Endometriosis and Ovarian Cancer

Wei, Jian Jun; William, Josette; Bulun, Serdar E.

doi:10.1097/pgp.0b013e31821f4b85

Cited by 153 publications

(111 citation statements)

References 109 publications

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“…This association has later been reported in several studies [3,4,5,6,7], particularly for endometriosis with ovarian endometrioid and clear cells carcinomas, suggesting that concurrent endometriosis is generally associated with a better prognosis for these specific subtypes of EOC [8,9,10]. Moreover, atypical endometriosis has been described as a precursor lesion that can lead to certain types of ovarian cancer [11,12,13,14,15]. Other authors have also suggested a hormonal dependence or a relationship with other hormone-dependent pathologies in this type of association [16,17].…”

Section: Introductionmentioning

confidence: 90%

“…On the other hand, atypical endometriosis is considered to be precancerous and strongly associated with endometriosis-associated ovarian cancer [15], although recognition of this form of endometriosis as a diagnostic criterion for pathological and clinical management remains controversial. Czernobilsky and Morris [11] first described atypical endometriosis, and Thomas and Campbell [19] further classified it based on the features that were identified in histological examinations.…”

Section: Discussionmentioning

confidence: 99%

“…Estrogens seem to be a mitogen for both endometriosis and ovarian cancer [15] since most endometriotic tissues and several endometrioid carcinomas have a functional stroma and in situ estrogen production [39,40,41]. So, although there is evidence supporting a role for estrogens in the etiology of endometriosis and the enhancement of inflammation [42,43], a plausible mechanism that links estrogens to ovarian carcinogenesis, as well as the steps for malignant transformation in ectopic endometrium has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

“…Endometriosis-induced inflammation and the auto- and paracrine production of sex steroid hormones could contribute to ovarian tumor genesis because these changes provide a microenvironment that favors the accumulation of sufficient genetic alterations and endometriosis-associated malignant transformation [15]. So, Wei et al [15] have suggested that this pathophysiological progression begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), followed by well-defined borderline tumors and culminating in malignant ovarian cancer. However, although some cases of endometriosis-associated ovarian carcinomas appear to be the final consequence of this pathological progression, the development and neoplastic transformation is usually controversial, and the epidemiological findings on the association are still elusive [6,18].…”

Section: Introductionmentioning

confidence: 99%

“…Other authors have also suggested a hormonal dependence or a relationship with other hormone-dependent pathologies in this type of association [16,17]. Endometriosis-induced inflammation and the auto- and paracrine production of sex steroid hormones could contribute to ovarian tumor genesis because these changes provide a microenvironment that favors the accumulation of sufficient genetic alterations and endometriosis-associated malignant transformation [15]. So, Wei et al [15] have suggested that this pathophysiological progression begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), followed by well-defined borderline tumors and culminating in malignant ovarian cancer.…”

Section: Introductionmentioning

confidence: 99%

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Epithelial Ovarian Cancers and Endometriosis

Acién

Velasco²,

Acién³

et al. 2015

Gynecol Obstet Invest

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Aims: To determine the prevalence of endometriosis in epithelial ovarian cancers (EOC) and the association among their histological subtypes and with endometrial carcinoma. Methods: An observational cohort study performed in 192 patients operated on for EOC, 30 women with atypical endometriosis and 17 with p53 positive endometriosis. Data on associated endometriosis and endometrial carcinomas, histological subtypes, tumor stage, clinical and pathological characteristics and survival were analyzed. Results: Twenty cases of EOC (10.4%) had also endometriosis (12.7 in borderline and 9.3% in invasive cases), being a synchronous finding in most cases. Endometriosis associated with serous or mucinous EOC was observed in 2.2 and 2.7% of cases, respectively. However, this association was observed in 50 of endometrioid and 23% of clear cell EOC. Age, parity and tumor stage were lower in endometriosis-associated EOC patients; and all associated cases were type I (Kurman and Shih's classification) and showed better results in survival rate. Endometrial carcinoma was more frequently associated with endometrioid EOC (25%). Conclusions: There is a significant association between endometriosis, including atypical forms, and endometrioid and clear cell carcinomas, but not with other EOC histotypes. The presence of endometriosis in EOC suggests a better prognosis and an intermediate stage within the progression endometriosis-carcinoma.

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Section: Introductionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Epithelial Ovarian Cancers and Endometriosis

Acién

Velasco²,

Acién³

et al. 2015

Gynecol Obstet Invest

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Tubal ligation, hysterectomy and epithelial ovarian cancer in the New England Case–Control Study

Rice

Murphy

Vitonis

et al. 2013

Intl Journal of Cancer

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Previous studies have observed that tubal ligation and hysterectomy are associated with a decreased risk of ovarian cancer; however little is known about whether these associations vary bysurgical characteristics, individual characteristics, or tumor histology. We used logistic regression to examine tubal ligation, simple hysterectomy, and hysterectomy with unilateral oophorectomy in relation to risk of epithelial ovarian cancer in the New England Case-Control study. Our primary analysis included 2,265 cases and 2,333 controls. Overall, tubal ligation was associated with a lower risk of epithelial ovarian cancer (OR: 0.82, 95%CI: 0.68-0.97), especially for endometrioid tumors (OR=0.45, 95%CI: 0.29-0.69). The inverse association between tubal ligation and ovarian cancer risk was stronger for women who had undergone the procedure at the time of last delivery (OR=0.60, 95%CI: 0.42-0.84) rather than at a later time (OR=0.93, 95%CI: 0.75-1.15). Overall, simple hysterectomy was not associated with ovarian cancer risk (OR: 1.09, 95%CI: 0.83, 1.42), although it was associated with a non-significant decreased risk of ovarian cancer among women who underwent the procedure at age 45 or older (RR: 0.64, 95%CI: 0.40, 1.02) or within the last 10 years (OR=0.65, 95%CI: 0.38, 1.13). Overall, women who had a hysterectomy with a unilateral oophorectomy had significantly lower risk of ovarian cancer (OR=0.65, 95%CI: 0.45-0.94). In summary, tubal ligation and hysterectomy with unilateral oophorectomy were inversely associated with ovarian cancer risk in a large population-based case-control study. Additional research is necessary to understand the potential biologic mechanisms by which these procedures may reduce ovarian cancer risk.

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Distinct molecular pathways in ovarian endometrioid adenocarcinoma with concurrent endometriosis

Zhang

Wang

Anaya

et al. 2018

Intl Journal of Cancer

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Women with endometriosis, a benign growth of endometrial tissue outside the uterine cavity, are at increased risk of specific histotypes of epithelial ovarian cancer, such as ovarian endometrioid adenocarcinoma (OEA). Women with OEA who have endometriosis at time of surgical staging demonstrate improved clinical prognosis compared to women with OEA without evidence of endometriosis. However, the molecular contributions of the endometriotic tumor microenvironment to these ovarian cancers remain poorly understood. As a starting point, we used a platform for genome-wide transcriptomic profiling to compare specimens of OEA from women with and without concurrent endometriosis and benign reproductive tract tissues, including proliferative endometrium and typical and atypical endometrioma samples (n = 20). Principle component analysis revealed distinct clustering between benign and malignant samples as well as malignant samples with and without concurrent endometriosis. Examination of gene signatures revealed that OEA with concurrent endometriosis contained a unique molecular signature compared to OEA without concurrent endometriosis, distinguished by 682 unique genes differentially expressed (fold change < or >1.5, p < 0.01). Bioinformatic analysis of these differentially expressed gene products using ingenuity pathway analysis revealed activation of NFkB signaling, an inflammatory signaling pathway constitutively active in endometriosis. DAVID functional annotation clustering further revealed enrichment in RAS signaling as both cytoskeleton organization and GTPase regulator activity relied heavily on RAS protein signal transduction. Gene set enrichment analysis highlighted immune and inflammatory nodes involved in OEA with concurrent endometriosis. These observations provide novel resources for understanding molecular subtleties potentially involved in OEA within the context of the endometriotic tumor microenvironment.

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Endometriosis and Ovarian Cancer

Cited by 153 publications

References 109 publications

Epithelial Ovarian Cancers and Endometriosis

Epithelial Ovarian Cancers and Endometriosis

Tubal ligation, hysterectomy and epithelial ovarian cancer in the New England Case–Control Study

Distinct molecular pathways in ovarian endometrioid adenocarcinoma with concurrent endometriosis

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