Division of Gynecologic Pathology, Departments of.
Annu Rev Pathol. 2014;9:27-45. doi: 10.1146/annurev-pathol-020712-163949. Epub 2013 Aug 5.
A new paradigm for the pathogenesis of female pelvic cancer helps explain persistent problems in describing the development and diverse morphology of these neoplasms. This paradigm incorporates recent advances in the molecular pathogenesis of epithelial ovarian cancer (EOC) with new insights into the origin of these tumors. Correlated clinicopathologic and molecular genetic studies gave rise to a dualistic model that divides the various histologic types of EOCs into two broad categories designated type I and type II. Because serous carcinomas are the most common EOC and account for the vast majority of deaths, they form the subject of this review. Recent studies indicate that the precursor of ovarian high-grade serous carcinoma appears to develop from an occult intraepithelial carcinoma in the fimbria of the fallopian tube and involves the ovary secondarily. Another possible mechanism is implantation of normal fimbrial epithelium on the denuded ovarian surface at the site of rupture when ovulation occurs, causing the development of cortical inclusion cysts. The dualistic model serves as a framework for the study of ovarian cancer and can help investigators organize this complex group of neoplasms. It also facilitates the development of novel approaches to prevention, screening, and treatment of this devastating disease.
一种新的女性盆腔癌发病机制模式有助于解释在描述这些肿瘤的发生和多种形态方面持续存在的问题。该模式将卵巢上皮性癌（EOC）的分子发病机制的最新进展与这些肿瘤起源的新见解结合在一起。相关的临床病理和分子遗传学研究提出了一种二元模型，将各种组织学类型的 EOC 分为两类，分别命名为 I 型和 II 型。由于浆液性癌是最常见的 EOC，也是绝大多数死亡的原因，因此成为本次综述的主题。最近的研究表明，卵巢高级别浆液性癌的前体似乎是从输卵管伞部隐匿性上皮内癌发展而来，其次累及卵巢。另一种可能的机制是排卵时破裂时，正常输卵管上皮在裸露的卵巢表面上的植入，导致皮质包涵囊肿的形成。二元模型是研究卵巢癌的框架，可以帮助研究人员对这组复杂的肿瘤进行分类。它还有助于开发预防、筛查和治疗这种毁灭性疾病的新方法。
