Dørum A, Kristensen G B, Abeler V M, Tropé C G, Møller P
Unit of Medical Genetics, Norwegian Radium Hospital, Oslo, Norway.
Eur J Cancer. 1996 Sep;32A(10):1645-51. doi: 10.1016/0959-8049(96)00137-2.
When ovarian cancer is detected at an early stage, prognosis is good, which has led to discussion of a screening programme. The aim of this study was to identify and examine women at high risk of familial ovarian cancer, and to evaluate the inclusion criteria and the diagnostic methods for early detection of ovarian cancer. We report the first round screening findings in a prospective study of 180 women (mean age 43.4 years) considered to be at high risk of ovarian cancer based on family history. They were subjected to gynaecological examination with transvaginal ultrasound (TVU), CA125 and breast examination. Of these, 13 women with oestrogen receptor positive breast cancer had therapeutic oophorectomy and the ovaries were histologically examined. Among 180 women examined, nine ovarian cancers (among them two found at oophorectomy because of breast cancer) (mean age 49.0 years), seven benign tumours of the ovary (mean age 48.1 years), one cancer of the cervix, and four breast cancers were diagnosed. The prevalence of ovarian cancers (5%) was significantly more than in any previous series. TVU as a diagnostic method proved useful and detected 7/9 cancers, whereas CA125 was elevated in 4/9 cancers. To our knowledge, this is the first programme which has successfully delineated a high risk group and prospectively demonstrated their high prevalence of ovarian cancer. Possible biases are discussed.
卵巢癌若在早期被发现，预后良好，这引发了对筛查项目的讨论。本研究的目的是识别和检查有家族性卵巢癌高风险的女性，并评估早期检测卵巢癌的纳入标准和诊断方法。我们报告了一项前瞻性研究的首轮筛查结果，该研究针对180名（平均年龄43.4岁）基于家族史被认为有卵巢癌高风险的女性。她们接受了经阴道超声（TVU）妇科检查、CA125检测和乳房检查。其中，13名雌激素受体阳性乳腺癌女性接受了治疗性卵巢切除术，并对卵巢进行了组织学检查。在接受检查的180名女性中，诊断出9例卵巢癌（其中2例因乳腺癌在卵巢切除术中发现）（平均年龄49.0岁）、7例卵巢良性肿瘤（平均年龄48.1岁）、1例宫颈癌和4例乳腺癌。卵巢癌的患病率（5%）显著高于以往任何系列研究。TVU作为一种诊断方法被证明是有用的，检测出了7/9的癌症，而4/9的癌症患者CA125升高。据我们所知，这是首个成功界定高风险组并前瞻性证明其卵巢癌高患病率的项目。文中讨论了可能存在的偏差。
