Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, Maple House, 149 Tottenham Court Road, London W1T 7DN, UK.
Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, Maple House, 149 Tottenham Court Road, London W1T 7DN, UK.
Gynecol Oncol. 2014 Feb;132(2):490-5. doi: 10.1016/j.ygyno.2013.11.030. Epub 2013 Dec 3.
Evidence of a mortality benefit continues to elude ovarian cancer (OC) screening. Data from the US Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial which used a screening strategy incorporating CA125 cut-off and transvaginal ultrasound has not shown mortality benefit. The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is using the Risk of Ovarian Cancer (ROC) time series algorithm to interpret CA125, which has shown an encouraging sensitivity and specificity however the mortality data will only be available in 2015. The article explores the impact of growing insights into disease aetiology and evolution and biomarker discovery on future screening strategies. A better understanding of the target lesion, improved design of biomarker discovery studies, a focus on detecting low volume disease using cancer specific markers, novel biospecimens such as cervical cytology and targeted imaging and use of time series algorithms for interpreting markers profile suggests that a new era in screening is underway.
卵巢癌（OC）筛查仍然未能证实其具有生存获益。美国前列腺癌、肺癌、结直肠癌和卵巢癌（PLCO）筛查试验的数据采用了包含 CA125 截断值和经阴道超声的筛查策略，但并未显示出死亡率获益。英国卵巢癌筛查协作试验（UKCTOCS）正在使用卵巢癌风险（ROC）时间序列算法来解读 CA125，该算法显示出令人鼓舞的敏感性和特异性，但死亡率数据要到 2015 年才能获得。本文探讨了对疾病病因和演变以及生物标志物发现的深入了解对未来筛查策略的影响。对目标病变的更好理解、生物标志物发现研究的改进设计、专注于使用特定于癌症的标志物检测低体积疾病、新型生物标本（如宫颈细胞学和靶向成像）以及使用时间序列算法解释标志物谱表明，筛查的新时代已经到来。
