根據(jù)發(fā)表于Lancet Oncology上的一篇文章，有子宮內(nèi)膜異位癥病史的女性,，更有可能患3種特定類型的卵巢癌（透明細(xì)胞癌,，子宮內(nèi)膜癌及低度惡性漿液性卵巢癌）。
盡管有幾個(gè)小的研究表明,，子宮內(nèi)膜異位癥（一種常見(jiàn)的婦科疾病,，影響約10%的育齡婦女）與患上皮性卵巢癌（最致命及最普遍的形式）的風(fēng)險(xiǎn)相關(guān)，但該項(xiàng)研究明確地證實(shí)了這種風(fēng)險(xiǎn)的幅度與卵巢癌特定亞型的關(guān)系,。
"這一突破可能對(duì)患卵巢癌風(fēng)險(xiǎn)增加的婦女進(jìn)行更好的鑒定,，并能為有關(guān)人群癌癥增加的監(jiān)查提供基礎(chǔ)，從而提供更好的個(gè)性化預(yù)防及更好的早期檢測(cè)方法,，如減少風(fēng)險(xiǎn)的手術(shù)及篩查,，"南加州大學(xué)、研究的通訊作者Celeste Leigh Pearce解釋道,。
在這項(xiàng)研究中,，來(lái)自卵巢癌協(xié)會(huì)聯(lián)盟（OCAC）的一個(gè)小組對(duì)子宮內(nèi)膜異位癥的大小和5種主要的卵巢癌組織學(xué)亞型（高度惡性漿液性、低度惡性漿液性,、透明細(xì)胞癌,、子宮內(nèi)膜癌及粘液癌）。這項(xiàng)研究包括了13項(xiàng)病例對(duì)照研究,，其中包括來(lái)自超過(guò)23000名婦女的數(shù)據(jù)（13326例對(duì)照,，7911例侵襲性卵巢癌，1907例交界癌）,。
研究人員預(yù)計(jì),，子宮內(nèi)膜異位癥與3倍以上的卵巢透明細(xì)胞癌的患病風(fēng)險(xiǎn)及1倍的子宮內(nèi)膜癌患病風(fēng)險(xiǎn)相關(guān)。
重要的是,，這是首次注意到子宮內(nèi)膜異位癥和低度惡性漿液性卵巢癌相關(guān),，有子宮內(nèi)膜異位癥病史的女性其患低度惡性漿液性卵巢癌的風(fēng)險(xiǎn)增加了1倍。
未發(fā)現(xiàn)子宮內(nèi)膜異位癥與高度惡性漿液性,、粘液性,、漿液交界性、粘液交界性卵巢癌相關(guān),。
作者告誡稱,，盡管我們已經(jīng)報(bào)道了子宮內(nèi)膜異位癥與透明細(xì)胞癌、子宮內(nèi)膜癌,、低度惡性粘液性卵巢癌風(fēng)險(xiǎn)之間的強(qiáng)關(guān)聯(lián),，但大多數(shù)患子宮內(nèi)膜異位癥的婦女并不會(huì)患卵巢癌,。然而，醫(yī)療服務(wù)提供者應(yīng)警惕在有子宮內(nèi)膜異位癥病史婦女中患特定亞型卵巢癌風(fēng)險(xiǎn)的增加,。
在一篇評(píng)論中,，來(lái)自英國(guó)愛(ài)丁堡癌癥研究中心的Charlie Gourley指出，盡管結(jié)果顯示卵巢上皮癌的風(fēng)險(xiǎn)…其自身可能不足以證明對(duì)子宮內(nèi)膜異位癥患者有針對(duì)性的卵巢癌篩查,，事實(shí)上,，一些相關(guān)的組織學(xué)亞型（如透明細(xì)胞）主要是存在于早期階段（允許可能的根治性切除）這一點(diǎn)可能需要被考慮。（生物谷bioon.com）
doi:10.1016/S1470-2045(11)70404-1
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Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case-control studies
Celeste Leigh Pearce, Claire Templeman , Mary Anne Rossing , Alice Lee , Aimee M Near ,Penelope M Webb , Christina M Nagle, Jennifer A Doherty , Kara L Cushing-Haugen ,Kristine G Wicklund,Jenny Chang-Claude , Rebecca Hein , Galina Lurie ,Lynne R Wilkens , Michael E Carney , Marc T Goodman , Kirsten Moysich , Susanne K Kjaer ,Estrid Hogdall ,Allan Jensen ,Ellen L Goode , Brooke L Fridley ,Melissa C Larson ,Joellen M Schildkraut ,Rachel T Palmieri, Daniel W Cramer ,Kathryn L Terry, Allison F Vitonis ,Linda J Titus ,Argyrios Ziogas,Wendy Brewster , Hoda Anton-Culver, Alexandra Gentry-Maharaj,Susan J Ramus , A Rebecca Anderson ,Doerthe Brueggmann , Peter A Fasching,Simon A Gayther ,David G Huntsman,Usha Menon , Roberta B Ness , Malcolm C Pike , Harvey Risch , Anna H Wu , Andrew Berchuck , on behalf of the Ovarian Cancer Association Consortium
Summary Background：Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods：Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings：13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, p<0·0001), low-grade serous (31 [9·2%] of 336 cases, 2·11, 1·39-3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9%] of 1220 cases, 2·04, 1·67-2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0%] of 516 cases, 1·02, 0·69-1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1%] of 3659 cases, 1·13, 0·97-1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0%] of 1140 cases, 1·20, 0·95-1·52, p=0·12, and mucinous 65 [8·5%] of 767 cases, 1·12, 0·84-1·48, p=0·45). Interpretation：Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding：Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.
