Screening for early familial ovarian cancer with transvaginal ultrasonography and colour blood flow imaging.

Bourne, Tom; Campbell, Stuart; Reynolds, Karina; Whitehead, M. I.; Hampson, J.; Royston, Patrick; Crayford, Tim; Collins, William P.

doi:10.1136/bmj.306.6884.1025

Cited by 227 publications

(86 citation statements)

References 22 publications

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“…Color-flow Doppler imaging uses these altered blood flow patterns as markers to differentiate malignant from physiologic and benign lesions. It has been used as a first-line screening test in combination with transvaginal ultrasound (52,53) as well as a second-line test following an abnormal ultrasound (54,55) in both general and high-risk population screening. The initial promise of Doppler to differentiate between malignant and benign ovarian masses and therefore improve the specificity of ultrasound (52,53) has not been sustained (37,56,57).…”

Section: Ovx1mentioning

confidence: 99%

Progress and Challenges in Screening for Early Detection of Ovarian Cancer

Jacobs

Menon

2004

Molecular & Cellular Proteomics

413

312

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Ovarian cancer is characterize by few early symptoms, presentation at an advanced stage, and poor survival. As a result, it is the most frequent cause of death from gynecological cancer. During the last decade, a research effort has been directed toward improving outcomes for ovarian cancer by screening for preclinical, early stage disease using both imaging techniques and serum markers. Numerous biomarkers have shown potential in samples from clinically diagnosed ovarian cancer patients, but few have been thoroughly assessed in preclinical disease and screening. The most thoroughly investigated biomarker in ovarian cancer screening is CA125. Prospective studies have demonstrated that both CA125 and transvaginal ultrasound can detect a significant proportion of preclinical ovarian cancers, and refinements in interpretation of results have improved sensitivity and reduced the false-positive rate of screening. There is preliminary evidence that screening can improve survival, but the impact of screening on mortality from ovarian cancer is still unclear. Prospective studies of screening are in progress in both the general population and high-risk population, including the United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKC-TOCS), a randomized trial involving 200,000 postmenopausal women designed to document the impact of screening on mortality. Recent advances in technology for the study of the serum proteome offer exciting opportunities for the identification of novel biomarkers or patterns of markers that will have greater sensitivity and lead time for preclinical disease than CA125. Considerable interest and controversy has been generated by initial results utilizing surface-enhanced laser desorption/ionization (SELDI) in ovarian cancer. There are challenging issues related to the design of studies to evaluate SELDI and other proteomic technology, as well as the reproducibility, sensitivity, and specificity of this new technology. Large serum banks such as that assembled in UKCTOCS, which contain preclinical samples from patients who later developed ovarian cancer and other disorders, provide a unique resource for carefully designed studies of proteomic technology. There is a sound basis for optimism that further developments in serum proteomic analysis will provide powerful methods for screening in ovarian cancer and many other diseases.

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Section: Ovx1mentioning

confidence: 99%

Progress and Challenges in Screening for Early Detection of Ovarian Cancer

Jacobs

Menon

2004

Molecular & Cellular Proteomics

413

312

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“…The early stages of malignant growth in the ovary do not usually produce symptoms, and late diagnosis and ineffective treatments are probably the main reasons for the poor prognosis. Despite extensive research, the mortality does not seem to be decreasing (Bourne et al, 1993). However, even in patients presenting with early disease, an extensive surgical treatment does not guarantee cure (Scholl et al, 1994).…”

mentioning

confidence: 99%

Expression of the thymidine phosphorylase gene in epithelial ovarian cancer

et al. 1999

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Summary Thymidine phosphorylase (TP) is associated with angiogenesis and the progression of solid tumours. High intracellular levels of this enzyme indicate increased chemosensitivity to pyrimidine antimetabolites. TP gene expression in 56 cases of epithelial ovarian cancer (27 of serous, 10 mucinous, 12 endometrioid, five clear cell and two undifferentiated) were analysed by polymerase chain reaction of RNA after reverse transcription. These included eight of low malignant potential. Twenty were stage I, four stage II, 27 stage III and five stage IV. The level of TP gene expression was presented by the relative yield of the TP gene to the β2-microglobulin gene. TP gene expression ranged from 0.19 to 5.38 (median 0.93). The value of TP gene expression in stage III-IV was significantly higher than that of TP gene expression in stage I-II (P = 0.0005). Histological grade significantly associated with TP gene expression (P = 0.008), but histological subtype did not (P = 0.166). A follow-up study of 34 cases after complete resection of the primary tumours by surgical operation was performed. TP gene expression of the cases with recurrence showed significantly higher levels compared to cases without recurrence (P = 0.049). Survival data were available for 47 of the 56 patients. The prognosis of the patients with high TP gene expression (equal to, or greater than, median) was to be significantly worse than patients with low TP gene expression (less than median) (P = 0.021). The TP gene expression level may play one of the key roles in the biology of ovarian epithelial cancer and define a more aggressive tumour phenotype. A new therapeutic intervention mediated by TP protein activity is anticipated.

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“…Transvaginal ultrasound (TVUS) can detect changes in ovarian size and morphology and is superior to physical examination in evaluating ovarian size, especially in women who are postmenopausal, obese or who have an enlarged uterus 46 . Primary screening studies with TVUS in both asymptomatic and symptomatic at-risk women have been successful in identifying early stage ovarian cancers [47][48][49][50] . Ovarian volume is inversely related to age; thus an enlarged ovary in post-menopausal women can be a sign of an evolving ovarian cancer.…”

Section: How Effective Is Ultrasound In Detecting Early Stage Ovarianmentioning

confidence: 99%