Immunologic factors involved in the malignant transformation of endometriosis to endometriosis-associated ovarian carcinoma

Introduction Endometriosis is a risk factor for low-grade serous, clear cell, and endometroid ovarian carcinoma. In both endometriosis and ovarian carcinoma, immunological factors are associated with clinical outcome. Chronic inflammation in endometriosis may be linked to tumorigenesis, but exact processes contributing to endometriosis-associated ovarian carcinoma remain unknown. This review aims to describe potential immunological factors involved in the malignant transformation of endometriosis into ovarian carcinoma.

PubMed and Embase were searched from inception up to October 2020 for studies comparing immunological processes in endometriosis and endometriosis-associated ovarian carcinoma.

Detailed analysis of immune components in the malignant transformation of endometriosis into endometriosis-associated ovarian carcinoma is lacking. Altered levels of chemokines and cytokines as IL-6, IL-8, IL-10, and TNF-α are reported and the function, number and polarization of NK cells, dendritic cells, and monocytes differ between endometriosis and associated ovarian carcinoma compared to healthy tissue. In addition, altered inflammasome and complement systems, indicate a role for the immune system in the carcinogenesis of endometriosis.

Chronic inflammation in endometriosis may potentially drive inflammation-induced carcinogenesis in endometriosis-associated ovarian carcinoma. Exact immunological pathways and cellular processes remain unknown and require more thorough investigation. Similar content being viewed by others Data availability All articles used are published full text articles. Abbreviations - AE: - Atypical endometriosis - CCC: - Clear cell carcinoma - EAOC: - Endometriosis-associated ovarian carcinoma. - EC: - Endometrioid carcinoma - EOC: - Epithelial ovarian carcinoma - LGSC: - Low-grade serous carcinoma - OvCa: - Ovarian carcinoma

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SL and MH conducted the literature search and performed the selection of manuscripts. All authors contributed to the writing of the manuscript. Corresponding author Ethics declarations Conflict of interest All authors declare that they had no conflict of interest. Ethical approval This article does not contain any studies with human participants performed by any of the authors. Additional information Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. To our knowledge, this is the first review carried out that focusses solely on immunological factors involved in malignant transformation from endometriosis to associated ovarian carcinoma. Appendix Appendix Search specifics and exclusion protocol. Rights and permissions About this article Cite this article Leenen, S., Hermens, M., de Vos van Steenwijk, P.J. et al. Immunologic factors involved in the malignant transformation of endometriosis to endometriosis-associated ovarian carcinoma. Cancer Immunol Immunother 70, 1821–1829 (2021). https://doi.org/10.1007/s00262-020-02831-1 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s00262-020-02831-1