛查方法,包括新的或多种血清标志物以及蛋白质组学,也正在研究中。

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