Konishi I
Department of Obstetrics and Gynecology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto 390-8621, Japan.
Int J Gynecol Cancer. 2006 Jan-Feb;16(1):16-22. doi: 10.1111/j.1525-1438.2006.00425.x.
The possible relationship between gonadotropins and ovarian carcinoma development has received much attention, and in recent years, great progress has been made in basic and epidemiologic research about this issue. Gonadotropins sensitivity in the ovarian surface epithelium (OSE) and in a subset of ovarian carcinomas has been established in vivo and in vitro. Gonadotropins have been shown to induce various biologic actions in the OSE and ovarian carcinoma cells, such as changes in cell proliferation, apoptosis, cell adhesion, and chemosensitivity. These basic studies strongly suggest that gonadotropins are involved in the development and progression of ovarian carcinoma. In contrast, although earlier studies showed a significant risk of infertility therapy for ovarian carcinoma development, subsequent studies reported only slightly increased or no significant increased risk of gonadotropin stimulation and/or assisted reproductive technologies for ovarian carcinoma development. Therefore, the association between ovarian stimulation and ovarian carcinoma remains controversial. Nevertheless, since development of ovarian carcinoma in infertile women during infertility treatment is a serious concern for gynecologists, this review also covers important points for clinical practice, especially the issue of early detection of ovarian carcinoma.
促性腺激素与卵巢癌发生之间的可能关系已备受关注，近年来，关于此问题的基础研究和流行病学研究均取得了重大进展。促性腺激素在卵巢表面上皮（OSE）及部分卵巢癌中的敏感性已在体内和体外得到证实。促性腺激素已被证明可在OSE和卵巢癌细胞中诱导多种生物学效应，如细胞增殖、凋亡、细胞黏附及化学敏感性的改变。这些基础研究有力地表明促性腺激素参与了卵巢癌的发生和发展。相比之下，尽管早期研究显示不孕治疗会显著增加卵巢癌发生风险，但后续研究报告称，促性腺激素刺激和/或辅助生殖技术导致卵巢癌发生的风险仅略有增加或无显著增加。因此，卵巢刺激与卵巢癌之间的关联仍存在争议。然而，由于不孕治疗期间不孕女性发生卵巢癌是妇科医生严重关切的问题，本综述还涵盖了临床实践要点，尤其是卵巢癌早期检测问题。
