Sato S, Sugo T, Maruyama H, Kunugi K, Saito Y, Hasuo Y
Department of Obstetrics and Gynecology, Hirosaki University School of Medicine, Yutaka, Hasuo.
Nihon Sanka Fujinka Gakkai Zasshi. 1994 Nov;46(11):1234-40.
Mass-screening for ovarian cancer by means of transvaginal ultrasonography has been performed in Aomori Prefecture since 1989. To select appropriate candidates to receive the second screening, the findings in 614 ultrasonic pictures of pelvic tumors over 30mm recorded on a VTR were studied. The results were as follows: 1) At the first screening, the rate of solid tumors was similar in each age group, but that of mixed tumors was higher in the thirties. 2) When ultrasonic findings at the first screening with that of the second screening were compared, (1) Twenty to thirty per cent of all tumors detected in the first screening had disappeared or had become under 30mm in size at the second screening. (2) About 20% of solid tumors detected in the first screening were not ovarian tumors (uterine myomas or others) in the second screening, regardless of the tumor size. (3) The rate which decided the course of therapy or follow up at the time of the second screening was not related to the ultrasonic findings for tumors smaller than 50mm. At the present time, classification of transvaginal ultrasonic findings is insufficient, and so it is difficult to use it to select appropriate candidates to receive the second screening. But the ultrasonic findings are very important in deciding on the course of therapy and follow up.
自1989年以来,青森县一直通过经阴道超声检查对卵巢癌进行大规模筛查。为了选择合适的对象接受第二次筛查,对录像带上记录的614张直径超过30mm的盆腔肿瘤超声图像的检查结果进行了研究。结果如下:1)在第一次筛查时,各年龄组实性肿瘤的发生率相似,但30多岁人群中混合性肿瘤的发生率较高。2) 将第一次筛查时的超声检查结果与第二次筛查的结果进行比较时,(1)第一次筛查中检测到的所有肿瘤中有20%至30%在第二次筛查时消失或直径变小至30mm以下。(2) 无论肿瘤大小,第一次筛查中检测到的约20%的实性肿瘤在第二次筛查时并非卵巢肿瘤(子宫肌瘤或其他肿瘤)。(3) 在第二次筛查时决定治疗或随访方案的比例与直径小于50mm的肿瘤的超声检查结果无关。目前,经阴道超声检查结果的分类尚不充分,因此很难用它来选择合适的对象接受第二次筛查。但超声检查结果在决定治疗方案和随访方面非常重要。