Mount Vernon Cancer Centre, Northwood, Middlesex HA62RN, UK.
Curr Opin Oncol. 2013 Sep;25(5):539-45. doi: 10.1097/01.cco.0000432609.39293.77.
Fewer than 70 new cases of malignant ovarian germ cell tumours (MOGCTs) are seen each year in the UK. Because of their rarity, no randomized trials have been reported and many of the advances in management have arisen from adopting practices developed for managing male germ cell tumours (GCTs). Not surprisingly, there have been few important publications related to ovarian germ cell tumuors over the past 2 years. We have therefore included some relevant male germ cell publications. The area in which there is greatest variability in practice globally is in the proportion of patients with stage 1a disease who go on surveillance rather than receiving adjuvant chemotherapy. Although there is increasing agreement about the best management of ovarian GCTs amongst those who treat more than five per year, many patients are still treated by doctors who usually manage epithelial ovarian cancer but rarely see these patients.
Novel biomarkers including microRNA profiles and DICER1 mutations, identify potential diagnostic and therapeutic targets in this group of tumours. The role of KIT mutation and amplification in the development of ovarian dysgerminoma and the use of Sunitinib, a receptor tyrosine kinase inhibitor with an effect on vascular endothelial growth factor, platelet-derived growth factor and KIT receptors in patients with platinum-resistant GCT, are novel promising approaches.
We will therefore highlight some key differences in management of epithelial and germ cell ovarian tumours.
在英国，每年恶性卵巢生殖细胞肿瘤（MOGCT）的新发病例少于 70 例。由于其罕见性，没有报告随机试验，许多管理方面的进展是通过采用为治疗男性生殖细胞肿瘤（GCT）而制定的实践来实现的。毫不奇怪，在过去 2 年中，与卵巢生殖细胞瘤相关的重要出版物很少。因此，我们纳入了一些相关的男性生殖细胞出版物。在全球范围内，实践中最具变异性的领域是在接受监测而不是接受辅助化疗的 1a 期疾病患者比例。尽管在每年治疗超过 5 例的医生中，对于卵巢 GCT 的最佳治疗方法已经达成越来越多的共识，但许多患者仍由通常治疗上皮性卵巢癌但很少见到这些患者的医生治疗。
包括 microRNA 图谱和 DICER1 突变在内的新型生物标志物，为这群肿瘤确定了潜在的诊断和治疗靶点。KIT 突变和扩增在卵巢无性细胞瘤发生中的作用，以及受体酪氨酸激酶抑制剂 Sunitinib（对血管内皮生长因子、血小板衍生生长因子和 KIT 受体均有作用）在铂耐药 GCT 患者中的应用，是新的有前途的方法。
因此，我们将重点介绍上皮性和生殖细胞性卵巢肿瘤管理方面的一些关键差异。
