卵巢癌篩檢沒用 害多於益？！內診最重要 2012年9月12日 22:12 生活中心／綜合報導美國一個癌症專家小組表示，現有的卵巢癌篩檢法，沒有一個可以有效降低死亡率，有時害多於益。國內婦癌專家也贊同的表示，無論是透過抽血還是超音波來檢查卵巢癌，都沒有明顯的效果，不僅傷害受檢婦女，也浪費醫療資源。台北榮總醫師屠乃方今（12）日說，明確診斷卵巢癌，內診還是最重要的方式。美國預防工作小組主席穆易爾表示：「事實上，相當高比例接受卵巢癌篩檢的婦女，得到不實的陽性檢驗結果，可能受到沒有必要的傷害，諸如動重大手術。」美國預防工作小組說，他們不建議沒有出現卵巢癌徵兆，或有突變基因BRCA1或BRCA2，而罹患卵巢癌風險較高的婦女，接受例行性篩檢。台北醫學大學附設醫院婦產部主任劉偉民表示，不管是透過抽血或超音波來檢查卵巢癌，根本就沒有多大效果。婦女作健康檢查大都加作抽血驗「CA125」，也就是「卵巢癌指數」，台北榮總醫師屠乃方說，CA125指數異常不見得就有卵巢癌；反之，CA125指數正常也不見得沒有罹卵巢癌，CA125是種指標，異常後仍需透過診斷，內診是最重要的方式。
Accuracy of CA 125 in the diagnosis of ovarian tumors: a quantitative systematic review. Medeiros LR, Rosa DD, da Rosa MI, Bozzetti MC. Source Postgraduate Program in Epidemiology at Federal University of Rio Grande do Sul, Porto Alegre, Brazil. lidia.rosi@terra.com.br Eur J Obstet Gynecol Reprod Biol. 2009 Feb;142(2):99-105. Epub 2008 Nov 7.
Abstract A quantitative systematic review was performed to estimate the accuracy of CA 125 assay in the diagnosis of ovarian tumors. Studies that evaluated CA 125 levels for the diagnosis of ovarian tumors and compared them with paraffin-embedded sections as the diagnostic standard were included. Seventeen studies were analyzed, which included 2374 women. The pooled sensitivity for the diagnosis of borderline tumors or ovarian cancer was 0.80 (I.C. 95% 0.76-0.82) and the specificity was 0.75 (I.C. 95% 0.73-0.77). The diagnostic odds ratio for ovarian cancer and borderline lesions vs. benign lesions was 21.2 (95% C.I., 12-37). Summary receiver operating characteristic curves were constructed due to heterogeneity in the diagnostic odds ratio. For malignant and borderline ovarian tumors vs. benign lesions the area under the curve was 0.8877. A CA 125 level of >or= 35 U/ml is a useful preoperative test for predicting the benign or malignant nature of pelvic masses. The accuracy of CA 125 in the diagnosis of ovarian tumors is high and very important in helping the surgeon to decide what kind of surgery should be performed.
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