Elias Kevin M, Guo Jing, Bast Robert C
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
Department of Experimental Therapeutics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA; Department of Gynecology and Obstetrics, Shanghai Tenth People's Hospital, Tongji University, 301 Yanchang Road, Jingan, Shanghai 200072, China.
Hematol Oncol Clin North Am. 2018 Dec;32(6):903-914. doi: 10.1016/j.hoc.2018.07.003. Epub 2018 Sep 28.
Early detection of ovarian cancer could reduce mortality by 10% to 30%. Effective screening requires high sensitivity (>75%) and extremely high specificity (99.7%). Clinical trials suggest the best specificity is achieved with 2-stage strategies in which increasing serum CA125 level triggers transvaginal sonography to detect a malignant pelvic mass, although evidence for such approaches improving overall survival has been limited. Screening may be improved by combining CA125 with novel biomarkers, such as autoantibodies, circulating tumor DNA, or microRNAs. In order to detect premetastatic ovarian cancers originating in the distal fallopian tube, more sensitive approaches to diagnostic imaging are required.
卵巢癌的早期检测可将死亡率降低10%至30%。有效的筛查需要高灵敏度（>75%）和极高的特异性（99.7%）。临床试验表明，采用两阶段策略可实现最佳特异性，即血清CA125水平升高会触发经阴道超声检查以检测盆腔恶性肿块，不过此类方法改善总体生存率的证据有限。将CA125与新型生物标志物（如自身抗体、循环肿瘤DNA或微小RNA）相结合，可能会改善筛查效果。为了检测起源于远端输卵管的转移前卵巢癌，需要更敏感的诊断成像方法。
