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A review of the fertility sparing approach to endometrial cancer: Current recommendations 保留生育能力治疗子宫内膜癌的综述:目前的建议
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304168P
A. Papadopoulos
© 2013, Oncology Institute of Vojvodina, Sremska Kamenica Endometrial cancer is the most common cancer of the female genital tract; with 20%-25% diagnosed pre-menopausally, the median age in this group of patients is 40 yrs (range 31-45 yrs) (1). However future fertility is an issue for these young patients as many as 61%-79% are nulliparous compared to 24% in the older group (1). In women with early stage endometrial cancer the standard surgical treatment of total hysterectomy, bilateral salpingo-oophorectomy (TAHBSO) and possible lymph node assessment is often not acceptable. The conservative fertility retaining option is often only possible in a select group of early stage cases, and in these cases the risks are something that needs to be carefully weighed. The low risk group of grade 1 endometrioid adenocarcinoma confined to the endometrium without lymphovascular space invasion (LVSI) or disease outside the uterus are those who may be candidates for conservative treatment. Since these patients do not undergo the usual surgical staging procedure they need to be carefully evaluated. Indeed as survival in these group approaches 95% and above it can be difficult to contemplate the risk associated option of conservative management. However it is not uncommon for women to come to clinic and request this line of management. It is important that several factors are assessed before contemplating the conservative option. Pre-treatment investigation must include a hysteroscopy and biopsy and contrast MRI. The biopsy will give information regarding cell type i.e. endometrioid adenocarcinoma, grade 1 and may exclude the presence of LVSI and may also detect myometrial invasion. The contrast-enhanced MRI is used to assess the primary tumour and exclude myometrial invasion. In addition it can be used to exclude cervical or extra uterine disease including lymph nodal involvement. This group of patients with grade 1 cancer and no myometrial invasion (i.e. presumed IA) will have a risk of lymph nodal disease of approximately 3%-5% (2). Some clinicians have advocated a laparoscopy with concurrent peritoneal washings and a preoperative CA125. Others recommend a PET scan for evaluation at distant sites but microscopic disease will not be detected. The continual evaluation of the sentinel node procedure may be relevant in these early cases to evaluate and exclude lymph node involvement. Finally, the case should be evaluated in a multi-disciplinary team setting, the options discussed and a treatment plan reached (see Table 1 for prerequisites). All other cases other than grade 1, endometrioid adenocarcinoma without apparent LVSI, myometrial, cervical or extrauterine disease should be offered standard treatment involving surgery including TAH BSO, pertioneal washes and possibly lymph nodal harvest (pelvic with/without para-aortic nodes). Table 1. Pre-treatment factors that need to be met prior to conservative management • Age less than 45 years and wishes fertility,
©2013,伏伊伏丁那肿瘤研究所,Sremska Kamenica子宫内膜癌是女性生殖道最常见的癌症;20%-25%的患者在绝经前被诊断,这组患者的中位年龄为40岁(范围31-45岁)(1)。然而,这些年轻患者的未来生育能力是一个问题,多达61%-79%的患者没有生育,而老年组的这一比例为24%(1)。对于早期子宫内膜癌的女性,标准的全子宫切除术、双侧输卵管-卵巢切除术(TAHBSO)和可能的淋巴结评估等手术治疗通常是不可接受的。保守的保留生育能力的选择通常只在一组早期病例中可行,在这些情况下,风险是需要仔细权衡的。1级子宫内膜样腺癌局限于子宫内膜,无淋巴血管间隙侵犯(LVSI)或子宫外病变的低风险组可能是保守治疗的候选人。由于这些患者没有经过通常的手术分期程序,他们需要仔细评估。事实上,当这些组的存活率接近95%及以上时,很难考虑与风险相关的保守管理选择。然而,女性来到诊所并要求这种管理方式并不罕见。在考虑保守的选择之前,评估几个因素是很重要的。治疗前检查必须包括宫腔镜、活检和MRI对比检查。活检将提供有关细胞类型的信息,如子宫内膜样腺癌,1级,可能排除LVSI的存在,也可能检测子宫内膜浸润。对比增强MRI用于评估原发肿瘤并排除肌层浸润。此外,它还可用于排除宫颈或子宫外疾病,包括淋巴结受累。这组1级癌症患者没有子宫肌瘤浸润(即假定为IA),其发生淋巴结疾病的风险约为3%-5%(2)。一些临床医生建议进行腹腔镜检查并同时进行腹膜冲洗和术前CA125检查。其他人则建议使用PET扫描来评估远处部位,但无法检测到显微镜下的疾病。在这些早期病例中,前哨淋巴结手术的持续评估可能与评估和排除淋巴结累及有关。最后,病例应在多学科团队环境下进行评估,讨论方案并达成治疗计划(先决条件见表1)。除1级、无明显LVSI的子宫内膜样腺癌、子宫肌瘤、宫颈或子宫外疾病外的所有其他病例应提供标准治疗,包括手术,包括TAH BSO、腹腔清洗和可能的淋巴结清扫(伴有/不伴有主动脉旁淋巴结的盆腔)。表1。保守治疗前需要满足的治疗前因素•年龄小于45岁,希望生育,了解同意的含义•1级子宫内膜样癌•无LVSI•MRI:无子宫肌瘤浸润•无宫颈累及、卵巢累及、淋巴结累及或其他子宫外疾病的证据•MDM确诊G1(2名妇科病理学家复查)•IA期局限于子宫内膜
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引用次数: 0
Neonatal oncology: Diagnostics and management 新生儿肿瘤学:诊断和管理
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304125D
D. Dobanovacki, N. Vuckovic, S. Marinković, J. Kolarovic, S. Bukarica
Tumors are rarely diagnosed in newborns. Natural history of such tumors, their type, and response to treatment differ from those seen in older children. The etiology is still unclear. In this paper, a retrospective study is presented of diagnostics and management of neonatal tumors from 2008 to 2012. Out of 518 neonatal admissions in that period, tumors were diagnosed in 15 patients (2.8%), in only 3 of them (20.0%) prenatally. The diagnosed tumors were teratomas (4), retroperitoneal (4), and liver tumors (7). Ten of them (66.6%) had a natural history of benign tumors. Complete surgical excision was the treatment of choice in 10 (66.6%) cases and there was no need for adjuvant chemotherapy.
新生儿很少被诊断出肿瘤。这些肿瘤的自然史、类型和对治疗的反应与年龄较大的儿童不同。病因尚不清楚。本文对2008年至2012年新生儿肿瘤的诊断和治疗进行回顾性研究。在此期间入院的518名新生儿中,有15名患者(2.8%)被诊断出肿瘤,其中只有3名患者(20.0%)在产前被诊断出肿瘤。诊断的肿瘤为畸胎瘤(4例)、腹膜后肿瘤(4例)和肝脏肿瘤(7例),其中10例(66.6%)有良性肿瘤的自然病史。10例(66.6%)患者选择完全手术切除,不需要辅助化疗。
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引用次数: 0
Preoperative evaluation of uterine isthmus-cervical infiltration in patient with cervical cancer using nuclear magnetic resonance 术前应用核磁共振评价宫颈癌患者子宫峡部-宫颈浸润
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/aoo1304087m
A. Mandić, T. Vujkov, N. Prvulovic, B. Gutic, S. Knežević-Ušaj
www.onk.ns.ac.rs/Archive Vol 21, No. 3-4, December 2013 INTRODUCTION Cervical carcinoma represents one of the major problems in developing countries where the cervical population-screening program is still not developed (1). Approximately 45% of surgically treated stage IB cancers occur in women under the age of 40 years (2). However, in developed countries, screening enables the detection of cancer in its early phase, which suggests a new approach in comprehension and surgical treatment of early invasive cervical carcinoma. Radical trachelectomy is a surgical method, together with the pelvic lymphadenectomy, for treating invasive forms of cervical carcinoma in its early stage in women who are in their fertile ages and who want to keep their reproductive function (3-8). The general eligibility criteria for radical trachelectomy include the following: women less than 40 years of age who have a strong desire to preserve fertility, no clinical evidence of impaired fertility, lesion size less than 2 cm, International Federation of Gynecology and Obstetrics (FIGO) stages IA –IB-1, no involvement of the upper endocervical canal, and negative regional lymph nodes (9). The absence of metastatic disease in lymph nodes and parametrial involvement allow continuation of the procedure. Another crucial point of the procedure is the level where the cervix has to be incised. In the preservation of uterine corpus in fertility-sparing surgery, the most important factor is the absence of internal uterine ostium or uterine corpus tumor infiltration (10). When computed tomography (CT) and NMR are compared, NMR is signifycantly more accurate in the evaluation of tumor volume, local tumor stage, and parametrial invasion due to its distinctive tissue contrast and multiplanar capability (11). Cervical tumor is best shown in T2W sequence, which gives the most evident difference between normal structures in the body and cervix of the uterus. The same sequence is determined by the integrity of the stromal ring and its deficiency is explained by the penetration of the tumor to the parametrium. The aim was to evaluate the accuracy of NMR in detection of infiltration of uterine isthmus-cervical part in cervical cancer patients without fertility preservation.
www.onk.ns.ac.rs/Archive Vol 21, No. 3-4, December 2013引言宫颈癌是发展中国家的主要问题之一,在这些国家,宫颈人口筛查计划仍然不发达(1)。大约45%的手术治疗的IB期癌症发生在40岁以下的女性中(2)。然而,在发达国家,筛查能够在早期发现癌症。为早期浸润性宫颈癌的认识和手术治疗提供了新的思路。根治性气管切除术与盆腔淋巴结切除术是一种治疗早期侵袭性宫颈癌的手术方法,适用于育龄妇女,希望保持生殖功能(3-8)。根治性气管切除术的一般资格标准包括:年龄小于40岁的女性,有强烈的保留生育能力的愿望,没有生育能力受损的临床证据,病变大小小于2厘米,国际妇产科学联合会(FIGO)分期IA -IB-1,未累及上颈内管,区域淋巴结阴性(9)。淋巴结中没有转移性疾病和参数累及允许继续手术。手术的另一个关键点是子宫颈被切开的位置。在保留生育能力的手术中保存子宫体,最重要的因素是没有子宫内口或子宫体肿瘤浸润(10)。当计算机断层扫描(CT)和核磁共振相比较时,核磁共振由于其独特的组织对比和多平面能力,在评估肿瘤体积、局部肿瘤分期和参数侵袭方面明显更准确(11)。宫颈肿瘤以T2W序列表现最为明显,这是机体正常结构与宫颈正常结构的最明显区别。相同的序列是由基质环的完整性决定的,其缺陷是由肿瘤对参数的渗透来解释的。目的是评价核磁共振检测宫颈峡部浸润的准确性宫颈癌患者无生育能力保存。
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引用次数: 0
Cutaneous metastasis as the first sign of lung cancer 皮肤转移是肺癌的第一个征兆
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1301020D
M. Ðuric, Mirjana Makevic-Ðuric, Dobrica Gajic, G. Damjanović
Cutaneous metastases of lung tumors are occurring in 1-12% of cases. High prevalence of lung cancer increases the likelihood of finding these changes in clinical practice. They are usually in the form of a firm, mobile and painless nodule on the head, neck and chest, and their appearance is a sign of advanced disease. Cutaneous metastases are rarely the first sign of malignancy. A 62-year-old patient presented to her doctor a fast-growing nodule on the forehead. Extirpation of the nodule and further diagnosis showed that it was a metastasis of small cell lung cancer localized in the right lung with extensive metastases to the contralateral lung, liver and spine. Cutaneous metastases may be the first sign of malignancy or the first sign of progression of already diagnosed malignancy. A diagnosis of metastatic disease should be considered in patients with risk factors or a known cancer. The presence of a skin metastasis in a patient with a lung cancer indicates poor prognosis.
1-12%的病例发生肺肿瘤皮肤转移。肺癌的高患病率增加了在临床实践中发现这些变化的可能性。它们通常在头部,颈部和胸部以坚固,可移动和无痛的结节的形式出现,其外观是疾病晚期的标志。皮肤转移很少是恶性肿瘤的第一征兆。一名62岁的病人向她的医生报告了额头上一个快速生长的结节。经切除结节及进一步诊断为右肺小细胞肺癌转移灶,并广泛转移至对侧肺、肝及脊柱。皮肤转移可能是恶性肿瘤的第一个征象,也可能是已确诊恶性肿瘤进展的第一个征象。在有危险因素或已知癌症的患者中,应考虑转移性疾病的诊断。肺癌患者出现皮肤转移提示预后不良。
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引用次数: 2
The influence of indirect exposure to chlorine pesticides on nuclear anomalies in exfoliated buccal cells 间接接触氯农药对脱落颊细胞核异常的影响
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304115N
A. Nersesyan, G. Parsadanyan, G. Zalinyan, N. Chobanyan
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引用次数: 0
Insights of potential G-quadruplex sequences in telomeres and proto-oncogenes 端粒和原癌基因中潜在的g -四重体序列的见解
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304118B
R. Bhadane, Rupali R. Bhadane, D. Meshram
www.onk.ns.ac.rs/Archive Vol 21, No. 3-4, December 2013 INTRODUCTION The earliest research in the antineoplastic drug discovery was related to suppressing the synthesis and function of DNA. Today, a variety of other targets is under intensive investigation and they will provide oncologist with significant new approaches of therapy. Some of these approaches are inhibition of protease involved in metastasis, angiogenesis inhibitors, antisense technology, and G-quadruplexes. G-quadruplexes are generally formed in DNA and RNA sequences containing repeated G-G-G-G called as G-tetrad. G-quadruplexes formed from planar stacking of hoogsteen bonded G-tetrads (1, 2) folded from a single G-rich sequence by intraor inter-molecular association of 2 to 4 separate strands (3, 4). The core of G-quadruplexes are formed by the stacking of several G-tetrads and joined together by sugar phosphate backbone. The binding energy for this process arises from three main factors: hydrogen bonding between the guanines in a plane, π π interaction between the guanines in adjacent planes and charge – charge interaction between partially negative oxygen of guanines and cations that typically sit in the octahedral position between the stacks (5-7). The monovalent cations such as K+ and Na+ at a physiological temperature and pH stabilize G-quadruplex by coordinating the carbonyl group of guanine at the center of G-tetrad core (5, 8). It has been estimated that there are more than 376,000 potential quadruplex sequences found in number of important biological processes (9). Intramolecular G-quadruplexes formed by single-stranded DNA are currently under intensive research due to their potential formation in telomeres and promoter sequences (10, 11). The present review reports the G-quadruplexes formed in human telomeres and proto-oncogenes.
www.onk.ns.ac.rs/Archive Vol 21 No. 3-4, December 2013 INTRODUCTION抗肿瘤药物发现中最早的研究与抑制DNA的合成和功能有关。今天,各种其他靶点正在深入研究中,它们将为肿瘤学家提供重要的新治疗方法。其中一些方法是抑制参与转移的蛋白酶,血管生成抑制剂,反义技术和g -四联体。g -四聚体通常在含有重复G-G-G-G的DNA和RNA序列中形成,称为g -四聚体。g -四聚体是由hoogsteen键合的g -四聚体(1,2)通过分子内或分子间的2到4条独立链的结合从一个单一的富g序列折叠而成(3,4)。g -四聚体的核心是由几个g -四聚体堆叠而成,并通过磷酸糖骨架连接在一起。该过程的结合能来自三个主要因素:一个平面上鸟嘌呤之间的氢键,相邻平面上鸟嘌呤之间的π π相互作用,以及鸟嘌呤部分负氧与通常位于堆叠之间八面体位置的阳离子之间的电荷-电荷相互作用(5-7)。在生理温度和pH下,K+和Na+等单价阳离子通过在g -四元体核心中心配位鸟嘌呤羰基来稳定g -四元体(5;8)。据估计,在许多重要的生物过程中发现了超过376,000个潜在的四重体序列(9)。分子内由单链DNA形成的g -四重体由于其可能在端粒和启动子序列中形成,目前正在深入研究中(10,11)。本文综述了在人类端粒和原癌基因中形成的g -四联体。
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引用次数: 1
Oncologic superiority of extralevator abdominoperineal excision for low rectal cancer 腹外展手术治疗低位直肠癌的肿瘤学优势
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1301011L
D. Lukić, Z. Radovanovic, T. Petrovic, M. Breberina, A. Golubović, Svetlana Škorić-Jokić
Background: Rectal cancer treatment has been dramatically improved during the last two decades in terms of a lower local recurrence rate and prolonged survival. This improvement was achieved mainly due to a better surgical technique (implementation of a total mesorectal excision-TME) and neoadjuvant chemo and radio therapy. A more radical approach to abdominoperineal excision, extralevator abdominoperineal excision technique in the prone Jack- knife position, may improve the oncological outcome. The aim of this study is to show our early experience by using extralevator abdominoperineal excision. Methods: Extralevator abdominoperineal excision has been used routinely at Oncology Institute of Vojvodina since 2011. In the last 23 months, we had 11 operations. Clinical and pathological data were obtained from operative proto- cols, histopathological data and patients' medical history. Results: An audit of results showed reduced rate of intra-operative perforations and circumferential resection margin involvement. Late postoperative complications have occurred in two patients, sexual dysfunction in one and pelvic pain in the other. The follow up period is too short (min 2 months, max 23 months, median 8 months) for analysis of local recurrence.
背景:在过去的二十年中,直肠癌的治疗在降低局部复发率和延长生存期方面有了显著的改善。这种改善主要是由于更好的手术技术(实施全肠系膜切除术- tme)和新辅助化疗和放疗。一种更激进的腹会阴切除方法,俯卧刀位腹会阴外提术,可能改善肿瘤预后。本研究的目的是展示我们使用腹外提肌切除的早期经验。方法:伏伊伏丁那肿瘤研究所自2011年起常规应用腹外展手术。在过去的23个月里,我们做了11次手术。临床及病理资料来源于手术方案、组织病理资料及患者病史。结果:审计结果显示术中穿孔和环切缘受累率降低。2例患者出现术后晚期并发症,1例出现性功能障碍,1例出现盆腔疼痛。随访时间短(最小2个月,最大23个月,中位8个月),无法分析局部复发。
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引用次数: 0
Toxicology of iodine: A mini review 碘的毒理学:一个小综述
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1302065I
A. Ilin, A. Nersesyan
2 SUMMARY Iodine is necessary for all living organisms. Deficiency of iodine in the organism leads to various diseases (including mental) and increased rates of cancer. It is well known that one third of the world's population lived in iodine-deficient areas. At present time, the primary intervention for preventing iodine deficiency disorders worldwide is through the iodization of salt. The two most common types of fortificant used to iodize salt are potassium iodide and potassium iodate. Iodine-containing compounds are also widely used in clinical medicine as a highly effective topical antimi- crobial agent that has been used clinically in the treatment of wounds. Hence, the genetic toxicology of iodine and iodine-containing compounds is very essential topic. In this literature review are analyzed the data concerning genetic toxicology and the influence of these compounds on tumor rates in epidemiological and experimental studies.
碘对所有生物都是必需的。机体缺碘会导致各种疾病(包括精神疾病)和癌症发病率增加。众所周知,世界上三分之一的人口生活在缺碘地区。目前,世界范围内预防碘缺乏症的主要干预措施是通过食盐加碘。两种最常用的强化剂是碘化钾和碘酸钾。含碘化合物作为一种高效的局部抗菌药物在临床医学中也广泛应用于伤口的治疗。因此,碘和含碘化合物的遗传毒理学研究是一个非常重要的课题。本文从流行病学和实验研究的角度,综述了遗传毒理学和这些化合物对肿瘤发生率影响的相关文献。
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引用次数: 11
Clinical and histopathological characteristics in patients with postmenopausal bleeding 绝经后出血患者的临床和组织病理学特征
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1301005M
A. Mandić, B. Gutic, Tatjana Kapicl-Ivkovic, Ljiljana Segedi-Mladenovic, Mihaela Mocko-Kacanski
SUMMARY Background: Incidence of endometrial carcinoma in Vojvodina is 15-20/100 000. In 75% cases, endometrial carci- noma is diagnosed in postmenopausal period. In 90 % of patients, the first clinical sign is postmenopausal bleeding. The aim of the study was to investigate clinical and histopathological characteristics in patients with postmenopausal bleeding. Methods: The study included 122 patients with postmenopausal bleeding. All of these patients underwent gynecologi- cal examination and vaginal ultrasound. We obtained materials for histopathological analysis by fractionate explorative curettage. Once we had definitive histopathological findings, we divided patients in two groups A (endometrial carci- noma) and B (benign changes). Results: We confirmed significant statistical differences between examined group A and B, including age (64.49 compared with 58.81 years), postmenopausal period (13.67 instead 9.11 years), and length of uterine corpus (6.41 instead 5.25 cm). Conclusion: Elderly women with longer postmenopausal interval and postmenopausal bleeding had increased risk for endometrial carcinoma. Measurement of endometrial thickness by transvaginal ultrasound appeared to be insufficient parameter for differentiating the benign from the malignant changes of endometrium. Patients with endometrial car- cinoma had significantly longer corpus of uterus comparing to patients with benign changes. Body mass index was not found to be significant risk factor in development of endometrial carcinoma in the examined groups. Obesity was diagnosed in both groups, suggesting that increased body mass index is a risk factor for development of pathological changes in endometrium, which could lead to postmenopausal bleeding.
背景:伏伊伏丁那地区子宫内膜癌的发病率为15-20/10万。在75%的病例中,子宫内膜癌在绝经后被诊断出来。在90%的患者中,第一个临床症状是绝经后出血。该研究的目的是探讨绝经后出血患者的临床和组织病理学特征。方法:纳入122例绝经后出血患者。所有患者均行妇科检查及阴道超声检查。我们通过分式探查刮除获得组织病理学分析的材料。一旦我们有明确的组织病理学发现,我们将患者分为两组A(子宫内膜癌-瘤)和B(良性改变)。结果:A组和B组在年龄(64.49岁比58.81岁)、绝经后时间(13.67年比9.11年)、子宫体长度(6.41厘米比5.25厘米)等方面存在显著的统计学差异。结论:老年妇女绝经间隔时间越长,绝经后出血的妇女发生子宫内膜癌的风险越高。经阴道超声测量子宫内膜厚度不足以作为鉴别子宫内膜良恶性病变的参数。子宫内膜癌患者的子宫体明显长于良性病变患者。在检查组中,体重指数并不是子宫内膜癌发生的重要危险因素。两组患者均被诊断为肥胖,这表明体重指数增加是子宫内膜病理变化的危险因素,这可能导致绝经后出血。
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引用次数: 2
Epidemiological data of ovarian cancer in Vojvodina and south great plain region in Hungary in 2007-2012 period: Crossbiomark IPA PROJECT HUSRB/1203/214/091 2007-2012年匈牙利伏伊伏丁那省和南部大平原地区卵巢癌流行病学资料:Crossbiomark IPA PROJECT HUSRB/1203/214/091
Q4 Medicine Pub Date : 2013-01-01 DOI: 10.2298/AOO1304097M
A. Mandić, L. Thurzó, D. Ninčić, M. Zivaljević, T. Dugandžija, R. Berkecz
www.onk.ns.ac.rs/Archive Vol 21, No. 3-4, December 2013 INTRODUCTION It is estimated that there are 65,697 new cases of ovarian cancer and 41,448 deaths in Europe each year (1). Ovarian cancer is among the sixth leading cancers in Vojvodina and the fifth leading cause of cancer death among female population in Vojvodina according to Cancer Registry of Vojvodina in 2010 (2). Only one fourth of women present with localized disease at diagnosis. The majority of ovarian cancer cases are diagnosed at an advanced stage of disease (FIGO stage III-IV) (3). The prognosis for survival from ovarian cancer is largely dependent upon the extent of disease at diagnosis. Approximately 15% of patients are presented with disease confined to the ovaries and after surgery, their 5-year survival is more than 90%. A 5-year survival among patients with advanced disease (FIGO stage III-IV) is less than 30% (4). The etiology of ovarian cancer is poorly understood. Early diagnostic of ovarian cancer is mandatory. Still, there is not enough sensitive diagnostic tool for early detection that can be recommended. There are numerous methods that have been tested in the preoperative identification of adnexal masses suspicious for malignancy. The results of some trials have reported the efficacy of screening of asymptomatic women with annual measurement of CA 125 and transvaginal ultrasound examination but they have failed to demonstrate a reduction in mortality (5). Risk factors for developing ovarian cancer are numerous: ages (over 50), gene mutation (BRCA 1, BRCA 2, and Lynch II syndrome), geographic variations (higher incidence in North America, and North Europe), reproductive factors (nullipara, infertility), and hormonal factors (6). The most common histopathological type of ovarian cancer is epithelial cancer and the most common histological subtype is serous carcinoma (7). The clinical symptoms of early ovarian cancer are nonspecific such as abdominal pain, bloating, changes in bowel frequency, and urinary and/or pelvic symptoms (8-10). The aim of this study was to evaluate epidemiological data of newly diagnosed ovarian cancer from Hospital Registry for Malignant Disease in Oncology Institute of Vojvodina and Department of Oncotherapy, University of Szeged in South Great Plain region in Hungary, in the period 2007-2012.
www.onk.ns.ac.rs/Archive第21卷,第3-4号,2013年12月引言据估计,欧洲每年有65,697例卵巢癌新病例和41,448例死亡(1)。根据2010年伏伊伏丁那癌症登记处的数据,卵巢癌是伏伊伏丁那省第六大癌症之一,也是伏伊伏丁那省女性癌症死亡的第五大原因(2)。只有四分之一的妇女在诊断时患有局部疾病。大多数卵巢癌病例在疾病晚期被诊断出来(FIGO III-IV期)(3)。卵巢癌的生存预后在很大程度上取决于诊断时疾病的严重程度。大约15%的患者表现为局限于卵巢的疾病,手术后,其5年生存率超过90%。晚期疾病(FIGO III-IV期)患者的5年生存率低于30%(4)。卵巢癌的病因尚不清楚。卵巢癌的早期诊断是强制性的。然而,目前还没有足够敏感的早期诊断工具可供推荐。有许多方法已被测试在术前识别附件肿块可疑的恶性肿瘤。一些试验的结果报道了每年检测ca125和经阴道超声检查对无症状妇女的筛查效果,但未能证明死亡率的降低(5)。卵巢癌的危险因素有很多:年龄(50岁以上)、基因突变(brca1、brca2和Lynch II综合征)、地理变异(在北美和北欧发病率较高)、生殖因素(无生育能力、不孕症)和激素因素(6)。卵巢癌最常见的组织病理学类型是上皮性癌,最常见的组织病理学亚型是浆液性癌(7)。早期卵巢癌的临床症状无特异性,如腹痛、腹胀、肠频率改变、泌尿和/或盆腔症状(8-10)。本研究的目的是评估2007-2012年期间匈牙利南大平原地区塞格德大学伏伊伏丁那肿瘤研究所和肿瘤治疗部门恶性疾病医院登记处新诊断的卵巢癌的流行病学数据。
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引用次数: 1
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Archive of Oncology
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