Higashiura Yumi, Kajihara Hirotaka, Shigetomi Hiroshi, Kobayashi Hiroshi
Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
Oncol Lett. 2012 Jul;4(1):3-9. doi: 10.3892/ol.2012.690. Epub 2012 Apr 23.
The association between endometriosis and malignant transformation has often been described in the medical literature. A search was conducted between 1966 and 2010 through the English language literature (online Medline PubMed database) using the keywords endometriosis combined with malignant transformation. The search revealed an increase in reports describing endometriosis and malignancy. Approximately 1.0% of women with endometriosis have lesions that undergo malignant transformation. The malignant processes that are associated with endometriosis may be classified into three groups: i) epithelial ovarian cancers (endometrioid adenocarcinoma and clear cell carcinoma), ii) other Müllerian-type tumors, including Müllerian-type mucinous borderline tumor and serous borderline tumor and iii) sarcomas such as adenosarcoma and endometrial stromal sarcoma in the female pelvic cavity. Persistent oxidative stress induced by endometriosis-dependent hemorrhage may be associated with carcinogenesis. In conclusion, the malignant transformation of endometriosis has multiple pathways of development and may share a common pathogenic mechanism; iron-induced oxidative stress derived from repeated hemorrhage.
子宫内膜异位症与恶性转化之间的关联在医学文献中常有描述。于1966年至2010年间通过英文文献（在线医学文献数据库Medline PubMed），使用关键词“子宫内膜异位症”并结合“恶性转化”进行检索。检索发现描述子宫内膜异位症与恶性肿瘤的报告有所增加。约1.0%的子宫内膜异位症女性患者有发生恶性转化的病变。与子宫内膜异位症相关的恶性病变可分为三组：i）上皮性卵巢癌（子宫内膜样腺癌和透明细胞癌），ii）其他苗勒管型肿瘤，包括苗勒管型黏液性交界性肿瘤和浆液性交界性肿瘤，以及iii）女性盆腔中的肉瘤，如腺肉瘤和子宫内膜间质肉瘤。由子宫内膜异位症相关出血诱导的持续性氧化应激可能与致癌作用有关。总之，子宫内膜异位症的恶性转化有多种发展途径，可能共享一种常见的致病机制；即反复出血导致的铁诱导氧化应激。
