The dichotomy in the histogenesis of endometriosis-associated ovarian cancer: clear cell-type versus endometrioid-type adenocarcinoma.
The histogenesis of endometriosis and endometriosis-associated ovarian cancer is one of the most mysterious aspects of pathology. To better understand the histogenesis of endometriosis and endometriosis-associated ovarian cancer, we analyzed the possibility of a link of endometrium, ovarian surface epithelium, and a cortical inclusion cyst to ovarian endometriosis and endometriosis-associated ovarian cancer by immunohistochemistry using the epithelial membrane antigen (an epithelial marker), calretinin (a mesothelial marker), and hepatocyte nuclear factor (HNF)-1β (a clear cell carcinoma-specific transcription factor). During ovarian surface epithelium invagination, cortical inclusion cyst epithelial cells may, in some cases, undergo mesothelial-epithelial transition and subsequently differentiate into endometriosis. This case of endometriosis that has undergone Müllerian metaplasia arises from the HNF-1β-negative cells. The remaining endometriosis may develop from the late secretory and menstrual endometria, with HNF-1β-positive staining, by retrograde menstruation. Endometrioid adenocarcinoma and clear cell carcinoma arise from the HNF-1β-negative and HNF-1β-positive epithelial cells of endometriosis, respectively. It has been proposed that clear cell and endometrioid-type adenocarcinomas arise from distinct types of endometriosis with different cells of origin.
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Kashihara, Japan.
Hirotaka
H
Kajihara
Yoshihiko
Y
Yamada
Hiroshi
H
Shigetomi
Yumi
Y
Higashiura
Hiroshi
H
Kobayashi
D005260:Female; D006801:Humans; D018262:Adenocarcinoma, Clear Cell / Q000378:metabolism / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis; D064032:Calbindin 2; D018269:Carcinoma, Endometrioid / Q000378:metabolism / Q000473:pathology; D004715:Endometriosis / Q000378:metabolism / Q000473:pathology; D051539:Hepatocyte Nuclear Factor 1-beta / Q000378:metabolism; D007150:Immunohistochemistry; D008869:Microtubule-Associated Proteins / Q000378:metabolism; D010051:Ovarian Neoplasms / Q000378:metabolism / Q000473:pathology; D064030:S100 Calcium Binding Protein G / Q000378:metabolism
D014408:Biomarkers, Tumor; C576764:CALB2 protein, human; D064032:Calbindin 2; D051539:Hepatocyte Nuclear Factor 1-beta; D008869:Microtubule-Associated Proteins; D064030:S100 Calcium Binding Protein G; C000721969:MAP7 protein, human