Lynch H T, Fitzsimmons M L, Conway T A, Bewtra C, Lynch J
Department of Preventive Medicine/Public Health, Creighton University School of Medicine, Omaha, Nebraska.
Gynecol Oncol. 1990 Jan;36(1):48-55. doi: 10.1016/0090-8258(90)90107-v.
Increasing attention has been given to host factors in the etiology of ovarian carcinoma. Case/control studies have shown a significant excess of this disease among primary relatives of ovarian cancer affected. Pedigree studies have demonstrated its occurrence on a site-specific basis, in association with carcinoma of the breast (breast/ovarian carcinoma syndrome), and in other hereditary disorders. The complexity of this heterogeneity clearly warrants more intensive family studies. We have described genetic and clinicopathologic nuances in two extended ovarian cancer-prone families. The absence of premonitory physical stigmata and/or biomarkers which signify the cancer-prone genotype compels the physician to employ the best posits from the pedigree to identify those patients who are at inordinately high risk for ovarian and/or syndrome-associated cancer so that surveillance strategies can be more focused. Because of limitations of current surveillance strategies for the early detection of ovarian carcinoma, the clinician's responsibility includes the identification and counseling of candidates for prophylactic oophorectomy.
卵巢癌病因中的宿主因素已受到越来越多的关注。病例对照研究表明,在受卵巢癌影响的一级亲属中,这种疾病的发病率显著过高。系谱研究表明,它在特定部位发生,与乳腺癌(乳腺/卵巢癌综合征)及其他遗传性疾病有关。这种异质性的复杂性显然需要更深入的家族研究。我们已经描述了两个易患卵巢癌的大家族中的遗传和临床病理细微差别。由于缺乏预示癌症易患基因型的先兆体征和/或生物标志物,医生不得不利用系谱中的最佳推测来识别那些患卵巢癌和/或综合征相关癌症风险极高的患者,以便使监测策略更具针对性。由于目前早期检测卵巢癌的监测策略存在局限性,临床医生的职责包括识别和咨询预防性卵巢切除术的候选者。