Holcakova Jitka, Bartosik Martin, Anton Milan, Minar Lubos, Hausnerova Jitka, Bednarikova Marketa, Weinberger Vit, Hrstka Roman
Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, 656 53 Brno, Czech Republic.
Department of Obstetrics and Gynecology, Masaryk University and University Hospital, 625 00 Brno, Czech Republic.
Cancers (Basel). 2021 Dec 17;13(24):6339. doi: 10.3390/cancers13246339.
The prevention and early diagnostics of precancerous stages are key aspects of contemporary oncology. In cervical cancer, well-organized screening and vaccination programs, especially in developed countries, are responsible for the dramatic decline of invasive cancer incidence and mortality. Cytological screening has a long and successful history, and the ongoing implementation of HPV triage with increased sensitivity can further decrease mortality. On the other hand, endometrial and ovarian cancers are characterized by a poor accessibility to specimen collection, which represents a major complication for early diagnostics. Therefore, despite relatively promising data from evaluating the combined effects of genetic variants, population screening does not exist, and the implementation of new biomarkers is, thus, necessary. The introduction of various circulating biomarkers is of potential interest due to the considerable heterogeneity of cancer, as highlighted in this review, which focuses exclusively on the most common tumors of the genital tract, namely, cervical, endometrial, and ovarian cancers. However, it is clearly shown that these malignancies represent different entities that evolve in different ways, and it is therefore necessary to use different methods for their diagnosis and treatment.
癌前阶段的预防和早期诊断是当代肿瘤学的关键方面。在宫颈癌方面，尤其是在发达国家，组织完善的筛查和疫苗接种计划使得浸润性癌的发病率和死亡率大幅下降。细胞学筛查有着悠久且成功的历史，持续实施具有更高敏感性的HPV分流检测可进一步降低死亡率。另一方面，子宫内膜癌和卵巢癌的特点是标本采集难度大，这是早期诊断的一个主要难题。因此，尽管评估基因变异综合效应的数据相对乐观，但目前尚无人群筛查，所以引入新的生物标志物很有必要。鉴于癌症具有相当大的异质性，各种循环生物标志物的引入具有潜在意义，本综述专门聚焦于生殖道最常见的肿瘤，即宫颈癌、子宫内膜癌和卵巢癌。然而，很明显这些恶性肿瘤是不同的实体，其发展方式各异，因此有必要采用不同的方法进行诊断和治疗。
