Ueland Frederick R
Department of Obstetrics and Gynecology, Division of Gynecologic Oncology and the Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY 40515, USA.
Diagnostics (Basel). 2017 Mar 8;7(1):14. doi: 10.3390/diagnostics7010014.
The history of biomarkers and ultrasonography dates back over more than 50 years. The present status of biomarkers used in the context of ovarian cancer is addressed. Attention is given to new interpretations of the etiology of ovarian cancer. Cancer antigen 125 (CA125) and multivariate index assays (Ova1, Risk of Ovarian Malignancy Algorithm, Overa) are biomarker-driven considerations that are presented. Integration of biomarkers into ovarian cancer diagnostics and screening are presented in conjunction with ultrasound. Consideration is given to the serial application of both biomarkers and ultrasound, as well as morphology-based indices. Attempts are made to foresee how individualized molecular signatures may be able to both provide an alert of the potential for ovarian cancer and to provide molecular treatments tailored to a personalized genetic signature. In the future, an annual pelvic ultrasound and a comprehensive serum biomarker screening/diagnostic panel may replace the much maligned bimanual examination as part of the annual gynecologic examination. Taken together, it is likely that a new medical specialty for screening and early diagnostics will emerge for physicians and epidemiologists, a field of study that is independent of patient gender, organ, or the subspecialties of today.
生物标志物和超声检查的历史可以追溯到50多年前。本文探讨了卵巢癌中使用的生物标志物的现状。文中关注了对卵巢癌病因的新解释。介绍了癌症抗原125（CA125）和多变量指标检测（Ova1、卵巢恶性肿瘤风险算法、Overa）等基于生物标志物的考量因素。文中阐述了将生物标志物与超声相结合应用于卵巢癌诊断和筛查的情况。同时考虑了生物标志物和超声的系列应用以及基于形态学的指标。人们试图预测个性化分子特征如何既能提示卵巢癌的潜在风险，又能提供针对个性化基因特征的分子治疗方案。未来，每年一次的盆腔超声检查和全面的血清生物标志物筛查/诊断组合可能会取代备受诟病的双合诊检查，成为年度妇科检查的一部分。综上所述，很可能会为医生和流行病学家开辟一个用于筛查和早期诊断的新医学专业领域，这是一个独立于患者性别、器官或当今各亚专业的研究领域。
