ASSOCİATİON BETWEEN ENDOMETRİOSİS AND OVARİAN CANCER

Endometriosis is a benign hormone-dependent condition and a common gynecologic disorder, with an estimated frequency of approximately 10% among women of reproductive age. The association between endometriosis and epithelial ovarian cancer has been supported by years of epidemiologic research. Epidemiologic studies have shown an increased risk of epithelial ovarian cancer, especially endometrioid and clear cell histologies, among women with endometriosis. Approximately 1.0% of women with endometriosis may undergo malignant transformation. Endometriosis shares several genetic characteristics with ovarian cancer. A tumor suppressor gene ARID1A (AT-rich interactive domain 1A (SWI-like)) as frequently disrupted in endometriosis-associated ovarian cancer and clear cell and endometrioid adenocarcinomas. The same pathophysiology (immune alterations, excess oxidative stress and inflammation, estrogen excess, and steroid hormone interaction) orchestrates the progression of endometriosis and its transformation to ovarian cancer. These facts show that some endometriosis has been shown to undergo malignant transformation. Ovarian cancer precursor lesions are known to be atypical endometriosis, which was identified in about 50% of these histologic subtypes.