Ovarian intraepithelial dysplasia in relation to ovulation patterns

Reproductive factors alter the risk of ovarian cancer; pregnancy reduces the risk while infertility increases it. However it is still nor clear whether it is infertility itself or its treatment that is responsible for the increased risk. Alternatively, it could be postulated that infertility and epithelial ovarian cancer are consequences of a common underlying genetic abnormality. There is mounting evidence that in some cases endometriosis could be a precursor lesion to ovarian cancer. Endometriosis has been found within or adjacent to endometrioid and clear cell ovarian cancer in up to 25% of cases. Accumulation of genetic mutations underlies the development of neoplasm. Precursor lesions have been identified in many malignancies with alterations in cell cycle genes. Since ovarian malignancy has a unifocal origin, it could be assumed that there is a precursor lesion in ovarian cancer, but owing to its intra-abdominal nature it has yet to be identified. In this review, we describe cytological and architectural abnormalities in the surface of the ovary in high-risk groups. These high-risk groups also show changes in some cell cycle proteins, which could indicate that these lesions are a precursor to ovarian cancer.