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Chen B, Zhao L, Yang R, Xu T. New insights about endometriosis-associated ovarian cancer: pathogenesis, risk factors, prediction and diagnosis and treatment. Front Oncol 2024; 14:1329133. [PMID: 38384812 PMCID: PMC10879431 DOI: 10.3389/fonc.2024.1329133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
Previous studies have shown that the risk of malignant transformation of endometriosis in premenopausal women is approximately 1%, significantly impacting the overall well-being and quality of life of affected women. Presently, the diagnostic gold standard for endometriosis-associated ovarian cancer (EAOC) continues to be invasive laparoscopy followed by histological examination. However, the application of this technique is limited due to its high cost, highlighting the importance of identifying a non-invasive diagnostic approach. Therefore, there is a critical need to explore non-invasive diagnostic methods to improve diagnostic precision and optimize clinical outcomes for patients. This review presents a comprehensive survey of the current progress in comprehending the pathogenesis of malignant transformation in endometriosis. Furthermore, it examines the most recent research discoveries concerning the diagnosis of EAOC and emphasizes potential targets for therapeutic intervention. The ultimate objective is to improve prevention, early detection, precise diagnosis, and treatment approaches, thereby optimizing the clinical outcomes for patients.
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Affiliation(s)
| | | | | | - Tianmin Xu
- Department of Obstetrics and Gynecology, The Second Hospital of Jilin University, Changchun, China
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2
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Lainé A, Hanvic B, Ray-Coquard I. Importance of guidelines and networking for the management of rare gynecological cancers. Curr Opin Oncol 2021; 33:442-446. [PMID: 34172594 DOI: 10.1097/cco.0000000000000760] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW Guidelines are essential to support appropriate medical management. The objective of our paper is to highlight the need for such recommendations, to reinforce strategies in place and to promote the creation of multidisciplinary networks to provide the most appropriate care to patients and to improve it. RECENT FINDINGS Gynecological rare cancers are not that rare since they represent around 50% of all gynecological cancers. Surgery remains the cornerstone of management for all subtypes. Apart from malignant ovarian germ-cell tumors for which conventional chemotherapy was proven to be efficient, response to standard systemic treatment for other gynecological cancers are disappointing. Better understanding of these pathologies is needed and requires more adapted management. SUMMARY Rare cancers are substantially heterogeneous but raise the need of integrating new cases in dedicated networks to enhance and homogenize medical practices. Centralized diagnosis, improved medical practice based on regularly updated international guidelines, and inclusion in innovative clinical trials linked to preclinical studies are essential to contribute to the promotion of improvement in patient care.
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Affiliation(s)
| | - Brunhilde Hanvic
- Centre Léon Bérard, University Claude Bernard Lyon I, Lyon
- Institut de cancérologie de Lorraine, Nancy, France
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3
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Mikhaleva LM, Davydov AI, Patsap OI, Mikhaylenko EV, Nikolenko VN, Neganova ME, Klochkov SG, Somasundaram SG, Kirkland CE, Aliev G. Malignant Transformation and Associated Biomarkers of Ovarian Endometriosis: A Narrative Review. Adv Ther 2020; 37:2580-2603. [PMID: 32385745 PMCID: PMC7467438 DOI: 10.1007/s12325-020-01363-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Indexed: 02/07/2023]
Abstract
This review focuses on pathogenesis of endometriosis, its possible biomarkers and role in endometriosis-associated ovarian cancer. We analyzed various databases to obtain new insights, theories, and biomarkers associated with endometriosis. There are several theories of endometriosis development and biomarker changes including atypical forms. A number of studies have attempted to establish specific, reliable biomarkers to help diagnose endometriosis and endometriosis-associated diseases on the basis of different pathogenetic pathways. Nevertheless, despite intensive research extending even to the molecular level, the origin, natural history, malignant transformation, and laboratory management of endometriosis and related diseases are not yet clearly defined. Therefore, early laboratory diagnoses of endometriosis, its atypical form, and endometriosis-associated ovarian tumors are important problems that require further study in the context of advanced therapeutic strategies to provide maximal health benefits to patients.
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Affiliation(s)
- Liudmila M Mikhaleva
- Department of Clinical Pathology, Federal State Budgetary Institution "Research Institute of Human Morphology", 3, Tsyurupy Str, Moscow, 117418, Russian Federation
| | - Aleksandr I Davydov
- Department of Obstetrics, Gynecology and Perinatology, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), 8/2, Trubetskaya Str., Moscow, 119991, Russian Federation
- Department of Pathology, City Clinical Hospital After Named S.S. Udina, 4, Bld., 3, Kolomensky Passage, Moscow, 115446, Russian Federation
| | - Olga I Patsap
- Department of Pathology, City Clinical Hospital After Named S.S. Udina, 4, Bld., 3, Kolomensky Passage, Moscow, 115446, Russian Federation
| | - Elizaveta V Mikhaylenko
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str, Moscow, 119991, Russia
| | - Vladimir N Nikolenko
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str, Moscow, 119991, Russia
- Department of Normal and Topographic Anatomy, M.V. Lomonosov Moscow State University, Leninskie Gory, 1, Moscow, 119991, Russia
| | - Margarita E Neganova
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 1 Severny pr, Chernogolovka, Moscow Region, 142432, Russia
| | - Sergey G Klochkov
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 1 Severny pr, Chernogolovka, Moscow Region, 142432, Russia
| | | | - Cecil E Kirkland
- Department of Biological Sciences, Salem University, Salem, WV, 26426, USA
| | - Gjumrakch Aliev
- Department of Clinical Pathology, Federal State Budgetary Institution "Research Institute of Human Morphology", 3, Tsyurupy Str, Moscow, 117418, Russian Federation.
- I. M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), 8/2 Trubetskaya Str, Moscow, 119991, Russia.
- Institute of Physiologically Active Compounds, Russian Academy of Sciences, 1 Severny pr, Chernogolovka, Moscow Region, 142432, Russia.
- GALLY International Research Institute, 7733 Louis Pasteur Drive, #330, San Antonio, TX, 78229, USA.
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4
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Therapeutic preferability of gemcitabine for ARID1A-deficient ovarian clear cell carcinoma. Gynecol Oncol 2019; 155:489-498. [DOI: 10.1016/j.ygyno.2019.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/29/2019] [Accepted: 10/03/2019] [Indexed: 12/12/2022]
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5
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Yang Y, Wang X, Yang J, Duan J, Wu Z, Yang F, Zhang X, Xiao S. Loss of ARID1A promotes proliferation, migration and invasion via the Akt signaling pathway in NPC. Cancer Manag Res 2019; 11:4931-4946. [PMID: 31213911 PMCID: PMC6549766 DOI: 10.2147/cmar.s207329] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 05/10/2019] [Indexed: 12/12/2022] Open
Abstract
Background: AT-rich interactive domain-containing protein 1A (ARID1A) is a member of the switch/sucrose nonfermentable chromatin remodeling complex, which has been observed to be mutated in various tumors. The loss of ARID1A is reported to be frequently associated with PI3K/Akt pathway activation. Objective: The roles of ARID1A in nasopharyngeal carcinoma (NPC) have not been reported until now. The aim of this research was to explore the clinical significance and potential mechanism of ARID1A in NPC development and progression. Methods: ARID1A expression levels were investigated in human NPC tissues and cell lines. The effects of ARID1A knockdown on nasopharyngeal cancer cell proliferation, migration and invasion were evaluated in vitro using CCK8, wound healing, transwell and flow cytometry assays. The expression of relevant proteins was evaluated by Western blot assays. Results: In this study, ARID1A was significantly downregulated in NPC tissues and cells. Furthermore, low ARID1A expression was significantly associated with aggressive clinicopathological characteristics and poor survival in NPC patients. Depletion of endogenous ARID1A by siRNA promoted proliferation, migration and invasion in CNE1 and HNE1 cells. Additionally, ARID1A knockdown increased the phosphorylation of Akt in NPC cells. High levels of p-Akt were also observed in NPC biopsies and correlated with ARID1A downregulation. These results imply that the loss of ARID1A could activate Akt signaling. In addition, MK-2206 (a highly selective inhibitor of Akt) partially suppressed NPC cell proliferation, migration and invasion, which were induced by ARID1A knockdown. Conclusion: Our findings indicate that ARID1A plays an essential role in modulating the Akt pathway, functions as a tumor suppressor in NPC and may be a potential target for NPC treatment.
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Affiliation(s)
- Yang Yang
- Department of Pathology, the Second Affiliated Hospital, Guilin Medical University, Guilin 541199, People's Republic of China
| | - Xiaoyu Wang
- Department of Pathology, the Second Affiliated Hospital, Guilin Medical University, Guilin 541199, People's Republic of China
| | - Junjun Yang
- Department of Stomatology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430000, People's Republic of China
| | - Jingling Duan
- Department of Pathology, the Second Affiliated Hospital, Guilin Medical University, Guilin 541199, People's Republic of China
| | - Zhen Wu
- Xiangya Medical College of South Central University, Changsha 413000, People's Republic of China
| | - Fan Yang
- Department of Pathology, the Second Affiliated Hospital, Guilin Medical University, Guilin 541199, People's Republic of China
| | - Xiaoling Zhang
- Department of Physiology, Faculty of Basic Medical Science, Guilin Medical University, Guilin 541199, People's Republic of China
| | - Shengjun Xiao
- Department of Pathology, the Second Affiliated Hospital, Guilin Medical University, Guilin 541199, People's Republic of China
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6
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Kinali B, Senoglu M, Karadag FK, Karadag A, Middlebrooks EH, Oksuz P, Sandal E, Turk C, Diniz G. Hypoxia-Inducible Factor 1α and AT-Rich Interactive Domain-Containing Protein 1A Expression in Pituitary Adenomas: Association with Pathological, Clinical, and Radiological Features. World Neurosurg 2019; 121:e716-e722. [DOI: 10.1016/j.wneu.2018.09.196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 02/07/2023]
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7
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Zhu YP, Sheng LL, Wu J, Yang M, Cheng XF, Wu NN, Ye XB, Cai J, Wang L, Shen Q, Wu JQ. Loss of ARID1A expression is associated with poor prognosis in patients with gastric cancer. Hum Pathol 2018; 78:28-35. [PMID: 29689245 DOI: 10.1016/j.humpath.2018.04.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 12/12/2022]
Abstract
Deletion of the frequently mutated AT-rich interacting domain-containing protein 1A (ARID1A), an SWI/SNF subunit, is associated with poor prognosis in various tumors. This study observed and analyzed ARID1A expression and its correlation with prognosis in gastric carcinoma. Postoperative sections of 98 patients with primary gastric cancer and 40 patients with gastric benign lesions were examined by immunohistochemistry. ARID1A deficiency was observed in 19.39% of gastric cancer tissues, 4.08% of matched paracancerous tissues, and 2.5% of normal gastric mucosa tissues. ARID1A expression was significantly down-regulated in gastric cancer tissues compared with paracancerous tissues (P = .001) and normal gastric mucosa tissues (P = .011). ARID1A deletion significantly correlated with tumor size (P = .022), lymph node metastasis (P = .030), and tumor differentiation (P = .009). In the 90 gastric cancer tissues with tumor stages II and III, the clinical outcome of the ARID1A-negative patients was significantly poorer than that of the ARID1A-positive patients (P = .005). Univariate analysis revealed that tumor invasion depth (P = .025), stage (P = .032), poor differentiation (P = .046), lymph node metastasis (P = .038), and ARID1A expression (P = .023) were significantly related to the overall survival of gastric cancer patients. Multivariate analysis demonstrated that tumor invasion depth (P = .029) and ARID1A expression (P = .031) were independent factors that indicate poor prognosis. In conclusion, the loss of ARID1A expression in gastric cancer patients significantly correlated with poor survival.
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Affiliation(s)
- Yi Ping Zhu
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Li Li Sheng
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Jing Wu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou 215006,China
| | - Mo Yang
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Xian Feng Cheng
- Department of Clinical Laboratory, Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, Jiangsu 210000, China
| | - Ning Ni Wu
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Xiao Bing Ye
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Juan Cai
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Lu Wang
- Department of Oncology, Yijishan Hospital, Wannan Medical College, Wuhu, Anhui 241001, China
| | - Qian Shen
- Department of Oncology, Nantong Cancer Hospital, Nantong, Jiangsu 226000, China.
| | - Jian Qiu Wu
- Department of Oncology, Jiangsu Cancer Hospital, Nanjing, Jiangsu 210000, China.
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8
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Demographic, Clinical, and Prognostic Factors of Ovarian Clear Cell Adenocarcinomas According to Endometriosis Status. Int J Gynecol Cancer 2018; 27:1804-1812. [PMID: 28976447 DOI: 10.1097/igc.0000000000001102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Women with endometriosis carry an increased risk for ovarian clear cell adenocarcinomas (CCCs). Clear cell adenocarcinoma may develop from endometriosis lesions. Few studies have compared clinical and prognostic factors and overall survival in patients diagnosed as having CCC according to endometriosis status. METHODS Population-based prospectively collected data on CCC with coexisting pelvic (including ovarian; n = 80) and ovarian (n = 46) endometriosis or without endometriosis (n = 95) were obtained through the Danish Gynecological Cancer Database. χ Test, independent-samples t test, logistic regression, Kaplan-Meier test, and Cox regression were used. Statistical tests were 2 sided. P values less than 0.05 were considered statistically significant. RESULTS Patients with CCC and pelvic or ovarian endometriosis were significantly younger than CCC patients without endometriosis, and a higher proportion of them were nulliparous (28% and 31% vs 17% (P = 0.07 and P = 0.09). Accordingly, a significantly higher proportion of women without endometriosis had given birth to more than 1 child. Interestingly, a significantly higher proportion of patients with ovarian endometriosis had pure CCCs (97.8% vs 82.1%; P = 0.001) as compared with patients without endometriosis. Overall survival was poorer among CCC patients with concomitant ovarian endometriosis (hazard ratio, 2.56 [95% confidence interval, 1.29-5.02], in the multivariate analysis. CONCLUSIONS Age at CCC diagnosis and parity as well as histology differ between CCC patients with and without concomitant endometriosis. Furthermore, CCC patients with concomitant ovarian endometriosis have a poorer prognosis compared with endometriosis-negative CCC patients. These differences warrant further research to determine whether CCCs with and without concomitant endometriosis develop through distinct pathogenic pathways.
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9
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Nishikimi K, Nakagawa K, Tate S, Matsuoka A, Iwamoto M, Kiyokawa T, Shozu M. Uncommon Human Telomerase Reverse Transcriptase Promoter Mutations Are Associated With Poor Survival in Ovarian Clear Cell Carcinoma. Am J Clin Pathol 2018; 149:352-361. [PMID: 29474637 DOI: 10.1093/ajcp/aqx166] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES The present study assessed whether human telomerase reverse transcriptase (TERT) promoter mutations mediate the increased mortality risk observed in patients with ovarian clear cell carcinoma (CCC) and characterized the pathologic features of TERT promoter mutation-associated ovarian CCC. METHODS The TERT promoter region in genomic DNA extracted from paraffin-embedded ovarian CCC specimens (n = 93) was bidirectionally sequenced. RESULTS A total of 24 TERT promoter mutations were identified among the analyzed CCC cases, of which 11 were known "hotspot" mutations whose frequency was increased in CCC cases with compared to without coexistent adenofibroma (P < .05). In contrast, the 14 (including three novel) identified uncommon site mutations were shown to be associated with a poor progression-free survival rate (P < .01). CONCLUSIONS The identified uncommon TERT promoter mutations exacerbate the poor prognosis characteristic of ovarian CCC cases, and the hotspot mutations appear to be a molecular feature of the adenofibroma-associated form of the disease.
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MESH Headings
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Clear Cell/mortality
- Adenocarcinoma, Clear Cell/pathology
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Carcinoma, Ovarian Epithelial
- Female
- Humans
- Middle Aged
- Mutation
- Neoplasms, Glandular and Epithelial/genetics
- Neoplasms, Glandular and Epithelial/mortality
- Neoplasms, Glandular and Epithelial/pathology
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/mortality
- Ovarian Neoplasms/pathology
- Prognosis
- Promoter Regions, Genetic
- Retrospective Studies
- Survival Analysis
- Telomerase/genetics
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Affiliation(s)
- Kyoko Nishikimi
- Department of Gynecology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Kiyoshi Nakagawa
- Department of Gynecology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Shinichi Tate
- Department of Gynecology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Ayumu Matsuoka
- Department of Gynecology, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Masami Iwamoto
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Takako Kiyokawa
- Department of Pathology, Jikei University School of Medicine, Tokyo, Japan
| | - Makio Shozu
- Department of Gynecology, Chiba University Graduate School of Medicine, Chiba, Japan
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10
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Dawson A, Fernandez ML, Anglesio M, Yong PJ, Carey MS. Endometriosis and endometriosis-associated cancers: new insights into the molecular mechanisms of ovarian cancer development. Ecancermedicalscience 2018; 12:803. [PMID: 29456620 PMCID: PMC5813919 DOI: 10.3332/ecancer.2018.803] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is a fascinating disease that we strive to better understand. Molecular techniques are shedding new light on many important aspects of this disease: from pathogenesis to the recognition of distinct disease variants like deep infiltrating endometriosis. The observation that endometriosis is a cancer precursor has now been strengthened with the knowledge that mutations that are present in endometriosis-associated cancers can be found in adjacent endometriosis lesions. Recent genomic studies, placed in context, suggest that deep infiltrating endometriosis may represent a benign neoplasm that invades locally but rarely metastasises. Further research will help elucidate distinct aberrations which result in this phenotype. With respect to identifying those patients who may be at risk of developing endometriosis-associated cancers, a combination of molecular, pathological, and inheritance markers may define a high-risk group that might benefit from risk-reducing strategies.
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Affiliation(s)
- Amy Dawson
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada
| | - Marta Llauradó Fernandez
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada
| | - Michael Anglesio
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada.,Department of Pathology and Laboratory Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6T 2B5, Canada
| | - Paul J Yong
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada
| | - Mark S Carey
- Department of Obstetrics & Gynaecology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia V6Z 2K8, Canada.,Department of Surgical Oncology, BC Cancer Agency, Vancouver, British Columbia V5Z 1G1, Canada
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11
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Matias-Guiu X, Stewart CJR. Endometriosis-associated ovarian neoplasia. Pathology 2017; 50:190-204. [PMID: 29241974 DOI: 10.1016/j.pathol.2017.10.006] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/10/2017] [Accepted: 10/11/2017] [Indexed: 12/13/2022]
Abstract
This article reviews the most relevant pathological and molecular features of ovarian tumours that are associated with endometriosis. Endometriosis is a common condition, affecting 5-15% of all women, and it has been estimated that 0.5-1% of cases are complicated by neoplasia. The most common malignant tumours in this setting are endometrioid adenocarcinoma and clear cell adenocarcinoma, each accounting for approximately 10% of ovarian carcinomas in Western countries. A minority of cases are associated with Lynch syndrome. These carcinomas are often confined to the ovaries at presentation in which case they have relatively favourable outcomes. However, high-stage tumours, particularly clear cell carcinomas, generally have a poor prognosis and this partly reflects relative resistance to current treatment. Histological diagnosis is straightforward in the majority of cases but some variants, for example endometrioid carcinomas with sex cord-like appearances or oxyphil cells, may create diagnostic difficulty. Similarly, clear cell carcinomas can show a range of architectural and cytological patterns that overlap with other tumours, both primary and metastatic, involving the ovaries. Endometriosis-associated borderline tumours are less common, and they often show mixed patterns of differentiation (seromucinous tumours). Atypical endometriosis may represent an intermediate step in neoplastic progression and some of these lesions demonstrate immunohistological and molecular alterations similar to those observed in endometriosis-related tumours. ARID1A mutations are relatively common in all of these tumours, but each has additional characteristic molecular alterations which are likely to be of increasing clinical relevance as targeted therapies are developed. Less is known of the pathogenesis of rarer endometriosis-associated ovarian tumours including endometrioid stromal sarcoma, mesodermal (Müllerian) adenosarcoma, and carcinosarcoma. This article also briefly reviews the issue of synchronous endometrioid carcinomas of the endometrium and the ovary, including the most recent developments on pathogenesis.
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Affiliation(s)
- Xavier Matias-Guiu
- Department of Pathology, Hospital U Arnau de Vilanova and Hospital U de Bellvitge, IDIBELL, IRBLleida, University of Lleida, and CIBERONC, Spain
| | - Colin J R Stewart
- Department of Histopathology, King Edward Memorial Hospital, Perth, and School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia.
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Okawa R, Banno K, Iida M, Yanokura M, Takeda T, Iijima M, Kunitomi-Irie H, Nakamura K, Adachi M, Umene K, Nogami Y, Masuda K, Kobayashi Y, Tominaga E, Aoki D. Aberrant chromatin remodeling in gynecological cancer. Oncol Lett 2017; 14:5107-5113. [PMID: 29113150 DOI: 10.3892/ol.2017.6891] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 05/11/2017] [Indexed: 12/16/2022] Open
Abstract
Epigenetic regulatory mechanisms are a current focus in studies investigating cancer. Chromatin remodeling alters chromatin structure and regulates gene expression, and aberrant chromatin remodeling is involved in carcinogenesis. AT-rich interactive domain-containing protein 1A (ARID1A) and SWItch/sucrose non-fermentable-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4 are remodeling factors that are mutated in numerous types of cancer. In gynecological cancer, ARID1A mutations have been identified in 46-57% of clear cell carcinoma and 30% of endometrioid carcinoma. Mutations of chromodomain helicase, DNA-binding protein 4 have been detected in 17-21% of endometrial serous cancer, and mutations of ARID1A and mixed-lineage leukemia 3 occur in 36 and 27% of uterine carcinosarcoma, respectively. These data suggest that aberrant chromatin remodeling is a potential cause of cancer, and have led to the development of novel proteins targeting these processes. Additional accumulation of information on the mechanisms of chromatin remodeling and markers for these events may promote personalized anticancer therapies.
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Affiliation(s)
- Ryuichiro Okawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Miho Iida
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Megumi Yanokura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Takashi Takeda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Moito Iijima
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Haruko Kunitomi-Irie
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kanako Nakamura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Masataka Adachi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kiyoko Umene
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yuya Nogami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Kenta Masuda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Eiichiro Tominaga
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo 160-8582, Japan
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13
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Kawabata A, Yanaihara N, Nagata C, Saito M, Noguchi D, Takenaka M, Iida Y, Takano H, Yamada K, Iwamoto M, Kiyokawa T, Okamoto A. Prognostic impact of interleukin-6 expression in stage I ovarian clear cell carcinoma. Gynecol Oncol 2017; 146:609-614. [PMID: 28673661 DOI: 10.1016/j.ygyno.2017.06.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 06/12/2017] [Accepted: 06/20/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Ovarian clear cell carcinoma (OCCC) frequently presents at an early stage. In stage I OCCC, the prognosis differs according to substage. In particular, predictive biomarkers and new treatment strategies are needed for stage IC2/IC3 disease. We investigated tumor biology and prognostic factors for stage I OCCC from a clinicopathological perspective, including the expression of ARID1A and IL-6, which are considered critical for OCCC carcinogenesis. METHODS A retrospective cohort study of 192 patients with stage I OCCC treated at a single institution was performed. We calculated overall survival (OS) with respect to 12 clinicopathological parameters that included the unique and diverse histological features of OCCC. RESULTS The estimated 5-year OS rate in patients with all stage I OCCC was 88.9% during a median of 91months of follow-up. The multivariate analysis indicated that substage classification and IL-6 expression status were associated with poor OS (p=0.010 and p=0.027, respectively). Loss of ARID1A expression had no impact on survival; however, it was associated with substage (p=0.001), capsule rupture status (p=0.011), and ascites cytology (p=0.016). No clear association was found between ARID1A and IL-6 expressions. Histological findings, including the presence of endometriosis, adenofibroma, architectural pattern, and tumor cell type, showed no prognostic effects. CONCLUSIONS Both substage classification and IL-6 expression status may be independent prognostic factors in stage I OCCC. Therefore, IL-6 molecular stratification may be crucial in optimizing therapeutic strategies for early stage OCCC to improve survival.
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Affiliation(s)
- Ayako Kawabata
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Nozomu Yanaihara
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan.
| | - Chie Nagata
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan; Department of Education for Clinical Research, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
| | - Misato Saito
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Daito Noguchi
- Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-0004, Japan
| | - Masataka Takenaka
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Yasushi Iida
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Hirokuni Takano
- Department of Obstetrics and Gynecology, The Jikei University Kashiwa Hospital, 163-1 Kashiwashita, Kashiwa-shi, Chiba 277-0004, Japan
| | - Kyosuke Yamada
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Masami Iwamoto
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Takako Kiyokawa
- Department of Pathology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
| | - Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan
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14
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Liu G, Xu P, Fu Z, Hua X, Liu X, Li W, Zhang M, Wu J, Wen J, Xu J, Jia X. Prognostic and Clinicopathological Significance of ARID1A in Endometrium-Related Gynecological Cancers: A Meta-Analysis. J Cell Biochem 2017; 118:4517-4525. [PMID: 28466574 DOI: 10.1002/jcb.26109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 05/01/2017] [Indexed: 12/31/2022]
Abstract
The tumor suppressor gene, AT Rich Interactive Domain 1A (ARID1A) mutation has been reported in a variety of cancers, especially the endometrium-related gynecological cancers, including the ovarian clear cell carcinoma, ovarian endometrioid carcinoma, and uterine endometrioid carcinoma. However, the prognostic value of ARID1A in endometrium-related gynecological cancers is still inconclusive. Therefore, we performed this meta-analysis to evaluate the clinical significance of ARID1A in endometrium-related gynecological cancers. By systematically searching all the relevant studies from Pubmed, Cochrane Library, and Web of Science up to September 2016, 11 studies with 1,432 patients were included. All the study characteristics and the prognostic data were extracted. Hazard ratios (HRs) and 95% confidence intervals (CIs) were pooled using the fixed-effect or random-effect model. Our results indicated that negative ARID1A expression predicted shorter Progression free survival (PFS, HR, 1.84; 95%CI, 1.32-2.57, P = 0.000) of patients with endometrium related gynecological cancers, especially the patiently with OCCC and the patients in Japan. Besides, a marginal trend towards the same direction was found in the Overall analysis (OS, HR, 1.34; 95%CI, 0.93-1.93, P = 0.112). Furthermore, the significant correlation was achieved between the negative ARID1A expression and the FIGO stage of endometrium-related gynecological cancers, but not the other characteristics. J. Cell. Biochem. 118: 4517-4525, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Guangquan Liu
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Pengfei Xu
- Nanjing Maternity and Child Health Medical Institute, Nanjing Maternity and Child, Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, 210004, China
| | - Ziyi Fu
- Nanjing Maternity and Child Health Medical Institute, Nanjing Maternity and Child, Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, 210004, China
| | - Xiangdong Hua
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Xiaoguang Liu
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Wenqu Li
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Mi Zhang
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Jiacong Wu
- Nantong Maternity and Child Health Care Hospital, Nantong, 226081, China
| | - Juan Wen
- Nanjing Maternity and Child Health Medical Institute, Nanjing Maternity and Child, Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, 210004, China
| | - Juan Xu
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
| | - Xuemei Jia
- Department of Obstetrics Gynecology, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical, University, Nanjing, 210004, China
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15
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Chiannilkulchai N, Pautier P, Genestie C, Bats A, Vacher-Lavenu M, Devouassoux-Shisheboran M, Treilleux I, Floquet A, Croce S, Ferron G, Mery E, Pomel C, Penault-Llorca F, Lefeuvre-Plesse C, Henno S, Leblanc E, Lemaire A, Averous G, Kurtz J, Ray-Coquard I. Networking for ovarian rare tumors: a significant breakthrough improving disease management. Ann Oncol 2017; 28:1274-1279. [DOI: 10.1093/annonc/mdx099] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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16
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Corrigendum. Histopathology 2016; 68:621. [DOI: 10.1111/his.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Cho I, Lim SC. Clear Cell Adenocarcinoma Arising from Adenofibroma in a Patient with Endometriosis of the Ovary. J Pathol Transl Med 2016; 50:155-9. [PMID: 26498012 PMCID: PMC4804142 DOI: 10.4132/jptm.2015.08.07] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/23/2015] [Accepted: 08/07/2015] [Indexed: 02/07/2023] Open
Abstract
Ovarian clear cell adenocarcinomas (CCACs) are frequently associated with endometriosis and, less often with clear cell adenofibromas (CCAFs). We encountered a case of ovarian CCAC arising from benign and borderline adenofibromas of the clear cell and endometrioid types with endometriosis in a 53-year-old woman. Regions of the adenofibromas showed transformation to CCAC and regions of the endometriosis showed atypical endometriotic cysts. This case demonstrates that CCAC can arise from CCAF or endometriosis.
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Affiliation(s)
| | - Sung-Chul Lim
- Corresponding Author: Sung-Chul Lim, MD, PhD Department of Pathology, Chosun University Hospital, 365 Pilmun-daero, Dong-gu, Gwangju 61453, Korea Tel: +82-62-230-6343 Fax: +82-62-226-5860 E-mail:
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18
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Chene G, Caloone J, Moret S, Le Bail-Carval K, Chabert P, Beaufils E, Mellier G, Lamblin G. [Is endometriosis a precancerous lesion? Perspectives and clinical implications]. ACTA ACUST UNITED AC 2016; 44:106-12. [PMID: 26850282 DOI: 10.1016/j.gyobfe.2016.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 12/21/2015] [Indexed: 01/17/2023]
Abstract
Epidemiological studies have shown a relationship between endometriosis and clear cell/endometrioid ovarian cancers (named "Endometriosis Associated Ovarian Cancer" or EAOC). The recent discovery of signaling pathways (especially the SWI/SNF and PI3K/AKT/mTOR pathways) that linked endometriosis and EAOC could lead to the development of specific biomarkers as ARID1A to screen benign to premalignant endometriosis and to new targeted treatment. Moreover, the better understanding of the pathogenesis of the epithelial ovarian cancer arising from the Fallopian tube could allow new early prevention strategies that will be described in this review.
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Affiliation(s)
- G Chene
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France; Université Claude Bernard Lyon 1, EMR 3738, 69000 Lyon, France.
| | - J Caloone
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - S Moret
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - K Le Bail-Carval
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - P Chabert
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - E Beaufils
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - G Mellier
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
| | - G Lamblin
- Département de Gynécologie, Hôpital Femme Mère Enfants, HCL, CHU Lyon Est, 59, boulevard Pinel, 69677 Bron, France
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