影响绝经后卵巢显示的因素：来自多国协作的英国卵巢癌筛查试验（UKCTOCS）的描述性研究。

Factors affecting visualization of postmenopausal ovaries: descriptive study from the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

机构信息

Women's Cancer, UCL EGA Institute for Women's Health, London, UK.

出版信息

Ultrasound Obstet Gynecol. 2013 Oct;42(4):472-7. doi: 10.1002/uog.12447.

DOI:10.1002/uog.12447

PMID:23456790

Abstract

OBJECTIVE

Transvaginal sonography (TVS) is core to any ovarian cancer screening strategy. General-population screening involves older postmenopausal women in whom ovarian visualization is difficult because of decreasing ovarian size and lack of follicular activity. We report on factors affecting the visualization of postmenopausal ovaries in the multicenter United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).

METHODS

The UKCTOCS is a randomized controlled trial of 202 638 postmenopausal women with 50 639 women in the ultrasound scan arm. TVS is the primary screening modality in the ultrasound scan arm. Age, education, ethnicity, body mass index (BMI), previous pelvic surgery, lifestyle and reproductive factors, and a personal/family history of cancer were assessed for their effects on ovarian visualization at the initial TVS.

RESULTS

Between 11 June 2001 and 18 August 2007, 43 867 women underwent TVS. The median age and BMI of the women were 60.6 (interquartile range (IQR), 9.9) years and 25.7 (IQR, 5.8), respectively. The right ovary was visualized in 29 297 (66.8%) and the left ovary was visualized in 28 726 (65.5%). Visualization of ovaries decreased with previous hysterectomy (odds ratio (OR) = 0.534; 95% CI, 0.504-0.567), previous tubal ligation (OR = 0.895; 95% CI, 0.852-0.940), increasing age (OR = 0.953; 95% CI, 0.950-0.956), unilateral oophorectomy (OR = 0.224; 95% CI, 0.186-0.269) and being overweight (OR = 0.918; 95% CI, 0.876-0.962) or obese (OR = 0.715; 95% CI, 0.677-0.755). Increased visualization was observed with a history of infertility (OR = 1.134; 95% CI, 1.005-1.279) and increasing age (in years) at menopause (OR = 1.005; 95% CI, 1.001-1.009).

CONCLUSIONS

Several factors affect the visualization of postmenopausal ovaries. Their impact needs to be taken into consideration when developing quality assurance for ovarian ultrasound scanning or comparing study results as their prevalence may differ between populations.

摘要

目的

经阴道超声（TVS）是任何卵巢癌筛查策略的核心。人群筛查涉及绝经后年龄较大的妇女，由于卵巢缩小和卵泡活动减少，卵巢可视化变得困难。我们报告了影响多中心英国卵巢癌筛查协作试验（UKCTOCS）中绝经后卵巢可视化的因素。

方法

UKCTOCS 是一项针对 202638 名绝经后妇女的随机对照试验，其中 50639 名妇女接受超声扫描。TVS 是超声扫描臂中的主要筛查方式。年龄、教育、种族、体重指数（BMI）、既往盆腔手术、生活方式和生殖因素以及个人/家族癌症史均评估了对初始 TVS 时卵巢可视化的影响。

结果

2001 年 6 月 11 日至 2007 年 8 月 18 日，43867 名妇女接受了 TVS。妇女的中位年龄和 BMI 分别为 60.6（四分位距（IQR），9.9）岁和 25.7（IQR，5.8）。右卵巢可见 29297 例（66.8%），左卵巢可见 28726 例（65.5%）。有过子宫切除术（比值比（OR）=0.534；95%CI，0.504-0.567）、输卵管结扎术（OR=0.895；95%CI，0.852-0.940）、年龄增长（OR=0.953；95%CI，0.950-0.956）、单侧卵巢切除术（OR=0.224；95%CI，0.186-0.269）和超重（OR=0.918；95%CI，0.876-0.962）或肥胖（OR=0.715；95%CI，0.677-0.755）的妇女卵巢可见性降低。有不孕史（OR=1.134；95%CI，1.005-1.279）和绝经年龄（OR=1.005；95%CI，1.001-1.009）增加可观察到卵巢可见性增加。