Centini Gabriele, Schettini Giorgia, Pieri Emilio, Giorgi Matteo, Lazzeri Lucia, Martire Francesco Giuseppe, Mancini Virginia, Raimondo Diego, Seracchioli Renato, Habib Nassir, Fedele Francesco, Zupi Errico
Department of Molecular and Developmental Medicine, Obstetrics and Gynecological Clinic, University of Siena, 53100 Siena, Italy.
Department of Surgical Sciences, Gynecological Unit, Valdarno Hospital, 52025 Montevarchi, Italy.
J Clin Med. 2024 Mar 27;13(7):1933. doi: 10.3390/jcm13071933.
Endometriosis affects more than 10% of reproductive-aged women, causing pelvic pain and infertility. Despite the benign nature of endometriosis, ovarian endometriomas carry a higher risk of developing endometrioid carcinomas (EnOCs) and clear cell ovarian carcinomas (CCCs). Atypical endometriosis, defined as cytological atypia resembling intraepithelial cancer, is considered the precursor of endometriosis-associated ovarian cancer (EAOC). This narrative review aims to provide an overview of EAOC, proposing a practical approach to clinical and therapeutic decision making.
An electronic literature search was conducted from inception up to January 2023, using the MEDLINE database via PubMed to evaluate the existing literature on EAOC, including its pathogenesis, the diagnostic process, and the therapeutic possibilities, with articles not relevant to the topic or lacking scientific merit being excluded.
Eighty-one articles were included in the review to present the current state of the art regarding EAOC. A pragmatic clinical flowchart is proposed to guide therapeutic decisions and improve patient outcomes.
Endometriosis patients may have an increased risk of developing EAOC (either EnOC or CCC). Despite not being fully accepted, the concept of AE may reshape the endometriosis-ovarian cancer relationship. Further research is needed to understand the unaddressed issues.
子宫内膜异位症影响超过10%的育龄妇女，导致盆腔疼痛和不孕。尽管子宫内膜异位症本质为良性，但卵巢子宫内膜异位囊肿发生子宫内膜样癌（EnOC）和卵巢透明细胞癌（CCC）的风险更高。非典型子宫内膜异位症定义为细胞学上类似于上皮内癌的异型性，被认为是子宫内膜异位症相关卵巢癌（EAOC）的前驱病变。本叙述性综述旨在概述EAOC，提出临床和治疗决策的实用方法。
从数据库建立至2023年1月进行电子文献检索，通过PubMed使用MEDLINE数据库评估关于EAOC的现有文献，包括其发病机制、诊断过程和治疗可能性，排除与主题无关或缺乏科学价值的文章。
81篇文章被纳入综述以呈现EAOC的当前研究现状。提出了一个实用的临床流程图以指导治疗决策并改善患者预后。
子宫内膜异位症患者发生EAOC（EnOC或CCC）的风险可能增加。尽管尚未被完全接受，但非典型子宫内膜异位症的概念可能重塑子宫内膜异位症与卵巢癌的关系。需要进一步研究以了解未解决的问题。
