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The Lancet:卵巢癌筛查可救命

来源:生物谷 2016-01-11 09:41

2016年1月11日讯/生物谷BIOON/伦敦大学学院研究的卵巢癌筛查试验新结果表明筛查基于每年的血液测试可以帮助减少疾病造成的20%左右的死亡率。

心理社会肿瘤学教授Lesley Fallowfield说:“这项研究表明,早期卵巢癌的筛查可以显著减少大量的妇女死于这种疾病。”

超过200000名年龄在50到74岁之间,没有卵巢癌家族遗传史的绝经后妇女参与了这一研究。他们被随机分配到三组:多通道筛选或阴道超声波,直到2011年12月前她们都要接受每年一次的检查,对照组不进行检查。直到2014年12月研究结束前诊断出1282名妇女中的649人死于这种疾病。

多通道筛选血液测试,卵巢癌的风险评估法则(ROCA)使用一种统计计算来解释随时间的推移改变血蛋白(CA125)的水平,而这与卵巢癌相关。这给了一个女性个体患卵巢癌风险的更精确的计算,而另一种方法使用一次性血液测试测量固定CA125的截止点。

早期的结果表明, 每10000名女性参加筛查计划,包括在7至11年间的年度血液测试中大约有15人可以预防因卵巢癌而死亡

这项研究发表在《柳叶刀》杂志上,需要注意的是长期随访还需要建立更确定的估计数据,也就是卵巢癌的筛查可以防止多少人因此病死亡。估计到目前为止很有希望,但确切的数据仍然不确定。(生物谷Bioon.com)

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Ovarian cancer screening and mortality in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS): a randomised controlled trial

Prof Ian J Jacobs, FRCOG*, Prof Usha Menon, FRCOG*, Andy Ryan, PhD, et.al.

Summary Background Ovarian cancer has a poor prognosis, with just 40% of patients surviving 5 years. We designed this trial to establish the effect of early detection by screening on ovarian cancer mortality. Methods In this randomised controlled trial, we recruited postmenopausal women aged 50–74 years from 13 centres in National Health Service Trusts in England, Wales, and Northern Ireland. Exclusion criteria were previous bilateral oophorectomy or ovarian malignancy, increased risk of familial ovarian cancer, and active non-ovarian malignancy. The trial management system confirmed eligibility and randomly allocated participants in blocks of 32 using computer-generated random numbers to annual multimodal screening (MMS) with serum CA125 interpreted with use of the risk of ovarian cancer algorithm, annual transvaginal ultrasound screening (USS), or no screening, in a 1:1:2 ratio. The primary outcome was death due to ovarian cancer by Dec 31, 2014, comparing MMS and USS separately with no screening, ascertained by an outcomes committee masked to randomisation group. All analyses were by modified intention to screen, excluding the small number of women we discovered after randomisation to have a bilateral oophorectomy, have ovarian cancer, or had exited the registry before recruitment. Investigators and participants were aware of screening type. This trial is registered with ClinicalTrials.gov, number NCT00058032.

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