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Minerva Medica 2019 August;110(4):279-91

DOI: 10.23736/S0026-4806.19.06086-5


language: English

Unraveling a difficult diagnosis: the tricks for early recognition of ovarian cancer

Pierluigi GIAMPAOLINO 1, Luigi DELLA CORTE 2, Virginia FORESTE 2, Salvatore G. VITALE 3 , Benito CHIOFALO 4, Stefano CIANCI 5, Fulvio ZULLO 2, Giuseppe BIFULCO 2

1 Department of Public Health, School of Medicine, University of Naples Federico II, Naples, Italy; 2 Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; 3 Department of General Surgery and Medical Surgical Specialties, University of Catania, Catania, Italy; 4 Unit of Gynecologic Oncology, Department of Experimental Clinical Oncology, “Regina Elena” National Cancer Institute, Rome, Italy; 5 Division of Gynecologic Oncology, Department of Women and Children’s Health, A. Gemelli University Hospital and Institute for Research and Care, Rome, Italy

Epithelial ovarian cancer (EOC) is the predominant type of ovarian cancer (OC). The 5-year survival of patients has improved over the last three decades, although the overall cure rate of OC if about 30%. Despite high response rates after initial chemotherapy, most patients with advanced ovarian cancer ultimately develop the recurrent disease because of resistance to chemotherapy. A proper early diagnosis and treatment of patients with ovarian cancer are urgently needed. Nowadays the diagnosis is performed by means of clinical symptoms and signs, often indicators of a disease already at an advanced stage, tumor markers (CA125 and HE4), transvaginal ultrasonography and imaging, very useful in distinguishing adnexal masses. Understand the nature of an adnexal mass is the primary point to begin the diagnosis of OC. Validated different model to approach and characterize adnexal pathology preoperatively are described, such as the International Ovarian Tumor Analysis (IOTA) and the Assessment of Different NEoplasias in the AdneXa (ADNEX) model. New tumor markers, such as PRSS8, FOLR1, KLK6/7, GSTT1, and miRNAs, are getting ahead and are worth noting for early detection of ovarian cancer. Despite the development of numerous ultrasound models for the diagnosis of adnexal masses and the analysis of different tumor markers, the early diagnosis of ovarian cancer is still difficult to practice. Moreover, identifying genetic risk alleles, such as germline BRCA1 and BRCA2 mutations, for ovarian cancer has had a significant impact on disease prevention strategies.

KEY WORDS: Carcinoma, ovarian epithelial; Early diagnosis; Biomarkers, tumor; Genetic profile

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