子宫内膜症和卵巢恶性肿瘤的关系
2009-05-26 20:36:09 来源: 作者: 评论:0 点击:
The relationship of endometriosis and ovarian malignancy: a review
综述:子宫内膜症和卵巢恶性肿瘤的关系
Objective
目的:
To review the malignant potential of endometriosis based on epidemiologic, histopathologic, and molecular data.
基于流行病学、组织病理学、分子医学数据回顾子宫内膜异位症的恶变潜能
Design
设计:
Literature review.
文献综述
Result
结果:
The pathogenesis of endometriosis remains unclear. The histopathologic development of endometriosis has undergone long-term investigation. Studies have confirmed histologic transition from benign endometriosis to ovarian malignancy, including malignant transformation of extraovarian endometriosis. The prevalence of endometriosis in patients with epithelial ovarian cancer, especially in endometrioid and clear cell types, has been confirmed to be higher than in the general population. Ovarian cancers and adjacent endometriotic lesions have shown common genetic alterations, such as PTEN, p53, and bcl gene mutations, suggesting a possible malignant genetic transition spectrum. Furthermore, endometriosis has been associated with a chronic inflammatory state leading to cytokine release. These cytokines act in a complex system in which they induce or repress their own synthesis and can cause unregulated mitotic division, growth and differentiation, and migration or apoptosis similar to malignant mechanisms.
在子宫内膜异位症的发病机制尚不清楚。子宫内膜异位症的组织病理学发展经历了长期的调查。研究已证实了良性子宫内膜异位症向卵巢恶性肿瘤转变的组织学证据,包括了卵巢外子宫内膜异位症的恶性转变。上皮性卵巢癌,尤其是子宫内膜样癌和透明细胞癌伴有子宫内膜异位症的发病率已被证实高于普通人群。卵巢癌和子宫内膜异位症病灶附近表现出共同的遗传改变,如中PTEN,p53基因,和bcl基因突变,暗示有可能恶性的遗传过渡谱。此外,子宫内膜异位症与慢性炎症状态相关,导致细胞因子的释放。这些细胞因子的作用形成一个复杂的系统,诱导或抑制其自身的合成,可能造成无序有丝分裂,生长和分化,迁移或凋亡等,类似于恶性机制。
Conclusion
结论:
The malignant potential of endometriosis holds serious implications for management, such as the need for earlier and more meticulous surgical intervention for complete disease treatment.
子宫内膜异位症的恶化潜能强烈提示需要治疗,比如子宫内膜异位症需要更早以及更精确的手术干预以进行治疗。
Key Words: Endometriosis; atypical endometriosis; malignant transformation; endometrioid carcinoma; clear cell carcinoma
关键词:子宫内膜异位症,不典型子宫内膜异位症,恶性转化,子宫内膜样癌,透明细胞癌
一项基于流行病学、组织病理学、分子医学的数据来回顾子宫内膜异位症的恶变潜能。研究已证实了良性子宫内膜异位症向卵巢恶性肿瘤转变的组织学证据,包括了卵巢外子宫内膜异位症的恶性转变。上皮性卵巢癌,尤其是子宫内膜样癌和透明细胞癌伴有子宫内膜异位症的发病率已被证实高于普通人群。卵巢癌和子宫内膜异位症病灶附近表现出共同的遗传改变,如中PTEN,p53基因,和bcl基因突变,暗示有可能恶性的遗传过渡谱。此外,子宫内膜异位症与慢性炎症状态相关,导致细胞因子的释放。这些细胞因子的作用形成一个复杂的系统,诱导或抑制其自身的合成,可能造成无序有丝分裂,生长和分化,迁移或凋亡等,类似于恶性机制。所以,子宫内膜异位症需要更早以及更精确的手术干预以进行治疗。
综述:子宫内膜症和卵巢恶性肿瘤的关系
Objective
目的:
To review the malignant potential of endometriosis based on epidemiologic, histopathologic, and molecular data.
基于流行病学、组织病理学、分子医学数据回顾子宫内膜异位症的恶变潜能
Design
设计:
Literature review.
文献综述
Result
结果:
The pathogenesis of endometriosis remains unclear. The histopathologic development of endometriosis has undergone long-term investigation. Studies have confirmed histologic transition from benign endometriosis to ovarian malignancy, including malignant transformation of extraovarian endometriosis. The prevalence of endometriosis in patients with epithelial ovarian cancer, especially in endometrioid and clear cell types, has been confirmed to be higher than in the general population. Ovarian cancers and adjacent endometriotic lesions have shown common genetic alterations, such as PTEN, p53, and bcl gene mutations, suggesting a possible malignant genetic transition spectrum. Furthermore, endometriosis has been associated with a chronic inflammatory state leading to cytokine release. These cytokines act in a complex system in which they induce or repress their own synthesis and can cause unregulated mitotic division, growth and differentiation, and migration or apoptosis similar to malignant mechanisms.
在子宫内膜异位症的发病机制尚不清楚。子宫内膜异位症的组织病理学发展经历了长期的调查。研究已证实了良性子宫内膜异位症向卵巢恶性肿瘤转变的组织学证据,包括了卵巢外子宫内膜异位症的恶性转变。上皮性卵巢癌,尤其是子宫内膜样癌和透明细胞癌伴有子宫内膜异位症的发病率已被证实高于普通人群。卵巢癌和子宫内膜异位症病灶附近表现出共同的遗传改变,如中PTEN,p53基因,和bcl基因突变,暗示有可能恶性的遗传过渡谱。此外,子宫内膜异位症与慢性炎症状态相关,导致细胞因子的释放。这些细胞因子的作用形成一个复杂的系统,诱导或抑制其自身的合成,可能造成无序有丝分裂,生长和分化,迁移或凋亡等,类似于恶性机制。
Conclusion
结论:
The malignant potential of endometriosis holds serious implications for management, such as the need for earlier and more meticulous surgical intervention for complete disease treatment.
子宫内膜异位症的恶化潜能强烈提示需要治疗,比如子宫内膜异位症需要更早以及更精确的手术干预以进行治疗。
Key Words: Endometriosis; atypical endometriosis; malignant transformation; endometrioid carcinoma; clear cell carcinoma
关键词:子宫内膜异位症,不典型子宫内膜异位症,恶性转化,子宫内膜样癌,透明细胞癌
一项基于流行病学、组织病理学、分子医学的数据来回顾子宫内膜异位症的恶变潜能。研究已证实了良性子宫内膜异位症向卵巢恶性肿瘤转变的组织学证据,包括了卵巢外子宫内膜异位症的恶性转变。上皮性卵巢癌,尤其是子宫内膜样癌和透明细胞癌伴有子宫内膜异位症的发病率已被证实高于普通人群。卵巢癌和子宫内膜异位症病灶附近表现出共同的遗传改变,如中PTEN,p53基因,和bcl基因突变,暗示有可能恶性的遗传过渡谱。此外,子宫内膜异位症与慢性炎症状态相关,导致细胞因子的释放。这些细胞因子的作用形成一个复杂的系统,诱导或抑制其自身的合成,可能造成无序有丝分裂,生长和分化,迁移或凋亡等,类似于恶性机制。所以,子宫内膜异位症需要更早以及更精确的手术干预以进行治疗。
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