根据发表于Lancet Oncology上的一篇文章，有子宫内膜异位症病史的女性，更有可能患3种特定类型的卵巢癌（透明细胞癌，子宫内膜癌及低度恶性浆液性卵巢癌）。
尽管有几个小的研究表明，子宫内膜异位症（一种常见的妇科疾病，影响约10%的育龄妇女）与患上皮性卵巢癌（最致命及最普遍的形式）的风险相关，但该项研究明确地证实了这种风险的幅度与卵巢癌特定亚型的关系。
"这一突破可能对患卵巢癌风险增加的妇女进行更好的鉴定，并能为有关人群癌症增加的监查提供基础，从而提供更好的个性化预防及更好的早期检测方法，如减少风险的手术及筛查，"南加州大学、研究的通讯作者Celeste Leigh Pearce解释道。
在这项研究中，来自卵巢癌协会联盟（OCAC）的一个小组对子宫内膜异位症的大小和5种主要的卵巢癌组织学亚型（高度恶性浆液性、低度恶性浆液性、透明细胞癌、子宫内膜癌及粘液癌）。这项研究包括了13项病例对照研究，其中包括来自超过23000名妇女的数据（13326例对照，7911例侵袭性卵巢癌，1907例交界癌）。
研究人员预计，子宫内膜异位症与3倍以上的卵巢透明细胞癌的患病风险及1倍的子宫内膜癌患病风险相关。
重要的是，这是首次注意到子宫内膜异位症和低度恶性浆液性卵巢癌相关，有子宫内膜异位症病史的女性其患低度恶性浆液性卵巢癌的风险增加了1倍。
未发现子宫内膜异位症与高度恶性浆液性、粘液性、浆液交界性、粘液交界性卵巢癌相关。
作者告诫称，尽管我们已经报道了子宫内膜异位症与透明细胞癌、子宫内膜癌、低度恶性粘液性卵巢癌风险之间的强关联，但大多数患子宫内膜异位症的妇女并不会患卵巢癌。然而，医疗服务提供者应警惕在有子宫内膜异位症病史妇女中患特定亚型卵巢癌风险的增加。
在一篇评论中，来自英国爱丁堡癌症研究中心的Charlie Gourley指出，尽管结果显示卵巢上皮癌的风险…其自身可能不足以证明对子宫内膜异位症患者有针对性的卵巢癌筛查，事实上，一些相关的组织学亚型（如透明细胞）主要是存在于早期阶段（允许可能的根治性切除）这一点可能需要被考虑。（生物谷bioon.com）
doi:10.1016/S1470-2045(11)70404-1
PMC:
PMID:
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.
