Redman Charles, Duffy Sean, Dobson Craig
University Hospital of North Staffordshire Stoke-on-Trent.
Practitioner. 2011 Jun;255(1741):27-30, 3.
Ovarian cancer is the fifth most common cancer in women, accounting for more than 6700 new cases diagnosed each year in the U.K. The incidence has increased over the past 20-25 years, particularly in the 65 and over age group. The outcome for women with ovarian cancer is generally poor, with an overall five-year survival rate of less than 35%. Most women are diagnosed with advanced stage disease. Earlier diagnosis could improve survival outcome. Although 93% of women experience symptoms before diagnosis, a GP with an average sized practice may only see one case of ovarian cancer every five years. Evidence has shown that combining a number of symptoms that occur on a persistent or frequent basis (particularly more than 12 times per month) can have a sensitivity of up to 85% and a positive predictive value of the order of 0.2%. NICE recommends that serum CA125 should be the initial test followed by pelvic and abdominal ultrasound if the serum CA125 is abnormal. These tests should be requested by GPs prior to definitive referral. If both tests are abnormal, then these women should be referred on the two-week urgent referral pathway to the local specialist unit. When ultrasound, CA125 and clinical status suggest ovarian cancer, a CT scan of the pelvis and abdomen should be performed to establish the extent of disease.
卵巢癌是女性中第五大常见癌症，在英国每年有超过6700例新确诊病例。在过去20至25年中发病率有所上升，尤其是在65岁及以上年龄组。卵巢癌女性患者的总体预后通常较差，总体五年生存率低于35%。大多数女性被诊断为晚期疾病。早期诊断可以改善生存结果。虽然93%的女性在确诊前会出现症状，但普通规模诊所的全科医生每五年可能仅会遇到一例卵巢癌病例。有证据表明，将一些持续或频繁出现的症状（尤其是每月超过12次）结合起来，敏感度可达85%，阳性预测值约为0.2%。英国国家卫生与临床优化研究所（NICE）建议，血清CA125应作为初始检测，如果血清CA125异常，则随后进行盆腔和腹部超声检查。这些检查应由全科医生在进行明确转诊之前提出申请。如果两项检查均异常，那么这些女性应通过两周紧急转诊途径转诊至当地专科单位。当超声、CA125和临床状况提示卵巢癌时，应进行盆腔和腹部CT扫描以确定疾病范围。
