Dilley James, Gentry-Maharaj Aleksandra, Menon Usha
Gynaecological Cancer Research Centre, Women's Cancer, UCL EGA Institute for Women's Health, London, UK -
Minerva Ginecol. 2016 Oct;68(5):497-508. Epub 2016 Mar 1.
In high-risk women, risk reducing surgery remains the cornerstone of prevention. However, the resulting premature menopause has led to continued efforts to develop effective screening strategies for those who wish to delay or avoid surgery. This review describes how the screening of women at risk of ovarian and endometrial cancer has evolved to its current state. Serial monitoring of CA125 is core to ovarian cancer screening and most recent studies have used the Risk of Ovarian Cancer Algorithm (ROCA) to interpret CA125 profile. The additional use of a second tumour marker, HE4, is reviewed. The results to date of key ovarian cancer screening studies in high-risk women are summarised ahead of their concluding findings due later in 2016. The role of both ultrasound and endometrial sampling in the management of women at increased risk of endometrial cancer is outlined. Exciting new methodology, which could help shape the future of screening is investigated. The article summarises the current recommendations and guidelines from recognised international bodies to aid the clinician with management of these women.
对于高危女性而言，降低风险的手术仍是预防的基石。然而，由此导致的过早绝经促使人们持续努力，为那些希望推迟或避免手术的女性制定有效的筛查策略。本综述描述了卵巢癌和子宫内膜癌高危女性的筛查是如何发展到当前状态的。CA125的连续监测是卵巢癌筛查的核心，最近的研究使用卵巢癌风险算法（ROCA）来解读CA125数据。本文还综述了第二种肿瘤标志物HE4的额外应用。在高危女性中进行的关键卵巢癌筛查研究的最新结果在2016年晚些时候得出最终结论之前进行了总结。概述了超声和子宫内膜取样在子宫内膜癌风险增加女性管理中的作用。对可能有助于塑造未来筛查方式的令人兴奋的新方法进行了研究。本文总结了公认国际机构的当前建议和指南，以帮助临床医生管理这些女性。
