Unfolded protein response, a link between endometrioid ovarian carcinoma and endometriosis: A pilot study

Andrea Ciavattini, Giovanni Delli Carpini, Matteo Serri, Alessandra Tozzi, Francesca Leoni, Eugenia Di Loreto, Franca Saccucci
Oncology letters · 2018 · vol. 16(4) , pp. 5449–5454 · doi:10.3892/ol.2018.9256 · PMID:30250617 · PMC6144292 · W2887900721
article OA: diamond CC0 ⤵ 7 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This pilot study found that altered expression of UPR genes CHOP and XBP1 is involved in the neoplastic progression of endometrioid ovarian cancer, acquired following ovarian localization of ectopic endometrial cells.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

This retrospective pilot study profiled unfolded protein response (UPR) gene expression (ATF6, GRP78/GRP78, CHOP, and XBP1) in women with FIGO stage IA endometrioid ovarian carcinoma, comparing affected ovaries to healthy contralateral ovaries and evaluating endometriotic ovarian cysts versus eutopic endometrium. Using qPCR on ovarian and endometrial tissues from surgically treated participants, the authors found significantly higher ATF6 and GRP78 expression in affected ovaries, alongside significantly lower CHOP and XBP1, with XBP1 expression highest in endometrial tissues and progressively decreasing in endometriosis cysts and endometrioid ovarian carcinoma. The main limitation is that this is a pilot study with retrospective tissue comparisons and relatively narrow sampling across disease stages, so causality for neoplastic progression is not established. This paper is centrally about endometriosis—specifically, it evaluates UPR gene alterations as potential contributors to the neoplastic progression of endometriosis to endometrioid ovarian carcinoma.

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Abstract

The aim of the present study was to analyze the expression profile of unfolded protein response (UPR) genes in endometrioid ovarian carcinoma and to evaluate its possible involvement in the neoplastic progression of endometriosis. An experimental retrospective pilot study was conducted on women with a diagnosis of endometrioid ovarian carcinoma at FIGO stage IA, ovarian endometriotic cysts or healthy subjects without a previous diagnosis of endometriosis. The expression profiles of UPR genes (ATF6, GRP78, CHOP and XBP1) were compared among ovaries with endometrioid ovarian cancer, endometriotic ovarian cysts, healthy contralateral ovaries and eutopic and healthy endometrial tissues. A significantly higher expression of ATF6 and GRP78 was detected in the affected ovaries in comparison with the healthy contralateral ovaries, while CHOP and XBP1 exhibited a significantly lower expression. XBP1 was overexpressed in endometrial tissues and its expression gradually decreased in endometriosis cysts and endometrioid ovarian carcinoma. These results support the hypothesis that alterations in the UPR genes CHOP and XBP1 are involved in the neoplastic progression of endometrioid ovarian cancer and are acquired following ovarian localization of ectopic endometrial cells.

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endometriosis

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