Bäumler Marcel, Gallant Delphine, Druckmann René, Kuhn Walther
CHU Nîmes, Gynécologie-Obstétrique, Nimes, France.
Universitair Ziekenhuis Gent, Gynecology and Obstetrics, Edegem, Belgium.
Horm Mol Biol Clin Investig. 2019 Sep 17;41(3):hmbci-2019-0022. doi: 10.1515/hmbci-2019-0022.
Ovarian cancer has a high mortality rate. The most common serous type spreads rapidly throughout the peritoneal cavity when 5-year survival is 10%. If diagnosed in earlier stages where the cancer is still confined to the ovary, this survival rate is about 90%. This is the reason to be interested in screening at earlier stages in the average-risk general population. Thus, annual transvaginal ultrasound (TVS) alone or as a multimodal screening test following serum carbohydrate antigen 125 (CA125) has been investigated. Ultrasound lacks sensitivity and specificity; new contrast-enhanced approaches might improve these. When the serum marker is combined with ultrasound and interpreted by a rise in the level rather than by a fixed cut-off, improved sensitivity and specificity and a late but not significant reduction in mortality are observed. Further investigations could highlight the interest of a shorter than annual screening, of a long-term follow-up and new contrast-enhanced ultrasound techniques.
卵巢癌死亡率很高。最常见的浆液性类型在5年生存率为10%时会迅速扩散至整个腹腔。如果在癌症仍局限于卵巢的早期阶段确诊，生存率约为90%。这就是在平均风险的普通人群中对早期筛查感兴趣的原因。因此，已经对单独进行年度经阴道超声检查（TVS）或作为血清糖类抗原125（CA125）之后的多模式筛查试验进行了研究。超声缺乏敏感性和特异性；新的增强造影方法可能会改善这些情况。当血清标志物与超声结合并通过水平升高而非固定临界值进行解读时，可观察到敏感性和特异性提高，死亡率虽有延迟但无显著降低。进一步的研究可能会凸显短于年度筛查、长期随访以及新的超声造影技术的意义。
