美國(guó)研究者周二表示，因BRCA1和BRCA2基因突變而具有癌癥高風(fēng)險(xiǎn)的女性,，在做了卵巢和輸卵管切除手術(shù)後，患卵巢癌和輸卵管癌的風(fēng)險(xiǎn)將減少80%,， 但她們?nèi)杂锌赡芑既橄侔?/p>
研究者從此前的研究報(bào)告中搜集數(shù)據(jù),，發(fā)現(xiàn)手術(shù)能將女性患乳腺癌的幾率減少50%，但女性患卵巢癌或輸卵管癌癥的幾率只能減少80%,，因?yàn)榧词箤⑦@些器官切除,，還會(huì)殘存一些組織細(xì)胞，仍有病變危險(xiǎn),。
此篇研究報(bào)告發(fā)表在《美國(guó)國(guó)家癌癥研究院期刊》上,。“只要很少的細(xì)胞就能導(dǎo)致卵巢癌。”文章作者,、賓夕法尼亞大學(xué)的Timothy Rebbeck在接受采訪時(shí)說(shuō),，“雖然風(fēng)險(xiǎn)被大大降低了，但還是存在,。此前的研究顯示,，手術(shù)能夠去除95%或100%的病變風(fēng)險(xiǎn)，但事實(shí)并非如此,。”
研究表明,，那些BRCA1和BRCA2基因出現(xiàn)突變的女性,，其中有些人手術(shù)做得太晚，而主刀醫(yī)生也應(yīng)該確保在手術(shù)中切除全部卵巢和輸卵管細(xì)胞,。
研究者認(rèn)為,，此項(xiàng)研究提出了如何降低患病風(fēng)險(xiǎn)的問(wèn)題，解決之道是提高手術(shù)技術(shù),，或提早做手術(shù),。
Rebbeck說(shuō)：“有力證據(jù)表明，手術(shù)還是有效果的,。女性患者需要做手術(shù),，而且要做得正確。”（生物谷Bioon.com）
生物谷推薦原始出處：
Journal of the National Cancer Institute, doi:10.1093/jnci/djn442
Meta-analysis of Risk Reduction Estimates Associated With Risk-Reducing Salpingo-oophorectomy in BRCA1 or BRCA2 Mutation Carriers
Timothy R. Rebbeck, Noah D. Kauff, Susan M. Domchek
Affiliations of authors: Center for Clinical Epidemiology and Biostatistics (TRR), Abramson Cancer Center (TRR, SMD), Department of Medicine (SMD), University of Pennsylvania School of Medicine, Philadelphia, PA; Clinical Genetics Service, Department of Medicine (NDK), Gynecology Service, Department of Surgery (NDK), Memorial Sloan-Kettering Cancer Center, New York, NY
Background: Risk-reducing salpingo-oophorectomy (RRSO) is widely used by carriers of BRCA1 or BRCA2 (BRCA1/2) mutations to reduce their risks of breast and ovarian cancer. To guide women and their clinicians in optimizing cancer prevention strategies, we summarized the magnitude of the risk reductions in women with BRCA1/2 mutations who have undergone RRSO compared with those who have not.
Methods: All reports of RRSO and breast and/or ovarian or fallopian tube cancer in BRCA1/2 mutation carriers published between 1999 and 2007 were obtained from a PubMed search. Hazard ratio (HR) estimates were identified directly from the original articles. Pooled results were computed from nonoverlapping studies by fixed-effects meta-analysis.
Results: Ten studies investigated breast or gynecologic cancer outcomes in BRCA1/2 mutation carriers who had undergone RRSO. Breast cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers, four of BRCA1 mutation carriers, and three of BRCA2 mutation carriers. Gynecologic cancer outcomes were investigated in three nonoverlapping studies of BRCA1/2 mutation carriers and one of BRCA1 mutation carriers. RRSO was associated with a statistically significant reduction in risk of breast cancer in BRCA1/2 mutation carriers (HR = 0.49; 95% confidence interval [CI] = 0.37 to 0.65). Similar risk reductions were observed in BRCA1 mutation carriers (HR = 0.47; 95% CI = 0.35 to 0.64) and in BRCA2 mutation carriers (HR = 0.47; 95% CI = 0.26 to 0.84). RRSO was also associated with a statistically significant reduction in the risk of BRCA1/2-associated ovarian or fallopian tube cancer (HR = 0.21; 95% CI = 0.12 to 0.39). Data were insufficient to obtain separate estimates for ovarian or fallopian tube cancer risk reduction with RRSO in BRCA1 or BRCA2 mutation carriers.
Conclusion: The summary estimates presented here indicate that RRSO is strongly associated with reductions in the risk of breast, ovarian, and fallopian tube cancers and should provide guidance to women in planning cancer risk reduction strategies.
