Department of Pathology, Division of Reproductive Biology Research, Northwestern University Feinberg School of Medicine, 251 E. Huron St., Chicago, IL, 60611, USA.
Int J Gynecol Pathol. 2011 Nov;30(6):553-68. doi: 10.1097/PGP.0b013e31821f4b85.
Endometriosis is a chronic disease that affects millions of reproductive-age women. Despite the destructive and invasive nature of endometrioses, most cases are perpetually benign or eventually regress; however, atypical endometriosis is a precursor lesion and can lead to certain types of ovarian cancer. Endometriosis induced inflammation and auto- and paracrine production of sex steroid hormones contribute to ovarian tumorigenesis. These changes provide microenvironment necessary to accumulate enough genetic alterations for endometriosis associated malignant transformation. It takes years for endometriosis to undergo the pathophysiological progression that begins with atypical epithelial proliferation (atypical endometriosis and metaplasia), and then is followed by the formation of well-defined borderline tumors, and finally culminates in fully malignant ovarian cancer. This study is a review of the natural history of endometriosis and the role of microenvironments that favor the accumulation of genetic alterations and endometriosis-associated ovarian cancer progression.
子宫内膜异位症是一种影响数百万育龄妇女的慢性疾病。尽管子宫内膜异位症具有破坏性和侵袭性，但大多数病例都是良性的或最终会消退；然而，非典型子宫内膜异位症是一种前驱病变，可导致某些类型的卵巢癌。子宫内膜异位症引起的炎症以及性激素的自分泌和旁分泌产生，有助于卵巢肿瘤的发生。这些变化为积累足够的遗传改变提供了微环境，从而导致与子宫内膜异位症相关的恶性转化。子宫内膜异位症要经历从非典型上皮增生（非典型子宫内膜异位症和化生）开始的病理生理进展，然后形成明确的交界性肿瘤，最后发展为完全恶性的卵巢癌，需要数年的时间。本研究综述了子宫内膜异位症的自然病史以及有利于遗传改变积累和子宫内膜异位症相关卵巢癌进展的微环境的作用。
