Ohman Anders W, Hasan Noor, Dinulescu Daniela M
Division of Women's and Perinatal Pathology, Department of Pathology, Eugene Braunwald Research Center, Brigham and Women's Hospital, Harvard Medical School , Boston, MA , USA.
Front Oncol. 2014 Nov 18;4:322. doi: 10.3389/fonc.2014.00322. eCollection 2014.
The majority of high-grade serous ovarian carcinoma cases are detected in advanced stages when treatment options are limited. Surgery is less effective at eradicating the disease when it is widespread, resulting in high rates of disease relapse and chemoresistance. Current screening techniques are ineffective for early tumor detection and consequently, BRCA mutations carriers, with an increased risk for developing high-grade serous ovarian cancer, elect to undergo risk-reducing surgery. While prophylactic surgery is associated with a significant reduction in the risk of cancer development, it also results in surgical menopause and significant adverse side effects. The development of efficient early-stage screening protocols and imaging technologies is critical to improving the outcome and quality of life for current patients and women at increased risk. In addition, more accurate animal models are necessary in order to provide relevant in vivo testing systems and advance our understanding of the disease origin and progression. Moreover, both genetically engineered and tumor xenograft animal models enable the preclinical testing of novel imaging techniques and molecularly targeted therapies as they become available. Recent advances in xenograft technologies have made possible the creation of avatar mice, personalized tumorgrafts, which can be used as therapy testing surrogates for individual patients prior to or during treatment. High-grade serous ovarian cancer may be an ideal candidate for use with avatar models based on key characteristics of the tumorgraft platform. This review explores multiple strategies, including novel imaging and screening technologies in both patients and animal models, aimed at detecting cancer in the early-stages and improving the disease prognosis.
大多数高级别浆液性卵巢癌病例在晚期才被发现，此时治疗选择有限。当疾病广泛传播时，手术在根除疾病方面效果较差，导致疾病复发率和化疗耐药率较高。目前的筛查技术对早期肿瘤检测无效，因此，携带BRCA突变、患高级别浆液性卵巢癌风险增加的女性选择接受降低风险的手术。虽然预防性手术可显著降低患癌风险，但也会导致手术绝经和严重的不良副作用。制定高效的早期筛查方案和成像技术对于改善当前患者以及高风险女性的治疗效果和生活质量至关重要。此外，需要更精确的动物模型来提供相关的体内测试系统，并增进我们对疾病起源和进展的了解。而且，随着基因工程和肿瘤异种移植动物模型的出现，新型成像技术和分子靶向疗法在临床前测试中变得可行。异种移植技术的最新进展使得创建替身小鼠（个性化肿瘤移植）成为可能，可在治疗前或治疗期间用作个体患者的治疗测试替代物。基于肿瘤移植平台的关键特性，高级别浆液性卵巢癌可能是使用替身模型的理想选择。本综述探讨了多种策略，包括患者和动物模型中的新型成像和筛查技术，旨在早期检测癌症并改善疾病预后。
