子宫内膜异位症相关恶变的研究近况

Research Status of Endometriosis-Related Malignancies

子宫内膜异位症是一类常见的妇科疾病,其发病率为6%～10%。虽然为良性疾病,但有恶变风险,卵巢子宫内膜异位囊肿恶变率约为1%。目前关于子宫内膜异位症相关恶变的病因及发病机制尚不清楚。许多研究提示了子宫内膜异位症与恶性肿瘤密切相关,并认为子宫内膜异位症是卵巢癌的高危因素。流行病学研究显示,初诊年龄大、囊肿直径大、不孕及肥胖等会增加其恶变风险,生育次数多、子宫内膜异位病灶清除术、患侧附件切除术以及长期服用避孕药等可降低此风险。基础研究显示,氧化应激与抗氧化防御、炎症反应、激素作用、环境因素及基因突变等因素与其恶变机制关系密切。此文主要对子宫内膜异位症相关恶变的发病风险、高危因素、保护因素和发病机制4方面的进展进行归纳与总结,有助于进一步了解该疾病。

Endometriosis is a common gynecological disease that troubles thousands of women,the incidence of which is 6%-10%.Though,it is a benign disease,the malignant incidence is about 1%.Recently,many researches have revealed endometriosis will increase the risk of ovarian cancer.What′s more,the age diagnosed with endometriosis,the large diameter of endometriosis cysts,infertility and obesity are high risk factors of the malignant transformation.On the contrary,more births,complete excision of endometriosis,unilateral oophorectomy and long-term use of contraceptive drugs will decrease the risk of ovarian carcinoma.There are a lot of theories about the pathogenesis of endometriosis related malignancies,such as oxidative stress and antioxidant defense,inflammatory reaction,hormonal effect,environmental factors and gene mutation,and so on.This article is about the onset risk,high risk factors,protective factors and the pathogenesis of endometriosis associated with malignancies so as to understand this disease more.