The association between endometriomas and ovarian cancer: preventive effect of inhibiting ovulation and menstruation during reproductive life
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Authors
Grandi, Giovanni
Toss, Angela
Cortesi, Laura
Botticelli, Laura
Volpe, Annibale
Cagnacci, Angelo
Issue Date
2015-08-30
Type
Article
Language
en_US
Keywords
Menstruation , Ovarian Neoplasms , Endometriosis
Alternative Title
Abstract
Although endometriosis frequently involves multiple sites in the pelvis, malignancies associated with this disease are mostly confined to the ovaries, evolving from an endometrioma. Endometriomas present a 2-3-fold increased risk of transformation in clear-cell, endometrioid, and possibly low-grade serous ovarian cancers, but not in mucinous ovarian cancers. These last cancers are, in some aspects, different from the other epithelial ovarian cancers, as they do not appear to be decreased by the inhibition of ovulation and menstruation. The step by step process of transformation from typical endometrioma, through atypical endometrioma, finally to ovarian cancer seems mainly related to oxidative stress, inflammation, hyperestrogenism, and specific molecular alterations. Particularly, activation of oncogenic KRAS and PI3K pathways and inactivation of tumor suppressor genes PTEN and ARID1A are suggested as major pathogenic mechanisms for endometriosis associated clear-cell and endometrioid ovarian cancer. Both the risk for endometriomas and their associated ovarian cancers seems to be highly and similarly decreased by the inhibition of ovulation and retrograde menstruation, suggesting a common pathogenetic mechanism and common possible preventive strategies during reproductive life.
Description
Citation
Grandi, G., Toss, A., Cortesi, L., Botticelli, L., Volpe, A., & Cagnacci, A. (2015). The Association between Endometriomas and Ovarian Cancer: Preventive Effect of Inhibiting Ovulation and Menstruation during Reproductive Life. BioMed research international, 2015, 751571. https://doi.org/10.1155/2015/751571
Publisher
BioMed Research International