Abstract:
Endometriosis is a medical condition affecting at least up to 10% of women of reproductive age. This condition occurs when ectopic endometrial glands and stroma implant outside the uterus and there are several theories regarding the underlying origins of the disease. Endometriosis is one of the major causes of severe dysmenorrhoea, chronic pelvic pain and infertility. While endometriosis is generally a non-malignant condition, it rarely may transform into an invasive cancer, and increase the risk for epithelial ovarian cancer, notably endometrioid or clear cell ovarian cancer. Despite the increased risk, the mechanisms behind the development of endometriosis-associated ovarian cancer (EAOC) are not yet well understood. Recent investigations have delved into the intricate interplay between endometriosis and EAOC, exploring pathways involving oxidative stress, inflammation, hyperestrogenism, and the discovery of genetic mutations within endometriotic lesions that hint at a transition towards invasive carcinoma. Efforts have been made to identify intermediary lesions between endometriosis and EAOC, which may enable earlier detection of endometriosis at risk of malignant transformation or even prevention of the transformation altogether. However, given the rarity of this malignancy, there is still the risk of late or missed diagnosis, with the risk of inappropriate management being offered to the patient, and the higher risk of poor prognosis and increased morbidity and mortality. This scoping review aims to summarize existing data on EAOC, with a focus on endometrioid and clear cell histologic subtypes. It also provides insights into its identification, prognosis, and delineating management strategies, seeking to provide a holistic understanding of the complexities surrounding EAOC, facilitating further research and the development of more effective prevention and treatment approaches.
摘要:
子宫内膜异位症是一种影响至少高达10%的育龄妇女的医疗状况。当子宫内膜腺体和基质在子宫外植入时,就会发生这种情况,并且有几种有关该疾病潜在起源的理论。子宫内膜异位症是严重痛经的主要原因之一,慢性盆腔疼痛和不孕症。虽然子宫内膜异位症通常是非恶性疾病,它很少会转变为浸润性癌症,增加上皮性卵巢癌的风险,尤其是子宫内膜样或透明细胞卵巢癌。尽管风险增加,子宫内膜异位症相关卵巢癌(EAOC)的发病机制尚不清楚.最近的研究已经深入到子宫内膜异位症和EAOC之间复杂的相互作用,探索涉及氧化应激的途径,炎症,雌激素过多症,以及子宫内膜异位病变中基因突变的发现,暗示了向浸润性癌的过渡。已经努力确定子宫内膜异位症和EAOC之间的中间病变,这可能使子宫内膜异位症的早期检测有恶性转化的风险,甚至完全预防转化。然而,鉴于这种恶性肿瘤的罕见性,仍然存在晚期或漏诊的风险,给病人提供不当管理的风险,预后不良的风险较高,发病率和死亡率增加。本次范围审查旨在总结EAOC的现有数据,重点关注子宫内膜样和透明细胞组织学亚型。它还提供了对其识别的见解,预后,描绘管理策略,寻求对EAOC周围的复杂性有一个整体的理解,促进进一步研究和开发更有效的预防和治疗方法。