Department of Medical Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, Massachusetts 02215, USA.
Department of Gynecologic Oncology and Reproductive Medicine, and Center for RNA Interference and Non-Coding RNA, University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Nat Rev Dis Primers. 2016 Aug 25;2:16061. doi: 10.1038/nrdp.2016.61.
Ovarian cancer is not a single disease and can be subdivided into at least five different histological subtypes that have different identifiable risk factors, cells of origin, molecular compositions, clinical features and treatments. Ovarian cancer is a global problem, is typically diagnosed at a late stage and has no effective screening strategy. Standard treatments for newly diagnosed cancer consist of cytoreductive surgery and platinum-based chemotherapy. In recurrent cancer, chemotherapy, anti-angiogenic agents and poly(ADP-ribose) polymerase inhibitors are used, and immunological therapies are currently being tested. High-grade serous carcinoma (HGSC) is the most commonly diagnosed form of ovarian cancer and at diagnosis is typically very responsive to platinum-based chemotherapy. However, in addition to the other histologies, HGSCs frequently relapse and become increasingly resistant to chemotherapy. Consequently, understanding the mechanisms underlying platinum resistance and finding ways to overcome them are active areas of study in ovarian cancer. Substantial progress has been made in identifying genes that are associated with a high risk of ovarian cancer (such as BRCA1 and BRCA2), as well as a precursor lesion of HGSC called serous tubal intraepithelial carcinoma, which holds promise for identifying individuals at high risk of developing the disease and for developing prevention strategies.
卵巢癌不是一种单一的疾病,可以细分为至少五种不同的组织学亚型,它们具有不同的可识别的危险因素、起源细胞、分子成分、临床特征和治疗方法。卵巢癌是一个全球性的问题,通常在晚期诊断,并且没有有效的筛查策略。新诊断癌症的标准治疗包括细胞减灭术和铂类化疗。在复发性癌症中,使用化疗、抗血管生成药物和聚(ADP-核糖)聚合酶抑制剂,免疫疗法正在进行测试。高级别浆液性癌(HGSC)是最常见的卵巢癌形式,在诊断时通常对铂类化疗非常敏感。然而,除了其他组织学类型外,HGSCs 经常复发,并对化疗越来越耐药。因此,了解导致铂类耐药的机制并寻找克服耐药的方法是卵巢癌研究的活跃领域。在识别与卵巢癌高风险相关的基因(如 BRCA1 和 BRCA2)方面已经取得了重大进展,以及一种称为浆液性输卵管上皮内癌的 HGSC 前体病变,这为识别高发病风险的个体提供了希望疾病的发展和制定预防策略。