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输卵管前驱病变时代的早期卵巢癌检测:一项系统评价

Early Ovarian Cancer Detection in the Age of Fallopian Tube Precursors: A Systematic Review.

作者信息

Greenwood Ashley, Woodruff Elizabeth R, Nguyen Cam, Piper Christi, Clauset Aaron, Brubaker Lindsay W, Behbakht Kian, Bitler Benjamin G

机构信息

Divisions of Reproductive Sciences and Gynecologic Oncology, Department of Obstetrics and Gynecology, and the Strauss Library, University of Colorado Denver, Anschutz Medical Campus, Aurora, and the Department of Computer Science and the BioFrontiers Institute, University of Colorado, Boulder, Colorado; and the Santa Fe Institute, New Mexico.

出版信息

Obstet Gynecol. 2024 Mar 1;143(3):e63-e77. doi: 10.1097/AOG.0000000000005496. Epub 2024 Jan 4.

Abstract

OBJECTIVE

To determine biomarkers other than CA 125 that could be used in identifying early-stage ovarian cancer.

DATA SOURCES

Ovid MEDLINE ALL, EMBASE, Web of Science Core Collection, ScienceDirect, Clinicaltrials.gov , and CAB Direct were searched for English-language studies between January 2008 and April 2023 for the concepts of high-grade serous ovarian cancer, testing, and prevention or early diagnosis.

METHODS OF STUDY SELECTION

The 5,523 related articles were uploaded to Covidence. Screening by two independent reviewers of the article abstracts led to the identification of 245 peer-reviewed primary research articles for full-text review. Full-text review by those reviewers led to the identification of 131 peer-reviewed primary research articles used for this review.

TABULATION, INTEGRATION, AND RESULTS: Of 131 studies, only 55 reported sensitivity, specificity, or area under the curve (AUC), with 36 of the studies reporting at least one biomarker with a specificity of 80% or greater specificity or 0.9 or greater AUC.

CONCLUSION

These findings suggest that although many types of biomarkers are being tested in ovarian cancer, most have similar or worse detection rates compared with CA 125 and have the same limitations of poor detection rates in early-stage disease. However, 27.5% of articles (36/131) reported biomarkers with better sensitivity and an AUC greater than 0.9 compared with CA 125 alone and deserve further exploration.

摘要

目的

确定可用于识别早期卵巢癌的除CA 125之外的生物标志物。

数据来源

检索了Ovid MEDLINE ALL、EMBASE、科学网核心合集、ScienceDirect、Clinicaltrials.gov和CAB Direct,以查找2008年1月至2023年4月期间关于高级别浆液性卵巢癌、检测以及预防或早期诊断概念的英文研究。

研究选择方法

将5523篇相关文章上传至Covidence。由两名独立审阅者对文章摘要进行筛选,从而确定了245篇经同行评审的初级研究文章进行全文评审。这些审阅者进行全文评审后,确定了131篇经同行评审的初级研究文章用于本综述。

制表、整合与结果:在131项研究中,只有55项报告了敏感性、特异性或曲线下面积(AUC),其中36项研究报告了至少一种特异性为80%或更高特异性或AUC为0.9或更高的生物标志物。

结论

这些发现表明,尽管在卵巢癌中正在测试多种类型的生物标志物,但与CA 125相比,大多数生物标志物的检测率相似或更低,并且在早期疾病中存在检测率低这一相同局限性。然而,27.5%的文章(36/131)报告的生物标志物与单独的CA 125相比具有更好的敏感性且AUC大于0.9,值得进一步探索。

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