L. Markin, O. Besedin, K. Isayeva, M. Doroshenko-Kravchyk
Danylo Halytsky Lviv National Medical University
Introduction. Nowadays, the incidence of ovarian tumors has increased from 6.0-11.0 % to 19.0-25.0 %, becoming the serious medical, economic and social problem, as they affect the reproductive potential, respectively, demographic situation in the country and future women’s health. Besides this, the majority of them have a tendency to become malignant. Also they are one of the causes of high mortality among the female population. Thus, determination of the main risk factors, knowledge of etiological causes and substantial understanding of pathogenic mechanisms of ovarian tumor will enable to conduct prophylaxis of this disease development and improve the medical aid.
The aim of the study. To review and summarize the published investigations devoted to the problems of etiology and pathogenesis of different ovarian tumors according to their histological structure.
Materials and methods. The content analysis, method of systemic and comparative analysis, bibliosemantic method of studying the actual scientific researches concerning the etiology and pathogenesis of ovarian tumors, differing by the histological structure and the course specificity, were conducted.
The data was searched in scientometric databases: PubMed-NCBI, Medline, Research Gate, Cochrane Database of Systematic Reviews by such keywords: “etiology”, “pathogenesis”, “hypothesis”, “ovarian benign tumor”, “ovarian cancer”, “risk factor”, “histogenesis”, “genetic mutations”, “World Health Organization”, “FIGO” (fr. – Fédération Internationale de Gynécologie et d’Obstétrique). Totally, 84 English, Ukrainian and Russian sources were analyzed.
Results. Analysis of modern literature shows that the process of tumor cell transformation has not been fully understood due to their histological features. Nowadays, the numerous endogenous and exogenous risk factors have been identified. And, recently, the traditional theory of the appearance of ovarian tumors has undergone the significant changes. Also, several hypotheses have been proposed to explain the epidemiological factors: the continuous ovulation hypothesis, the hypothesis of gonadotropins excessive secretion, the genetic theory, theory of microenvironment and genetic polymorphism. In recent years, the large number of studies are devoted to the study of the immune system state, the process of apoptosis, morphological and molecular cytogenetics.
Conclusions. Thus, according to epidemiological investigations, neoplasms of the ovaries can be regarded as systemic diseases, which occurs on a molecular genetic level with involvement of various endogenous and exogenous factors. However, despite the significant advancements in fundamental science, the causes of tumor appearance and, respectively, the issue of early diagnosis and prophylaxis of the most common neoplasms of the ovaries need further investigations.
- Yegorov MJ. Criteria for differential diagnosis and substantiation of pathogenetic treatment of patients with benign and borderline epithelial ovarian tumors [dissertation]. Kyiv: National Medical Academy of Postgraduate Education; 2016. 156 p. (Ukrainian).
- Yegunova MA, Kutsenko IG. Immunological studies in the differential diagnosis of benign and malignant neoplasms of the ovaries at the preoperative stage. Electronic Science Journal. 2015;1:44-47. (Russian).
- Ikromova ZM. Somatic and gynecological satus of reproductive age of women with benign tumors and tumor-like formations of the ovaries. Avicenna Bulletin. 2017;19(1):7-10. (Tajikistan).
- Kogan YaE. Actual issues of the pathogenesis and diagnosis of tumors and tumor-like formations of the ovaries. Practical Medicine. 2018;16(9):34-39. (Russian). https://doi.org/10.32000/2072-1757-2018-9-34-39
- KozachenkoV P. Tumor stroma tumors. 2015;4:42-46. (Russian).
- Makarov OV, Narimanova MR. Ovarian Cancer: New in the Questions of Etiopathogenesis and Diagnostics: a Literature Review. Bulletin of the Russian State Medical University. 2014;4:53-57. (Russian).
- National Cancer Institute. Cancer in Ukraine, 2016-2017. Morbidity, mortality, oncology indicators: Bulletin of the National Cancer Registry of Ukraine [Internet]. Kyiv: National Cancer Institute; 2018 [Updated 2018; cited 2018]. Available at: http://www.ncru.inf.ua/publications/index.htm (Ukrainian).
- Payanidi YuG, Zhordania KI, Loginov VI, Chemeris GYu, Sivakova NG. Endometriosis and endometrioid carcinoma. Obstetrics and Gynecology: News. Opinions. 2017;1:44-48. (Russian).
- Romaniv MP. Oncological pathology in the structure of morbidity and mortality of the population of Ukraine. Bulletin of Scientific Research. 2017;2:23-24. (Ukrainian).
- Serebrennikova KG, Kuznetsova EP. Modern views on aetiology and pathogenesis of tumor growths and benign ovarian tumors. Saratov Journal of Medical Scientific Research. 2010;6(3):552-558. (Russian).
- Sukhanova АА, NespryadkoSV, MelnikMM, EgorovMYu. Proliferative activity and receptor status of benign and borderline epithelial ovarian tumors. Health of Women. 2016;6(112):158-164. (Ukrainian).
- Charbonneau B, Good EL, Kimberly R K, Keith L K, Melissa SD. The immune system in the pathogenesis of ovarian cancer. Crit Rev Immunol. 2013;33(2):137-164.
- Colombo N, Sessa C, du Bois A, Ledermann J, McCluggage WG, McNeish I et al. ESMO-ESGO consensus conference recommendations on ovarian cancer: pathology and molecular biology, early and advanced stages, borderline tumours and recurrent disease. Annals of Oncology. 2019;30(5):672-705.
- Duska LR, Kohn EC. The new classifications of ovarian, fallopian tube, and primary peritoneal cancer and their clinical implications. Annals of Oncology. 2017;28(8):8-12.
- Erickson BK, Conner MG, Landen CN. The role of fallopian tube in the origin of ovarian cancer. Am J Obstet Gynecol. 2013;209:409-414. https://doi.org/10.1016/j.ajog.2013.04.019
- Fathalla MF. Incessant ovulation and ovarian cancer – a hypothesis re-visited. Facts Views and Vision Issues in Obstetrics Gynecology and Reproductive Health. 2013;(5):292-297.
- Jie L, Abushahin N. Pang NS, Xiang L, Chambers SK, Fadare O et al. Tubal origin of “ovarian” low-grade serous carcinoma. Modern Pathology. 2011: 24(11):1488-1499. https://doi.org/10.1038/modpathol.2011.106
- Koshiyama M, Matsumura N, Konishi I. Recent concepts of ovarian carcinogenesis: Type I and Type II. Biomed Resours International. 2014;2014:934261. https://doi.org/10.1155/2014/934261
- Kroeger PT, Drapkin R. Pathogenesis and heterogeneity of ovarian cancer. Current Opinion in Obstetrics and Gynecology. 2017;29(1):26-34. https://doi.org/10.1097/GCO.0000000000000340
- Landen CN, Birrer MJ, Sood AK. Early events in the pathogenesis of epithelial ovarian cancer. Journal of Clinical Oncology. 2008;26(6):995-1005. https://doi.org/10.1200/JCO.2006.07.9970
- Mandai M, Matsumura N, Baba T, Yamaguchi K, Hamanishi J, Konishi Ovarian clear cell carcinoma as a stress-responsive cancer: influence of the microenvironment on the carcinogenesis and cancer phenotype. Cancer Letters. 2011;310(2):129-133. https://doi.org/10.1016/j.canlet.2011.06.039
- Mandai M, Yamaguchi K, Matsumura N, Baba T, Konishi I. Ovarian cancer in endometriosis: molecular biology, pathology, and clinical management. International Journal of Clinical Oncology. 2009;(14):383-391. https://doi.org/10.1007/s10147-009-0935-y
- Pejovic T, Burki N, Odunsi K. Fiedler P, Achong N, Schwartz PE et al. Well-differentiated mucinous carcinoma of the ovary and a coexisting brenner tumor both exhibit amplification of 12q14-21 by comparative genomic hybridization. Gynecologic Oncology. 1999;74(1):134-137. https://doi.org/10.1006/gyno.1999.5402
- Ray-Coquard I, Morice P, Lorusso D, Prat J, Oaknin A, Pautier P et al. Non-epithelial ovarian cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2018;29(4):1-18. https://doi.org/10.1093/annonc/mdy001
- Samuel CM, Kwong J, William RW, Samimi G, Ozbun L, Bonome T et al. Etiology and pathogenesis of epithelialovarian cancer. Disease Markers. 2007;23(5-6):367-376. https://doi.org/10.1155/2007/474320
- Seidman JD, Khedmati F. Exploring the histogenesis of ovarian mucinous and transitional cell (Brenner) neoplasms and their relationship with walthard cell nests: a study of 120 tumors. Archives of Pathology and Laboratory Medicine. 2008;132(11):1753-1760.
- The Australian Cancer Network and National Breast Cancer Centre. Clinical practice guidelines for the management of women with epithelial ovarian cancer [Internet]. National Breast Cancer Centre, Camperdown, NSW; 2004 [updated 2009; 15; cited 2009]. Available from: http://www.nhmrc.gov.au.
- Turner TB, Buchsbaum DJ, Straughn MJr, Randall TD, Arend RC. Ovarian cancer and the immune system – the role of target therapy. Gynecologic Oncology. 2016;142(2):349-356. https://doi.org/10.1016/j.ygyno.2016.05.007
- Vang R, Levine DA, Soslow RA. Molecular alterations of TP53 are a defining feature of ovarian high-grade serous carcinoma: a rereview of cases lacking TP53 mutations in The Cancer Genome Atlas Ovarian Study. Int J Gynecol 2016;35:48-55. https://doi.org/10.1097/PGP.0000000000000207
- Worley MJ Jr, Welch WR, Berkowitz RS, Ng SW. Endometriosis associated ovarian cancer: a review of pathogenesis. International Journal of Molecular Sciences. 2013;14:5367-5369. https://doi.org/10.3390/ijms14035367