Department of Anatomy, Faculty of Medicine and Surgery, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta.
Gynecol Endocrinol. 2012 Aug;28(8):577-81. doi: 10.3109/09513590.2011.650761. Epub 2012 Feb 6.
Endometriosis is the leading cause of morbidity among premenopausal women affecting about 1 in 10 females. The features shared by endometriosis and cancer include the ability to evade apoptosis, the stem cell-like ability and angiogenic potential. As such characteristics are encoded by the cell's genetic constitution, acquired mutations are responsible for the malignant transformation of endometriosis. Indeed, a number of tumour-suppressor genes and proto-oncogenes, such as protein 53 (P53) and B-cell lymphoma 2 (BCL-2) respectively, are mutated and as a result differentially expressed between endometriotic and malignant tissue associated with endometriosis. Moreover, cytokines and macrophages, both of which are inflammatory mediators have been implicated in the transformation process. The angiogenic properties possessed by cancer arising from endometriosis signifies a bad prognosis, while the stem cell-like activity possessed by both endometriosis and cancer has been attributed to the effect of oestrogen. A number of differences between endometriosis and cancer are found at the molecular level. Considering the link between these two pathologies, the three components which fuel the malignant transformation of endometriosis can be embodied in the endometriosis-induced carcinoma (EIC) triangle which shows the intricate relationship between endocrinologic, immunologic and genetic components.
子宫内膜异位症是导致绝经前女性发病和患病的主要原因，影响大约十分之一的女性。子宫内膜异位症和癌症的共同特征包括逃避细胞凋亡、具有干细胞样能力和血管生成潜能。由于这些特征是由细胞的遗传构成编码的，获得性突变负责子宫内膜异位症的恶性转化。事实上，许多肿瘤抑制基因和原癌基因，如蛋白 53（P53）和 B 细胞淋巴瘤 2（BCL-2），分别发生突变，因此在与子宫内膜异位症相关的子宫内膜异位症和恶性组织中表达不同。此外，细胞因子和巨噬细胞，这两种炎症介质都与转化过程有关。起源于子宫内膜异位症的癌症的血管生成特性预示着预后不良，而子宫内膜异位症和癌症所具有的干细胞样活性归因于雌激素的作用。在分子水平上发现了子宫内膜异位症和癌症之间的一些差异。考虑到这两种病理之间的联系，促进子宫内膜异位症恶性转化的三个因素可以体现在子宫内膜异位症诱导的癌（EIC）三角形中，该三角形显示了内分泌、免疫和遗传成分之间的复杂关系。
