卵巢癌（ovarian cancer）被人们称之为“无声的杀手”（silent killer），是女性常见的恶性肿瘤之一。毫无疑问，尽早发现卵巢癌将有利于改善患者的预后。目前，在临床工作中妇科医生经常采用抽血化验CA-125（一种免疫指标）＋经阴道超声检查卵巢，以筛查卵巢癌。那么，这些检查的效果如何？请看美国犹他大学的研究结果。

为了论证上述两项检查的效果，犹他大学的研究人员联合应用“抽血化验CA-125＋经阴道超声检查卵巢”，对近80000名妇女进行了为期13年的观察，结果发现联合应用上述两项检查不仅未能被证明可有效地早期发现卵巢癌，还可因假阳性增加被检查妇女的精神负担，甚至因进一步活检而增加被检查妇女的痛苦和产生某些并发症。

在研究过程中，科研人员将约80000万名年龄在55～74岁的女性随机分为实验组和对照组，实验组的女性于进入实验观察后的前6年和前4年分别每年接受一次CA-125和经阴道超声检查，随访至13年后发现两组女性的卵巢癌诊断率和死亡率并无显著差别，并且实验组约有3300名女性的检查结果为假阳性，其中约1100名女性因实验结果的假阳性接受了手术活检，163人因活检出现了严重的并发症。

更多资讯，请参阅原文：

Study Finds Ovarian Screening Tests Don't Improve Survival

SATURDAY, June 4 (HealthDay News) -- New research finds that the only two tests available to screen for ovarian cancer don't reduce the average woman's risk of dying from this "silent killer."

Screening with a blood test and then a transvaginal ultrasound might even cause harm, the University of Utah study suggests, since there was a huge number of worrisome false-positive results, subsequent biopsies and resulting complications.

"I am neither surprised nor disappointed. We kind of knew that, but it's nice to have the final results of the study," said Dr. Karen Lu, a professor of gynecologic oncology at The University of Texas M.D. Anderson Cancer Center in Houston.

"This actually confirms what we've always known," added Dr. Mark Wakabayashi, chief of gynecologic oncology at City of Hope Cancer Center in Duarte, Calif.

The bottom line: there are currently no good screening techniques to detect ovarian cancer early in women who are otherwise healthy, Lu said. Unfortunately, that means that many women are diagnosed at a later stage of the illness, when it is less treatable.

"Most of these cancers are detected late, even in screening trials," Wakabayashi confirmed.

The researchers were slated to present their findings Saturday at the American Society of Clinical Oncology (ASCO) annual meeting in Chicago. The findings are also being published simultaneously online in the Journal of the American Medical Association.

Scientists have long been investigating a blood test for a marker called CA-125, as well as transvaginal ultrasound (TVA).

To test its effectiveness, the Utah authors randomized almost 80,000 women, aged 55 to 74, to either undergo an annual CA-125 screen for six years plus TVA annually for four years, or to "usual care."

After a follow-up of up to 13 years, the researchers found no differences in ovarian cancer diagnoses or mortality rates between the two groups. There were 212 cases of ovarian cancer in the screening group, compared to 176 in the usual care group, and 118 deaths in the screening group compared to 100 in the usual care group.

Moreover, almost 3,300 women received false positive results from the screens. Almost 1,100 of these women went on to undergo surgical biopsies and 163 had some kind of serious complication, the study found.

Other screening techniques for ovarian cancer are being studied, including a trial led by Lu that looks at whether changes in CA-125 levels over time could pick up malignancies.

However, for the time being, successful screening for ovarian cancer remains elusive.

"This doesn't change anything in terms of standard of care," Lu said. "There is still no successful current effective method to screen for ovarian cancer."

"There's really nothing that's good at this point [for women at average risk]," Wakabayashi said. But, she pointed out that women at high risk for ovarian cancer, such as those carrying the malignancy-linked BRCA gene mutation, should still have their CA-125 checked and undergo ultrasounds.

SOURCES: Karen Lu, M.D., professor, gynecologic oncology, M.D. Anderson Cancer Center, University of Texas, Houston; Mark Wakabayashi, M.D., chief, gynecologic oncology, City of Hope Cancer Center, Duarte, Calif.; June 4, 2011, Journal of the American Medical Association, online