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Cancer:科学家开发出诊断早期卵巢癌的方法

来源:生物谷 2013-08-28 10:37

2013年8月28日 讯 /生物谷BIOON/ --近期发表在Cancer杂志上的文章称,科学家开发出一种新的诊断方法,该方法能够高特异的检测早期卵巢癌。如果该方法应用于临床,每年将会挽救成千上万女性的生命。

现今还没有很好的诊断卵巢癌的方法,该病通常在早期没有特异的征兆,很难检测早期卵巢癌,而这个时期恰恰是癌细胞对治疗最敏感的时期。一旦病人被确诊为卵巢癌,往往已经到了癌症晚期,而晚期卵巢癌是致死的。

德克萨斯大学癌症研究中心的Karen Lu医生领导一个研究团队检测了血液中的蛋白CA125在早期和晚期卵巢癌中的变化情况,而CA125是已知的癌细胞生物标记物。

在长达11年的研究中,4051位更年期后期女性开始每年都进行一次CA125血液检测。基于"卵巢癌风险评估算法",这些人又分成三组,一组每年进行一次CA125检测(低发病风险),一组每三个月检查一次CA125(中等发病风险)和应该进行阴道超声检查,和妇科肿瘤学家检查的病人(高发病风险)。

平均每年有5.8%的女性有中等发病风险,而每年应该做进一步的超声检测的病人有0.9%。在十位建议进行超声检查的病人中有四位患有恶性卵巢癌,两位患有低转移性卵巢癌,一位患有子宫内膜癌,三位患有早期卵巢癌。

这相当于一个恶性卵巢癌阳性预测值为40%。该检测的准确率为99.9%,意味着仅0.1%的概率为假阳性。更重要的是所有的卵巢癌都为早期阶段。

本研究表明该方法具有高准确性低假阳性的特点。Lu博士称,我们的研究还没有进入到应用阶段,但是我们的研究表明长时间的监测对预测女性发展称卵巢癌是有利的。我们在等待在英国进行的大范围随机试验的结果,如果我们的卵巢癌风险评估算法仍然有效果的话,该方法将会具有重要的临床意义。(生物谷Bioon.com)

A 2-stage ovarian cancer screening strategy using the Risk of Ovarian Cancer Algorithm (ROCA) identifies early-stage incident cancers and demonstrates high positive predictive value

Karen H. Lu, Steven Skates, Mary A. Hernandez, Deepak Bedi, Therese Bevers, Leroy Leeds, Richard Moore, Cornelius Granai, Steven Harris, William Newland, Olasunkanmi Adeyinka, Jeremy Geffen, Michael T. Deavers, Charlotte C. Sun, Nora Horick, Herbert Fritsche, Robert C. Bast.

BACKGROUND A 2-stage ovarian cancer screening strategy was evaluated that incorporates change of carbohydrate antigen 125 (CA125) levels over time and age to estimate risk of ovarian cancer. Women with high-risk scores were referred for transvaginal ultrasound (TVS). METHODS A single-arm, prospective study of postmenopausal women was conducted. Participants underwent an annual CA125 blood test. Based on the Risk of Ovarian Cancer Algorithm (ROCA) result, women were triaged to next annual CA125 test (low risk), repeat CA125 test in 3 months (intermediate risk), or TVS and referral to a gynecologic oncologist (high risk). RESULTS A total of 4051 women participated over 11 years. The average annual rate of referral to a CA125 test in 3 months was 5.8%, and the average annual referral rate to TVS and review by a gynecologic oncologist was 0.9%. Ten women underwent surgery on the basis of TVS, with 4 invasive ovarian cancers (1 with stage IA disease, 2 with stage IC disease, and 1 with stage IIB disease), 2 ovarian tumors of low malignant potential (both stage IA), 1 endometrial cancer (stage I), and 3 benign ovarian tumors, providing a positive predictive value of 40% (95% confidence interval?=?12.2%, 73.8%) for detecting invasive ovarian cancer. The specificity was 99.9% (95% confidence interval?=?99.7%, 100%). All 4 women with invasive ovarian cancer were enrolled in the study for at least 3 years with low-risk annual CA125 test values prior to rising CA125 levels. CONCLUSIONS ROCA followed by TVS demonstrated excellent specificity and positive predictive value in a population of US women at average risk for ovarian cancer.

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