Ovarian Cancer

卵巢癌是一种影响女性初级生殖器官的毁灭性疾病. 卵巢在出生时就形成了身体组织, 直到非常复杂, 一旦雌性进入青春期，身体成熟, 她的卵巢也是如此.^1,2

尽管在治疗方面取得了进步，但卵巢癌是最常见的女性癌症之一³ 也是全球女性癌症死亡的第八大常见原因.⁴ The goals of front-line therapy have always been to delay progression of the disease for as long as possible and maintain the patient’s quality of life with the intent of achieving complete remission - yet currently ~70% of patients relapse within three years of initial treatment.^5,6,7,8

These statistics show there is still much to be done for women with ovarian cancer and that there needs to be a clear and accessible understanding of the latest scientific advancements and novel therapies. 在澳门在线赌城娱乐，澳门第一赌城在线娱乐将注意力集中在这一领域. Our aim is to help improve the outcomes of these patients and our ambition is to one day eliminate cancer as a cause of death.

要了解卵巢癌，澳门第一赌城在线娱乐必须首先了解卵巢的进化作用. One function only starts at puberty; the ovaries secrete reproductive hormones, 最常见的是雌激素和黄体酮, 驱动生殖周期，发展女性生理特征. 当女性进入更年期, 通常是四五十岁, 卵巢不再产生那么多的雌激素，不再每个月释放一个卵子^1,9,10 -月经周期停止.

The amount of hormone secreted therefore changes not only throughout the menstrual cycle but also across a lifespan. There is also disparity in ovarian cancer across the ages; although younger women can develop ovarian cancer, 它通常影响到更年期的女性⁵ 近80%的患者是50岁及以上的女性.⁵

快速诊断卵巢癌与提高生存率之间存在着令人放心的联系.^11,12,13,14 癌症的发展经历了四个阶段, 从早期(1-2期)到晚期(3-4期)，一旦成为“晚期”, 它可能已经从卵巢扩散到身体的其他部位，并且更难以控制.^8-11

目前三分之二的妇女被诊断患有晚期疾病, 当癌症已经扩散到卵巢以外的时候, 使其更难治疗, 大大降低了存活率. 尽管快速诊断和生存率之间存在明显的相关性, 大多数卵巢癌在晚期才被诊断出来^15,16,17 – but why?

Part of the complexity comes from recognising early symptoms so that the cancer can be diagnosed at an early stage. 症状是非特异性的, meaning they can often go unnoticed or may be misdiagnosed for another illness until the cancer is advanced.^17,20  重要的是要记住四种最常见的症状, listed here, 可能也不能说明癌症的存在.

另一个原因是，与其他癌症不同, 目前尚无可靠有效的卵巢癌筛查方法,^2,18 进一步推迟了诊断的能力. 众所周知，某些生活方式¹⁹ 医学因素确实表明，患卵巢癌的风险增加了，这与年龄无关, 比如缺乏平等, 子宫内膜异位症或卵巢家族史, breast, 或者结肠直肠癌.^3,15,20  除了身体特征和生活方式因素, 女性的基因构成也会影响她患卵巢癌的风险。

Every cell in the body suffers from DNA damage and undergoes a repair process in order to function normally.²¹ The 同源重组修复 (HRR)途径只是产生蛋白质的遗传途径之一, such as BRCA1/2, among others, 通过双链断裂进行修复过程. PARPs (poly(ADP-Ribose) Polymerases) are an example of a family of enzymes vital to another genetic pathway, 来修复单链DNA断裂.^21,22 This DNA damage response (DDR) shines a light on the connection between gene mutation and ovarian cancer.

HRD stands for 同源重组缺陷; a lack of functional components in one or more of the DNA repair pathways and a common trait of cancer cells, 哪些基因突变率高. BRCA就是一个例子. 男性和女性都有BRCA1和BRCA2蛋白, 正常工作时, 作为肿瘤抑制因子.²³ Their role within the HRR pathway is to repair cell damage and prevent them from growing and dividing too quickly – mutated BRCA genes result in abnormal cells which grow uncontrollably²⁴ 只是众多人权捍卫者中的一员.

你可以找到更多关于DDR、HRD和其他相关分子的信息 here.

Genetic testing allows both clinicians and patients to make an informed decision when it comes to the treatment they receive. Conducting testing prior to or at the point of diagnosis can be important in improving patient care and enabling access to certain targeted therapies.²⁵ By understanding the heritability of a woman’s cancer (if the mutation she possesses can be inherited) a patient’s family can also understand their risk of developing the disease – understanding the full picture has important implications for cancer risk assessment and prevention among relatives.²⁶

了解基因突变和癌症发展之间的联系是一回事, 另一个目标是利用科学和针对遗传脆弱性，以优化治疗. Targeted therapy for advanced ovarian cancer hinges on understanding the repair pathways and exploiting HRD by targeting PARPs. 通过抑制parp, the cells cannot repair single-stranded DNA breaks through its normal way and must rely on other pathways (such as HRR) to do so. Because cancer cells have HRD there are already fewer functional pathways; for BRCA mutations, HRR通路更少. 这意味着细胞损伤超出了修复的范围，导致细胞死亡. 因此，异常细胞的生长被阻止.²¹

澳门第一赌城在线娱乐对如何利用人力资源开发的理解正在不断发展. We will continue our research in this pathway to further our understanding of how treatment options and combinations can potentially help achieve the best possible outcome.

治疗分为积极治疗和维持治疗. 积极治疗包括手术, 化疗、放疗和维持治疗通常在一轮积极治疗后进行. 当卵巢癌患者处于缓解期时, 她可能没有接受任何治疗或以其他方式接受维持治疗来控制癌症.^27,28 年龄可能会影响这种治疗选择.²⁹

作为先驱者, AstraZeneca has a portfolio of approved and potential treatment for advanced ovarian cancer including in newly diagnosed patients. 通过澳门第一赌城在线娱乐的研究, we have made progress in increasing the time that women can live without disease progression and improving quality of life. Our approach is based on using ground-breaking science to further our understanding of targeted therapy within ovarian cancer, focusing on patients with HRD and transferring our learnings to the wider patient population and paving the way to achieve the best possible outcomes for progression-free and overall survival.

尽管在了解疾病和新疗法方面取得了进展, 要揭露卵巢癌的威胁，帮助挽救更多的生命，还有很长的路要走. Improvements in earlier diagnosis and accelerated access to the best available diagnostic testing and medicines are achievable goals which could help save countless lives.

作为一个创始成员 卵巢癌承诺 (OCC), together with our partners European Society of Gynaecological Oncology (ESGO) and the European network of Gynaecological Cancer Advocacy Groups (ENGAGe) we have a bold ambition to improve the experience and survival of people living with ovarian cancer.

Our aim is to facilitate 早期干预 -包括强调获得快速诊断的重要性, 遗传和生物标记检测和专门护理 并赋予医疗团队权力 因为他们为患有这种疾病的人提供持续的管理和支持.

OCC为合作伙伴提供了一个平台 保证他们的承诺 and 实施切实的行动. 随着计划的发展，澳门第一赌城在线娱乐的目标是增加伙伴组织的成员, 反映和解决全球在卵巢癌患者护理方面仍然存在的差距.

References

1. Livescience. 卵巢:事实、功能和疾病. Available at http://www.livescience.com/58862-ovary-facts.html. 2022年5月访问.
2. Patni R. 卵巢癌筛查:最新进展. 中年健康杂志. 2019;10(1), pp.3-5.
3. Momenimovahed Z, et al. 世界上的卵巢癌:流行病学和危险因素. 国际妇女健康杂志. 2019;11:287-299.
4. 世界卫生组织. 国际癌症研究机构2018年全球病例估计数，所有年龄段的女性. Available at http://gco.iarc.fr/today/. 2022年5月访问.
5. OCRA. Recurrence. Available at http://ocrahope.org/patients/about-ovarian-cancer/recurrence/. 2022年5月访问.
6. Chemoth. 一线和二线化疗方案的解释. Available at http://chemoth.com/firstline. 2022年5月访问.
7. Chemoth. 化疗的评价. Available at http://chemoth.com/evaluation. 2022年5月访问.
8. NHS Choices. 2020. 卵巢癌治疗. Available at http://www.nhs.uk/conditions/ovarian-cancer/treatment/. 2022年5月访问.
9. WebMD. 2021. Menopause? Available at http://www.webmd.com/menopause/guide/menopause-basics#:~:text=Their%20ovaries%20also%20make%20the,after%20the%20age%20of%2040. 2022年5月访问.
10. NHS选择(2018). 更年期的概述. 可在http://www下载.nhs.英国/条件/更年期/. 2022年5月访问.
11. 卵巢癌研究联盟. 关于I期卵巢癌. 可在奥克拉霍普.org/patients/about-ovarian-cancer/staging/stage-1/.  2022年5月访问.
    
12. 卵巢癌研究联盟. 关于II期卵巢癌. 可在奥克拉霍普.org/patients/about-ovarian-cancer/staging/stage-2/. 2022年5月访问.
13. 卵巢癌研究联盟. 关于III期卵巢癌. 可在奥克拉霍普.org/patients/about-ovarian-cancer/staging/stage-3/. 2022年5月访问.
    
14. 卵巢癌研究联盟. 关于第四期卵巢癌. 可在奥克拉霍普.org/patients/about-ovarian-cancer/staging/stage-4/. 2022年5月访问.
    
15. Target Ovarian. 主要事实及数字. Available at http://targetovariancancer.org.uk/about-us/media-centre/key-facts-and-figures. 2022年5月访问.
16. 英国癌症研究中心. 卵巢癌统计数字. Available at www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/ovarian-cancer/incidence#heading-Three. 2022年5月访问.
    
17. Colombo N, et al. ESMO-ESGO关于卵巢癌的共识会议建议:病理和分子生物学, 早期和晚期, 交界性肿瘤和复发性疾病. 肿瘤学年鉴. 2019;30:672-705.
18. 英国癌症研究中心. Screening. Available at http://www.cancerresearchuk.org/about-cancer/ovarian-cancer/getting-diagnosed/screening. 2022年5月访问.
    
19. Cancer.org. 卵巢癌危险因素. Available at http://www.cancer.org/cancer/ovarian-cancer/causes-risks-prevention/risk-factors.html. 2022年5月访问.
20. 世界卵巢癌日. 什么是卵巢癌? Available at http://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet. 2022年5月访问.
21. Bohen S, et al. DNA损伤反应——突破性癌症治疗的新靶点. European Oncology & 血液学2018;14(增刊1):2-7.
22. Pascal J. PARP-1对DNA损伤的反应. DNA Repair. 2018;71:177–182.
23. Bonadio R, et al. 卵巢癌同源重组缺乏症的流行病学及治疗进展. Clinics (Sao Paulo). 2018 8月20日;73(增刊1):e450.
24. 卵巢癌行动. 什么是基因突变? Available at http://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet. 2022年5月访问.
25. Ngoi NYL, et al. The role of homologous recombination deficiency testing in ovarian cancer and its clinical implications: do we need it? 打开癌症的视野 2021;6(3):1-12.
26. 国家癌症研究所. (2019). BRCA1和BRCA1:癌症风险和基因检测. Available at http://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet. 2022年5月访问.
27. Force. 卵巢癌治疗. Available at http://www.facingourrisk.org/understanding-brca-and-hboc/information/cancertreatment/ovarian-treatment/basics/maintenance-therapy-ovarian-cancer.php. 2022年5月访问.
28. 昆士兰癌症委员会-积极治疗. 可在http://cancerqld下载.org.非盟/术语表/积极治疗. 2022年5月访问.
29. Van Walree IC, et al. 老年妇女卵巢癌的治疗决策:基于年龄的比较. 妇科癌症. 2019;29(1):158-165.