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内异症相关卵巢癌的近期进展与治疗。

The recent progress and therapy in endometriosis-associated ovarian cancer.

机构信息

Department of Obstetrics and Gynecology, Tri-service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2020 Mar;83(3):227-232. doi: 10.1097/JCMA.0000000000000262.

Abstract

Endometriosis-associated ovarian cancers (EAOCs) including endometrioid and clear cell ovarian carcinoma are subgroups of epithelial ovarian carcinomas (EOCs), which is generally acknowledged as the most lethal gynecological malignancy. Endometriosis (ES), a common clinical disease among women, presents with clinical symptoms of pelvic pain, infertility, or adnexal masses with the formation of endometrioma. It has long been considered to be a potential risk factor for developing EOCs, mainly of endometrioid and clear cell subtypes. Here, we compiled data from previous researches on deregulated molecular functions among ES and EOCs using gene set-based integrative analysis to decipher molecular and genetic relationships between ovarian ES and EOCs, especially EAOCs. We conclude that epidermal growth factor receptor (ERBB) and Phosphoinositide 3-kinases (PI3K)-related pathways are important in the carcinogenesis of type I EOCs, including clear cell, endometrioid, and mucinous ovarian carcinoma. Dysfunctional molecular pathways, such as deregulated oxidoreductase activity, metabolism, hormone activity, inflammatory response, innate immune response, and cell-cell signaling, played key roles in the malignant transformation of EAOCs. Nine genes related to inflammasome complex and inflammasome-related pathway were identified, indicating the importance of inflammation/immunity in EAOC transformation. We also collect progressive treatments of EAOC focused on targeted therapies and immunotherapy so far. This summarized information can contribute toward effective detection and treatment of EAOCs in the future.

摘要

子宫内膜异位症相关卵巢癌(EAOC)包括子宫内膜样癌和透明细胞卵巢癌,是上皮性卵巢癌(EOC)的亚组,EOC 通常被认为是最致命的妇科恶性肿瘤。子宫内膜异位症(ES)是一种常见的妇科疾病,其临床表现为盆腔疼痛、不孕或附件包块形成子宫内膜异位囊肿。长期以来,它一直被认为是发展为 EOC 的潜在危险因素,主要是子宫内膜样癌和透明细胞癌。在这里,我们使用基于基因集的综合分析,对 ES 和 EOC 之间失调的分子功能进行了荟萃分析,以阐明卵巢 ES 和 EOC 之间的分子和遗传关系,特别是 EAOC。我们得出的结论是,表皮生长因子受体(ERBB)和磷脂酰肌醇 3-激酶(PI3K)相关途径在 I 型 EOC 的发生中起重要作用,包括透明细胞癌、子宫内膜样癌和黏液性卵巢癌。功能失调的分子途径,如氧化还原酶活性、代谢、激素活性、炎症反应、先天免疫反应和细胞间信号转导的失调,在 EAOC 的恶性转化中发挥了关键作用。鉴定出与炎症小体复合物和炎症小体相关途径相关的 9 个基因,表明炎症/免疫在 EAOC 转化中的重要性。我们还收集了迄今为止针对 EAOC 的靶向治疗和免疫治疗的进展性治疗方法。这些汇总信息有助于未来有效检测和治疗 EAOC。

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