The incidence of ovarian cancer is increasing
Ovarian cancer is one of the most common malignant tumors in female genital organs. The incidence rate is only third of the cervical cancer and uterine body cancer, ranking the highest in the female reproductive system cancer. However, the mortality rate of ovarian cancer is high in the first place of gynecologic malignancies. The 2014 global cancer report published by the World Health Organization (who) points out that in 2012, the number of new cancer cases worldwide reached 14 million, resulting in 8.2 million deaths, and the number of new cancer patients will increase by 70% in the next 20 years.
Classification of ovarian cancer
According to the cell types of tumor origin, ovarian cancer can be divided into three main types: epithelial cell source, germ cell source and stromal cell source. About 90% of ovarian cancer comes from epithelial cells.
Epithelial ovarian cancer can be divided into five histological subtypes: serous adenocarcinoma, mucinous adenocarcinoma, endometrioid adenocarcinoma, clear cell carcinoma and transitional cell carcinoma. Ovarian germ cell tumors originate from oocytes. Ovarian stromal cell tumors are rare and mainly originate from connective tissue cells that support the ovary and produce estrogen and progesterone. Ovarian germ cell tumors and stromal cell tumors account for only 5% – 10%.
To reduce the harm of ovarian cancer, early detection is the last word
The characteristics of “two high and one low” of ovarian cancer are high degree of malignancy, high mortality and low rate of early treatment. The survival rate of ovarian cancer is closely related to the stage at the time of diagnosis. The data from the National Cancer Institute show that the 5-year survival rate of non-invasive localized ovarian cancer is 92.1%, that of local lymph nodes is 73.2%, and that of patients with distant metastasis is only 28.3%. Although the prognosis of early ovarian cancer is good, the overall 5-year survival rate of ovarian cancer patients is only 45.6%, which is mainly because 79% of ovarian cancer patients are diagnosed with local or distal spread, and only 15% of patients are diagnosed early. Therefore, the early diagnosis of ovarian cancer is very important to the prognosis of patients.
Five categories of women more prone to ovarian cancer
The occurrence and development of ovarian cancer are caused by the interaction and interaction of environmental, genetic and social psychological factors. So, which women are at high risk of ovarian cancer? The Centers for Disease Control and prevention listed five high-risk groups.
1,Women over 50
2,No fertility or infertility, history of endometriosis
3,Estrogen alone for more than 10 years
4,Population with mutations in gene BRCA1 or BRCA2
5,Family genetic history of ovarian tumor or malignant tumor
Four common methods of ovarian cancer screening
The early detection of ovarian cancer can only be periodic screening for high-risk groups. According to the statistical results of an epidemiological survey in the United States, the total mortality of ovarian cancer in the United States decreased by 12.1% from 1950 to 2011; The 5-year survival rate of ovarian cancer was 30% from 1950 to 1954 and 43% from 2004 to 2010. This is partly due to the progress of medical technology and the application of more diagnostic methods. At present, there is still a lack of effective means to screen early ovarian cancer, but there are four commonly used means, namely double diagnosis and triple diagnosis, B-ultrasound, laparoscopy and tumor markers.
1,Double diagnosis and triple diagnosis: This is the most basic screening method, but its diagnostic specificity is poor, and the diagnostic results of different doctors vary greatly.
2,B-ultrasound examination: vaginal B-ultrasound examination has the highest sensitivity. B-ultrasound has become a routine examination of pelvic mass, but it is difficult to judge whether it is benign or malignant.
3,Laparoscopy: laparoscopy can be performed for people who have long-term gastrointestinal symptoms, but can not detect relevant factors of the digestive system, and who have a high incidence of ovarian cancer.
4,Tumor marker examination: CA125 combined with gynecological examination and vaginal B-ultrasound is a relatively convenient and reliable screening method. In addition, studies have shown that the combined detection of HE4 and CA125 and the use of appropriate algorithms can accurately diagnose 93.8% of patients with high-risk ovarian cancer.
Ovarian cancer triad can be used as an early screening signal
Ovarian cancer is mostly asymptomatic in the early stage. Once the symptoms appear, they are often in the late stage. If you have to say the early signal of ovarian cancer, you can take the “triple syndrome of ovarian cancer” as a signal to urge early examination.
1,Age: women aged 40-60 are the high incidence age of ovarian cancer. Women in this age group should be screened for ovarian cancer regularly every year as soon as possible
2,Ovarian dysfunction: if premenstrual tension syndrome, menorrhagia, breast swelling and pain, repeated spontaneous abortion, infertility, late menopause and other phenomena occur for a long time, it indicates that there may be a long-term imbalance of ovarian function, and the risk of disease will be greatly increased.
3,Unexplained abdominal discomfort: when the body has an unexplained discomfort, or some persistent gastrointestinal symptoms, such as poor diet and abdominal distention after eating, regular screening is required to eliminate the possibility of ovarian cancer.
Tumor markers are substances synthesized, secreted and shed into liquid or tissue by different gene expression of tumor cells in the process of malignant tumor occurrence and appreciation. These substances do not exist in normal human body, but only in embryo. When tumor occurs in vivo, its content will exceed the level of normal people, which can reflect different tumors.
Tumor markers are important indicators for tumor auxiliary diagnosis, prognosis judgment, curative effect observation and recurrence monitoring. The combined detection of HE4 and CA125 has better screening effect. If viewed from a single tumor marker, HE4 has the highest sensitivity, especially for the detection of stage I ovarian cancer. If the combination of the two tumor markers is considered, the combination of HE4 and CA125 for ovarian cancer detection further improves the sensitivity and specificity than CA125 alone. Therefore, the combined detection of HE4 and CA125 in tissue and serum can improve the sensitivity and specificity of the diagnosis of ovarian cancer Curative effect evaluation and condition monitoring are of great value.
1,Human epididymal protein 4 (HE4)
HE4 is a new tumor marker, which can be used for early diagnosis, differential diagnosis, treatment monitoring and prognosis evaluation of ovarian cancer. Compared with CA125, HE4 has higher sensitivity and specificity, especially in the asymptomatic stage of the disease. The sensitivity of early diagnosis of HE4 was 82.7%, and CA125 was only 45.9%; The specificity of HE4 was 99%, while that of CA125 was only 20%.
2,Carbohydrate antigen 125 (CA125)
The determination of serum CA125 can enhance the positive detection rate of gynecological tumors and contribute to the early detection of gynecological tumors. The growth and decline of CA125 level in more than 90% of patients with advanced ovarian cancer is consistent with the remission or deterioration of the disease. It has important clinical value in monitoring the recurrence and changes of the disease.
Reexamination of ovarian cancer after treatment
1,Regular examination is the key to prevent ovarian cancer recurrence
After ovarian cancer surgery and chemotherapy, some patients still have the possibility of recurrence. Therefore, ovarian cancer patients must be rechecked regularly after chemotherapy, so as to find and treat early. Even after patients with early ovarian cancer receive standardized and adequate treatment, they may still metastasize or relapse. It is very important to go to the hospital for review regularly, so as not to miss the best time for treatment.
2,How often is ovarian cancer reexamined
For patients with stage I, II, III and stage IV ovarian cancer in complete remission, they should be rechecked every 2-4 months in the first 2 years after operation; Recheck every 3-6 months in the next 3 years; Recheck at least once a year after 5 years. If it is a conditional patient, it can be rechecked 2-3 times a year; In particular, if there are abdominal discomfort, cough and other symptoms, and the cause cannot be found, see a doctor as soon as possible.
3,What needs to be checked during review?
Recheck should first let the doctor know the physical condition after discharge. Some special examinations will be given by the doctor according to the patient’s own physical condition, but routine examinations are essential. The examination items can include gynecological pelvic examination, CA125 or other tumor markers. If there are clinical indications, CT, MRI or PET-CT can be selected for imaging examination.
How to reduce the risk of ovarian cancer
Studies have shown that a diet with high cholesterol and low vitamins can cause the accumulation of toxic substances in cells and indirectly cause ovarian cancer. Moderate physical exercise, regular work and rest, reasonable diet, maintaining a good attitude and other healthy living habits can not only reduce the risk of a variety of cardiovascular diseases, improve the body’s immunity, but also help to reduce the incidence of ovarian cancer.
3,Regular work and rest