Parklane Clinic, Johannesburg, South Africa.
University of the Witwatersrand, Johannesburg, South Africa.
Climacteric. 2021 Dec;24(6):587-592. doi: 10.1080/13697137.2021.1948994. Epub 2021 Jul 16.
Endometriosis will affect about 10% of the female population and not only can it significantly impact adversely on quality of life and result in infertility, but data are accumulating that malignant transformation is an important consideration. Endometriosis can be histologically typical or atypical, ovarian, superficial peritoneal or deep infiltrating. The precursor for malignant transformation appears to be the ovarian atypical endometriosis component. Ovarian cancer is the most important associated cancer, primarily endometrioid and clear cell cancer. These are the only subtypes wherein a direct clonal relationship between endometriosis, as a direct precursor, and cancer has been made. There is no substantive evidence to support an altered association of borderline cancers of the ovary, serous ovarian cancers and breast, endometrial or cervical cancers. This review provides an overview of the prevailing data pertaining to the molecular and genetic aberrations that accompany the transformation of atypical endometriosis to malignancy and the accumulated epidemiologic evidence which supports the association.
子宫内膜异位症将影响大约 10%的女性人群，不仅会对生活质量产生重大负面影响并导致不孕，而且越来越多的数据表明恶性转化是一个重要的考虑因素。子宫内膜异位症在组织学上可以是典型的或非典型的、卵巢的、表面腹膜的或深部浸润的。恶性转化的前体似乎是卵巢非典型子宫内膜异位症成分。卵巢癌是最重要的相关癌症，主要是子宫内膜样癌和透明细胞癌。这些是唯一的亚型，其中子宫内膜异位症作为直接前体与癌症之间存在直接的克隆关系。没有实质性证据支持卵巢交界性癌、浆液性卵巢癌以及乳腺癌、子宫内膜癌或宫颈癌的关联发生改变。这篇综述概述了伴随非典型子宫内膜异位症向恶性转化的分子和遗传异常的现有数据，以及支持这种关联的累积流行病学证据。
