子宫内膜异位症与卵巢癌关系的研究进展

摘要/Abstract

摘要： 子宫内膜异位症（endometriosis，EMs）是一种良性妇科疾病，但具有恶性行为。流行病学及病理学等研究证实EMs可增加卵巢癌，尤其是透明细胞癌和子宫内膜样癌的风险。近年国内外关于EMs相关卵巢癌（endometriosis associated ovarian cancer，EAOC）的报道不断增加，已证实这是一类特定类型的卵巢癌，EAOC的病因、发病机制和临床特点的研究已成为热点。通过阅读大量文献，分析目前报道的EAOC的危险因素、发病机制、临床特点及诊断方法，以提高对该病的认识。

关键词: 子宫内膜异位症, 卵巢肿瘤, 危险因素, 发病机制, 临床特点, 诊断

Abstract: Endometriosis (EMs) is a benign gynecological disease with malignant behavior. Epidemiological and pathological studies have confirmed that EMs can increase the risk of ovarian cancer, especially clear cell cancer and endometrioid cancer. In recent years, reports on endometriosis associated ovarian cancer (EAOC) have been increasing both at home and abroad. Researches have confirmed that EAOC is a specific type of ovarian cancer. The research on the etiology, pathogenesis and clinical characteristics of EAOC has become a hot spot. Through reading a large number of literatures, this paper analyzed the risk factors, pathogenesis, clinical characteristics and diagnostic methods of EAOC reported so as to improve the understanding of the disease.

Key words: Endometriosis, Ovarian neoplasms, Risk factors, Pathogenesis, Clinical features, Diagnosis

门文婷，韩春颖，刘珊珊，王渠源. 子宫内膜异位症与卵巢癌关系的研究进展[J]. 国际妇产科学杂志, 2019, 46(2): 138-141.

MEN Wen-ting，HAN Chun-ying，LIU Shan-shan，WANG Qu-yuan. Research Progress on the Relationship between Endometriosis and Ovarian Cancer[J]. Journal of International Obstetrics and Gynecology, 2019, 46(2): 138-141.

参考文献

1. N. Krawczyk, M. Banyspaluchowski, D. Schmidt, U. Ulrich, T. Fehm, Endometriosis-associated Malignancy. Geburtshilfe Und Frauenheilkunde 76, 176 (2016). 2. B. M. Reid, J. B. Permuth, T. A. Sellers, Epidemiology of ovarian cancer: a review. Cancer Biology & Medicine 14, 9-32 (2017). 3. J. A. Sampson, ENDOMETRIAL CARCINOMA OF THE OVARY, ARISING IN ENDOMETRIAL TISSUE IN THAT ORGAN. American Journal of Obstetrics & Gynecology 9, 111-114 (1925). 4. R. B. Scott, Malignant changes in endometriosis. Obstetrics & Gynecology 2, 283 (1953). 5. M. Matalliotakis et al., Association between ovarian cancer and advanced endometriosis. Oncol Lett 15, 7689-7692 (2018). 6. M. A. Wilbur, I. M. Shih, J. H. Segars, A. N. Fader, Cancer Implications for Patients with Endometriosis. Seminars in Reproductive Medicine 35, 110-116 (2017). 7. J. P. Stamp et al., BAF250a Expression in Atypical Endometriosis and Endometriosis-Associated Ovarian Cancer. International Journal of Gynecological Cancer 26, 825-832 (2016). 8. L. Saraswat et al., Impact of endometriosis on risk of further gynaecological surgery and cancer: a national cohort study. BJOG 125, 64-72 (2018). 9. A. J. Chiang et al., Risk factors in progression from endometriosis to ovarian cancer: a cohort study based on medical insurance data. J Gynecol Oncol 29, e28 (2018). 10. T. Huang et al., Depression and risk of epithelial ovarian cancer: Results from two large prospective cohort studies. Gynecologic Oncology 139, 481-486 (2015). 11. H. Kapoor, D. K. Agrawal, S. K. Mittal, Barrett's esophagus: recent insights into pathogenesis and cellular ontogeny. Translational Research 166, 28 (2015). 12. S. Muangtan, W. Suknikhom, P. Sananpanichkul, K. Bhamarapravatana, K. Suwannarurk, Epithelial Ovarian Cancer with Endometriosis is not Associated with Menopausal Status: a Co-Association Study at Prapokklao Hospital. Asian Pac J Cancer Prev 19, 1337-1341 (2018). 13. E. Haidarali et al., Evaluation of the Pathogenesis of Tumor Development from Endometriosis by Estrogen Receptor, P53 and Bcl-2 Immunohistochemical Staining. Asian Pacific Journal of Cancer Prevention Apjcp 17, 6147 (2016). 14. L. H. Thomsen et al., Risk factors of epithelial ovarian carcinomas among women with endometriosis: a systematic review. Acta Obstet Gynecol Scand 96, (2016). 15. F. Taniguchi, New knowledge and insights about the malignant transformation of endometriosis. Journal of Obstetrics & Gynaecology Research 43, 1093 (2017). 16. K. C. Wiegand et al., ARID1A mutations in endometriosis-associated ovarian carcinomas. New England Journal of Medicine 363, 1532-1543 (2010). 17. K. Levanon, C. Crum, R. Drapkin, New insights into the pathogenesis of serous ovarian cancer and its clinical impact. Journal of Clinical Oncology 26, 5284-5293 (2008). 18. G. Singer, R. J. Kurman, H. W. Chang, S. K. Cho, S. Iem, Diverse tumorigenic pathways in ovarian serous carcinoma. American Journal of Pathology 160, 1223-1228 (2002). 19. N. Sato et al., Loss of Heterozygosity on 10q23.3 and Mutation of the Tumor Suppressor Gene PTEN in Benign Endometrial Cyst of the Ovary: Possible Sequence Progression from Benign Endometrial Cyst to Endometrioid Carcinoma and Clear Cell Carcinoma of the Ovary. Cancer Research 60, 7052 (2000). 20. R. C. Wu, T. L. Wang, S. Iem, The emerging roles of ARID1A in tumor suppression. Cancer Biology & Therapy 15, 655-664 (2014). 21. L. Zhao et al., Roles of Deletion of Arid1a, a Tumor Suppressor, in Mouse Ovarian Tumorigenesis. Journal of the National Cancer Institute 106, 766-776 (2014). 22. M. S. Anglesio et al., Multifocal endometriotic lesions associated with cancer are clonal and carry a high mutation burden. Journal of Pathology 236, 201-209 (2015). 23. A. Dawson, M. L. Fernandez, M. Anglesio, P. J. Yong, M. S. Carey, Endometriosis and endometriosis-associated cancers: new insights into the molecular mechanisms of ovarian cancer development. Ecancermedicalscience 12, 803 (2018). 24. J. P. Stamp et al., BAF250a Expression in Atypical Endometriosis and Endometriosis-Associated Ovarian Cancer. Int J Gynecol Cancer 26, 825-832 (2016). 25. K. Nishikimi, T. Kiyokawa, S. Tate, M. Iwamoto, M. Shozu, ARID1A Expression in Ovarian Clear Cell Carcinoma with an Adenofibromatous Component. Histopathology 67, 866-871 (2016). 26. G. M. Borrelli et al., (Partial) Loss of BAF250a (ARID1A) in rectovaginal deep-infiltrating endometriosis, endometriomas and involved pelvic sentinel lymph nodes. Molecular Human Reproduction 22, (2016). 27. S. Burghaus et al., Genetic risk factors for ovarian cancer and their role for endometriosis risk. Gynecologic Oncology 145, 142-147 (2017). 28. A. W. Lee et al., Evidence of a genetic link between endometriosis and ovarian cancer. Fertil Steril 105, 35-43 e31-10 (2016). 29. S. Suryawanshi et al., Complement Pathway is Frequently Altered in Endometriosis and Endometriosis-Associated Ovarian Cancer. Clinical Cancer Research An Official Journal of the American Association for Cancer Research 20, 6163-6174 (2014). 30. A. W. Lee et al., Evidence of a genetic link between endometriosis and ovarian cancer. Fertility & Sterility 105, 35-43 (2016). 31. Y. Lu et al., Shared genetics underlying epidemiological association between endometriosis and ovarian cancer. Human Molecular Genetics 24, 5955 (2015). 32. C. Tomasetti, B. Vogelstein, Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science 347, 78 (2015). 33. O. L. Braicu et al., miRNA expression profiling in formalin-fixed paraffin-embedded endometriosis and ovarian cancer samples. Oncotargets & Therapy 10, 4225-4238 (2017). 34. L. N. Heidemann, D. Hartwell, C. H. Heidemann, K. M. Jochumsen, The relation between endometriosis and ovarian cancer - a review. Acta Obstetricia Et Gynecologica Scandinavica 93, 20 (2014). 35. E. S. Paik et al., Clinical outcomes of patients with clear cell and endometrioid ovarian cancer arising from endometriosis. J Gynecol Oncol 29, e18 (2018). 36. H. S. Kim et al., Effect of Endometriosis on the Prognosis of Ovarian Clear Cell Carcinoma: A Two-Center Cohort Study and Meta-analysis. Annals of Surgical Oncology 22, 1-8 (2015). 37. D. Bassiouny et al., Endometriosis-associated Ovarian Cancer is a Subset With a More Favorable Outcome and Distinct Clinical-pathologic Characteristics. Int J Gynecol Pathol, (2018). 38. A. Barreta et al., Endometriosis-Associated Ovarian Cancer: Population Characteristics and Prognosis. Int J Gynecol Cancer 28, 1251-1257 (2018). 39. X. R. Xu, X. Wang, H. Zhang, M. Y. Liu, Q. Chen, The clinical significance of the combined detection of serum Smac, HE4 and CA125 in endometriosis-associated ovarian cancer. Cancer Biomark 21, 471-477 (2018). 40. M. A. Fraser, S. Agarwal, I. Chen, S. S. Singh, Routine vs. expert-guided transvaginal ultrasound in the diagnosis of endometriosis: A retrospective review. Abdominal Imaging 40, 587-594 (2015). 41. Y. Tanase, R. Kawaguchi, J. Takahama, H. Kobayashi, Factors that Differentiate between Endometriosis-associated Ovarian Cancer and Benign Ovarian Endometriosis with Mural Nodules. Magn Reson Med Sci 17, 231-237 (2018). 42. H. Yang et al., A mass spectrometric insight into the origins of benign gynecological disorders. Mass Spectrometry Reviews 36, 450 (2015). 43. S. Perakis, M. R. Speicher, Emerging concepts in liquid biopsies. Bmc Medicine 15, 75 (2017). 44. A. M. Di, J. Bartlett, Y. Cheng, M. D. Pasic, G. M. Yousef, Liquid biopsy: a step forward towards precision medicine in urologic malignancies. Molecular Cancer 16, 80 (2017). 45. M. Offin et al., Capturing Genomic Evolution of Lung Cancers through Liquid Biopsy for Circulating Tumor DNA. Journal of Oncology,2017,(2017-3-14) 2017, 1-5 (2017). 46. G. Kezia, G. Jane, P. Kirstin, R. Gillian, Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type. International Journal of Cancer 138, 1076-1084 (2016). 47. G. Chene et al., [Current surgical practice of prophylactic and opportunistic salpingectomy in France]. Gynecol Obstet Fertil, 377-384 (2016). 48. G. Chene et al., [Is endometriosis a precancerous lesion? Perspectives and clinical implications]. Gynecologie Obstetrique & Fertilite, (2016). 49. J. S. Kwon, Ovarian cancer risk reduction through opportunistic salpingectomy. Journal of Gynecologic Oncology 26, 83 (2015). 50. R. Tai, S. Choi, P. C. Coyte, The Cost-Effectiveness of Salpingectomies for Family Planning in the Prevention of Ovarian Cancer. Journal of obstetrics and gynaecology Canada: JOGC = Journal d'obstetrique et gynecologie du Canada: JOGC 40, (2017). 51. S. E. Dilley et al., Cost-effectiveness of opportunistic salpingectomy for ovarian cancer prevention. Gynecologic Oncology 146, 373 (2017). 52. J. S. Kwon et al., Costs and benefits of opportunistic salpingectomy as an ovarian cancer prevention strategy. Obstetrics & Gynecology 125, 338-345 (2015). 53. R. Manchanda, R. Legood, A. C. Antoniou, V. S. Gordeev, U. Menon, Specifying the ovarian cancer risk threshold of 'premenopausal risk-reducing salpingo-oophorectomy' for ovarian cancer prevention: a cost-effectiveness analysis. Journal of Medical Genetics 53, jmedgenet-2016-103800 (2016). 54. W. H. Parker et al., Long-term mortality associated with oophorectomy compared with ovarian conservation in the nurses' health study. Obstetrics & Gynecology 121, 709-716 (2013).

[1]	郭竞, 张茂祥, 周春鹤, 刘思宁, 李惠艳. 孟德尔随机化在暴露因素与宫颈癌因果关系中的研究进展[J]. 国际妇产科学杂志, 2025, 52(2): 169-174.
[2]	陈淑婉, 邓高丕, 袁烁. 子宫伴奇异形核平滑肌瘤一例[J]. 国际妇产科学杂志, 2025, 52(2): 187-190.
[3]	曹秀蓉, 周文柏, 范香, 王逸斐, 朱鹏峰. 单细胞RNA测序解析子宫内膜异位症血管生成机制[J]. 国际妇产科学杂志, 2025, 52(2): 199-205.
[4]	殷婷, 丛慧芳. 子宫内膜异位症与痛觉敏化的免疫学研究进展[J]. 国际妇产科学杂志, 2025, 52(2): 206-210.
[5]	江爱美, 张信美. 腹壁子宫内膜异位症的治疗进展[J]. 国际妇产科学杂志, 2025, 52(2): 211-216.
[6]	白耀俊, 王思瑶, 令菲菲, 张森淮, 李红丽, 刘畅. Trop-2及靶向Trop-2抗体偶联药物在妇科恶性肿瘤中的应用进展[J]. 国际妇产科学杂志, 2025, 52(1): 1-7.
[7]	侯春艳, 杜秀萍. 妊娠中晚期自发性子宫破裂二例[J]. 国际妇产科学杂志, 2025, 52(1): 110-113.
[8]	钟佩蕖, 招丽坚, 邹欣欣. 残角子宫妊娠行期待治疗至妊娠晚期一例[J]. 国际妇产科学杂志, 2025, 52(1): 114-116.
[9]	张云凤, 张宛玥, 卢悦, 王阳阳, 井佳雨, 牟婧祎, 王悦. ARID1A与PIK3CA突变在卵巢子宫内膜异位症恶变中的研究进展[J]. 国际妇产科学杂志, 2025, 52(1): 19-22.
[10]	李楠, 彭二玄, 刘风花. 卵巢上皮性癌脑转移20例临床分析[J]. 国际妇产科学杂志, 2025, 52(1): 23-27.
[11]	潘琪, 冯同富, 金晶, 吴莺, 杜欣. 腹腔镜切除成人腹膜后巨大成熟性畸胎瘤一例[J]. 国际妇产科学杂志, 2025, 52(1): 28-31.
[12]	贾炎峰, 吴珍珍, 王维红, 王玥元, 李娟. 原发性卵巢腺鳞癌一例[J]. 国际妇产科学杂志, 2025, 52(1): 32-36.
[13]	宋丽芳, 吴珍珍, 毛宝宏, 赵小丽, 刘青. 卵巢癌腹股沟淋巴结孤立转移一例[J]. 国际妇产科学杂志, 2025, 52(1): 37-41.
[14]	石百超, 王宇, 常惠, 卢凤娟, 关木馨, 余健楠, 吴效科. 中药及天然产物改善子宫内膜异位症的作用机制[J]. 国际妇产科学杂志, 2025, 52(1): 66-71.
[15]	张栋, 王筝, 李凯, 卞文丽, 高志华. 非妊娠期重度自发性卵巢过度刺激综合征一例[J]. 国际妇产科学杂志, 2025, 52(1): 79-83.