Department of Surgery, Centre Jean Perrin, Clermont-Ferrand, France.
Eur J Cancer. 2009 Nov;45(17):2977-83. doi: 10.1016/j.ejca.2009.06.012. Epub 2009 Oct 12.
Ovarian epithelial dysplasia (OED) was first described after prophylactic oophorectomy for genetic risk of ovarian cancer. In light of Fathalla's incessant ovulation theory, this study was set up to describe the presence of ovarian abnormalities (dysplasia) after ovulation induction and to compare dysplasia profiles in stimulated and genetic risk ovaries.
One-hundred and twenty-four patients who had undergone salpingo-oophorectomies or ovarian cystectomies between 1990 and 2005 were reviewed. They were divided into three groups: (1) previous in vitro fertilisation (n=35); (2) prophylactic oophorectomies for genetic risk (n=27) and (3) fertile non-cancerous controls (n=62). Eleven cytological and architectural epithelial features were defined and a dysplasia score was calculated to quantify ovarian epithelial abnormalities.
Mean dysplasia score was significantly higher in the genetic risk and stimulated ovary groups than in controls (9.55 versus 3.62, p<0.0001; 7.51 versus 3.62, p<0.0002, respectively). Cytological and architectural abnormalities were more frequent in the genetic risk group, while the profile of abnormalities was different in the genetic risk and stimulated groups.
These findings support a possible relationship between OED and the use of ovulation-stimulating drugs. The increased dysplasia score in stimulated and genetic risk ovaries might be consistent with progression towards neoplastic transformation, and may justify the use of the term dysplasia or intraepithelial ovarian neoplasia. The observation of dysplasia in the stimulated group may differentiate women at risk. Conversely, the fact that the dysplasia profile after stimulation differs from that in genetic risk ovaries suggests that ovarian stimulation may predispose to a different evolution.
卵巢上皮异型增生（OED）最初是在因遗传性卵巢癌风险而预防性行卵巢切除术后描述的。鉴于法塔拉（Fathalla）不断排卵理论，本研究旨在描述排卵诱导后卵巢异常（异型增生）的存在，并比较刺激和遗传风险卵巢中的异型增生谱。
回顾了 1990 年至 2005 年间接受输卵管卵巢切除术或卵巢囊肿切除术的 124 例患者。他们被分为三组：（1）既往体外受精（n=35）；（2）遗传性卵巢癌风险预防性卵巢切除术（n=27）和（3）无癌症的生育对照（n=62）。定义了 11 种细胞学和结构上皮特征，并计算了异型增生评分以量化卵巢上皮异常。
遗传风险和刺激卵巢组的平均异型增生评分明显高于对照组（9.55 对 3.62，p<0.0001；7.51 对 3.62，p<0.0002）。遗传风险组的细胞学和结构异常更为频繁，而遗传风险和刺激组的异常谱不同。
这些发现支持 OED 与使用排卵刺激药物之间可能存在关联。刺激和遗传风险卵巢中增加的异型增生评分可能与向肿瘤转化的进展一致，并且可能证明使用异型增生或卵巢上皮内肿瘤这一术语是合理的。在刺激组中观察到的异型增生可能使风险女性具有差异性。相反，刺激后异型增生谱与遗传风险卵巢中的异型增生谱不同，表明卵巢刺激可能导致不同的演变。
