8. This study found an increased risk for ovarian cancer among
infertile women with endometriosis.
Most studies suffer from methodological issues, such as lack of
controlling for confounding variables, short follow-up, a limited
number of cancer cases, and incomplete data collection.
Buis et al, 2013
14. ΗΕ4
Μεγαλύτερη ευαισθησία σε σχέση με όλες τις άλλες
πρωτεΐνες που έχουν μελετηθεί
CA 125 + ΗΕ4 = ευαισθησία
Βρέθηκε λιγότερα συχνά αυξημένο σε καλοήθεις παθήσεις
σε σχέση με το CA 125 (κυρίως σε περιστατικά με
ενδομητρίωση)
Zhang et al, 2016 & Nowak et al, 2015
15. Διαγνωστική αλγόριθμοι:
Risk of Malignancy Index (RMI )
RMI = U × M × CA125
Risk of Ovarian Malignancy
Algorithm (ROMA)
94% επιθηλιακών ΚΩ
Copenhagen Index (CPH-I)
Ευαισθησία 78%
Ειδικότητα 87%
16. 384 women 224 presented a benign ovarian
tumor
32 BOT
87 EOC
26 non-epithelial ovarian cancer
15 ovarian metastases.
CPH-I performed slightly better than ROMA, and
both approached 89% sensitivity and 85%
specificity.
When all malignant tumors (EOC, BOT, ovarian
metastases and non-epithelial ovarian cancer —
entire cohort) were included, the performance of
19. There is no indication that population-based screening
has a role in the early detection of endometrial cancer
among women who are at average endometrial cancer
risk and have no symptoms.
There is also no standard or routine screening test for
endometrial cancer.
ACOG & SRU,2015
ESMO, ESGO,ESTRO, 2015
26. meta-analysis [35 prospective studies] 6000 women
sensitivity TVUS 96%
≤5 mm was associated with a less than 1%
probability
meta-analysis consisted [57 studies] 9031 patients
≤5 mm cut-off level
a positive test result probability of carcinoma from
14-31%
a negative test 2.5 %
ACOG cut-off <4 mm
Smith-Bindman et al, Gupta et al, ACOG 2009
30. Metanalysis
positive test 82 percent negative test
0.9 percent
(95% CI, 60 to 93 percent) (95% CI, 0.4 to 2.4
percent)
Only 15 percent of specimens were inadequate
31. Metaanalysis of 39 studies involving 7914 women
• The Pipelle device was more sensitive for the detection of
endometrial cancer and atypical hyperplasia than all other
sampling devices.
• The sensitivity for the diagnosis of endometrial cancer (by
Pipelle) in postmenopausal women was 99.6 percent and in
premenopausal women was 91 percent. The sensitivity for the
diagnosis of atypical endometrial hyperplasia was 81 percent.
• The specificity for all endometrial biopsy devices for the
diagnosis of endometrial carcinoma was 98 to 100 percent.
• Fewer than 5 percent of patients had an insufficient or no
32. Απόξεση
Προτείνεται όταν:
Η ασθενής δεν επιθυμεί την βιοψία σε επίπεδο εξωτερικού
ιατρείου (π.χ. λόγω πόνου ή άγχους)
Ύστερα από μία καλοήθη βιοψία , που εμμένει η ανώμαλη
αιμορραγία
Δεν έχει προκύψει αρκετό δείγμα από βιοψία τύπου pipelle.
37. Systematic reviews and metaanalyses of
observational studies provide consistent and
compelling evidence that screening leads to a
decrease in incidence and mortality from cervical
cancer.
In a metaanalysis of 12 case control studies,
cytology screening was associated with decreased
risk of invasive cervical cancer.
Peirson et al, 2013 & Whitlock et al, 2011
38.
39.
40. Compared with test-pap: HPV testing, either
alone or in combination with cervical cytology, is
more sensitive than cervical cytology alone in
detecting cervical histopathology, including
adenocarcinoma
Co-testing (Pap test and HPV testing): Co-testing
may detect earlier cervical abnormalities than Pap
test alone, but also leads to an increased rate of
follow-up testing (colposcopy), and does not
appear to affect mortality
45. Κλινική εικόνα
Κολπική αιμόρροια (π.χ. μετά την συνουσία)
Ελκωτική εξεργασία του κόλπου
Συμπτωματολογία μέσω του ουροποιητικού (δυσουρία,
αιματουρία) ή/και του γαστρεντερικού(π.χ. τεινεσμός)
Πυελικό άλγος
