摘要
目的基于前瞻性遗传性卵巢癌研究分析患者接受肿瘤遗传咨询和遗传检测的意愿及相关因素。方法在2017年2至6月于北京协和妇产科诊疗的220例上皮性卵巢癌患者中，根据病历记录和调查问卷收集患者的流行病学特点、病理学特点以及对遗传咨询和检测的意愿。所有患者在咨询前通过小册子和微信进行宣教，如果接受咨询，在病房或妇科肿瘤遗传咨询门诊提供面对面的遗传咨询和检测。结果在220例患者中10例（4．5％）不愿意接受肿瘤遗传咨询。在210例接受遗传咨询的患者中，最终170例（81％）接受了遗传检测。多因素分析中与患者接受检测显著相关的因素包括：由妇科肿瘤医师负责肿瘤诊治，在妇科遗传咨询门诊接受咨询以及有乳腺癌家族史。不愿意接受检测的患者主观原因较多，最常见原因是“咨询后对遗传检测仍然不能理解”（25％）和“发现突变后靶向药物价格昂贵，无法负担”（25％）。结论上皮性卵巢癌患者接受遗传咨询和检测的比例较高，妇科肿瘤遗传咨询门诊可以进一步改善患者接受遗传检测的比例。
Objective To analyze patients＇ tendency towards genetics counseling and tests based on a prospective cohort study on hereditary ovarian cancer. Methods From February 2017 to June 2017, among 220 cases of epithelial ovarian cancer in Peking Union Medical College Hospital, we collected epidemiological, pathological and tendency towards genetics counseling and tests via medical records and questionnaire. All patients would get education about hereditary ovarian cancer by pamphlets and WeChat. If they would receive further counseling, a face to face interview and tests will be given. Results Among all 220 patients, 10 （ 4. 5% ） denied further counseling. For 210 patients receiving genetic counseling, 170 （81%） accepted genetic tests. In multivariate analysis, risk factors relevant to acceptance of genetic tests included： being charged by physicians of gynecologic oneology for diagnosis and treatment, receiving counseling in genetic counseling clinics, and having family history of breast cancer. For patients denying genetic tests, there were many subjective reasons, among which, ＂still not understanding genetic tests＂ （25%） and ＂unable bear following expensive targeting medicine＂. Conclusions High proportion patients of epithelial ovarian cancer would accept genetic counseling and tests. Genetic counseling clinics for gynecologic oncology would further improve genetic tests for patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2017年第43期3412-3415,共4页
National Medical Journal of China
关键词
卵巢肿瘤
遗传咨询
Ovarian neoplasm
Genetic counseling
