title: Risk of carcinoma in women with ovarian endometrioma.
abstract: Endometriosis affects an estimated 10% of women in the reproductive-age group. Here, we review current knowledge on molecular genesis of endometriosis-associated epithelial ovarian carcinoma (EOC). This article reviews the English language literature for biology, pathogenesis, and pathophysiological studies on endometriosis-associated EOC. Although endometriosis generally remains a benign condition, it demonstrates somatically acquired genetic alterations. Clear cell carcinoma (CCC) and endometrioid adenocarcinoma (EAC) are the most frequent types of EOC associated with endometriosis. Retrograde menstruation or ovarian hemorrhage carries highly pro-oxidant factors, such as iron, into the peritoneal cavity or ovarian endometrioma. CCC and EAC should be considered separately in studies of endometriosis-associated EOC. The repeated events of hemorrhage in endometriosis can contribute to carcinogenesis and progression via 3 major processes: 1) increasing oxidative stress promotes DNA methylation; 2) activating anti-apoptotic pathways supports tumor promotion; and 3) aberrant expression of stress signaling pathways contributes to tumor progression. This review summarizes recent advances in the understanding of epidemiology, carcinogenesis, pathogenesis, and pathophysiology of endometriosis-associated EOC; and a possible novel model is proposed.
authors.affiliation: Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan. hirokoba@naramed-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kajihara
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Yasuhito
authors.initials: Y
authors.lastname: Tanase
authors.forename: Seiji
authors.initials: S
authors.lastname: Kanayama
authors.forename: Naoto
authors.initials: N
authors.lastname: Furukawa
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Noguchi
authors.forename: Shoji
authors.initials: S
authors.lastname: Haruta
authors.forename: Shozo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Naruse
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sado
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Oi
mesh_terms: D002277:Carcinoma / Q000209:etiology / Q000235:genetics* / Q000503:physiopathology*; D019175:DNA Methylation / Q000502:physiology; D004715:Endometriosis / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D016162:Genes, Wilms Tumor; D011905:Genes, ras / Q000235:genetics; D006470:Hemorrhage / Q000209:etiology / Q000503:physiopathology; D051537:Hepatocyte Nuclear Factor 1 / Q000235:genetics; D006801:Humans; D019656:Loss of Heterozygosity; D018895:Microsatellite Repeats / Q000235:genetics; D008967:Molecular Biology; D010051:Ovarian Neoplasms / Q000209:etiology / Q000235:genetics* / Q000503:physiopathology*; D018384:Oxidative Stress / Q000502:physiology; D051059:PTEN Phosphohydrolase / Q000235:genetics; D011960:Receptors, Estrogen / Q000235:genetics; D012307:Risk Factors; D015398:Signal Transduction / Q000502:physiology; D013312:Stress, Physiological / Q000502:physiology
chemical_list: D011960:Receptors, Estrogen; D051537:Hepatocyte Nuclear Factor 1; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human