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Современные представления о канцерогенезе эпителиального рака яичников (обзор литературы) 

HEALTH OF WOMAN.2015.4(100):52–56; doi 10.15574/HW.2015.100.52 
 

Современные представления о канцерогенезе эпителиального рака яичников (обзор литературы) 
 

Чайка К. В., Жихарский Р. В., Каминский А. В., Сербенюк А. В.

Кафедра акушерства, гинекологии и репродуктологии Национальной медицинской академии последипломного образования имени П.Л. Шупика, м. Киев

Украинский государственный институт репродуктологии Национальной медицинской академии последипломного образования имени П.Л. Шупика, м. Киев

Киевский городской центр репродуктивной и перинатальной медицины 
 

В обзоре литературы высветлены современные представления о канцерогенезе эпителиального рака яичников. Исследования последних лет свидетельствуют о том, что большинство так называемых серозных карцином яичников высокой степени злокачественности фактически появляются из эпителия фимбриального конца маточной трубы. У женщин, которых вследствие мутации гена BRCA относят к группе высокого риска возникновения рака яичника, проведение двусторонней тубэктомии во время гистерэктомии по поводу доброкачественной гинекологической патологии, приводит к снижению этого риска. Пути профилактики возникновения эпителиального рака яичников основаны на устранении заболеваний-прекурсоров, разработке соответствующих скрининговых программ, а также на определении оптимальной хирургической тактики лечения женщин – носителей мутаций генов BRCA1 та BRCA2. 
 

Ключевые слова: эпителиальный рак яичников (ЭРЯ), дистальный отдел маточной трубы, мутации генов BRCA1 и BRCA2. 
 

Литература: 

1. Soslow RA. 2008. Histologic subtypes of ovarian carcinoma: an overview. Int J Gynecol Pathol 27:161–74. http://dx.doi.org/10.1097/pgp.0b013e31815ea812

2. McCluggage–WG. 2011. Morphological subtypes of ovarian carcinoma: a review with emphasis on new developments and pathogenesis. Pathology 43:420–32. http://dx.doi.org/10.1097/PAT.0b013e328348a6e7; PMid:21716157

3. Vang R, Shih IeM, Kurman RJ. 2009. Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. Adv Anat Pathol 16:267–82. http://dx.doi.org/10.1097/PAP.0b013e3181b4fffa; PMid:19700937 PMCid:PMC2745605

4. DeLair D, Soslow RA. 2012. Key features of extrauterine pelvic serous tumours (fallopian tube, ovary, and peritoneum). Histopathology 61:329–39. http://dx.doi.org/10.1111/j.1365-2559.2011.04167.x; PMid:22372521

5. National Cancer Institute. Surveillance, Epidemiology, and End Results Program. SEER Stat Fact Sheets: Ovary Cancer http://seer.cancer.gov/statfacts/html/ovary.html. Accessed 2014 Aug 20.

6. Malander S, Ridderheim M, Masbдck A, Loman N, Kristoffersson U, Olsson H et al. 2004. One in 10 ovarian cancer patients carry germ line BRCA1 or BRCA2 mutations: results of a prospective study in Southern Sweden. Eur J Cancer 40:422–8. http://dx.doi.org/10.1016/j.ejca.2003.09.016; PMid:14746861

7. Pal T, Permuth-Wey J, Betts JA, Krischer JP, Fiorica J, Arango H et al. 2005. BRCA1 and BRCA2 mutations account for a large proportion of ovarian carcinoma cases. Cancer 104:2807–16. http://dx.doi.org/10.1002/cncr.21536; PMid:16284991

8. Brozek I, Ochman K, Debniak J, Morzuch L, Ratajska M, Stepnowska M et al. 2008. High frequency of BRCA1/2 germline mutations in consecutive ovarian cancer patients in Poland. Gynecol Oncol. 108:433–7. http://dx.doi.org/10.1016/j.ygyno.2007.09.035; PMid:17997147

9. Hennessy BT, Timms KM, Carey MS, Gutin A, Meyer LA, Flake DD 2nd et al. 2010. Somatic mutations in BRCA1 and BRCA2 could expand the number of patients that benefit from poly (ADP ribose) polymerase inhibitors in ovarian cancer. J Clin Oncol. 28:3570–6. http://dx.doi.org/10.1200/JCO.2009.27.2997; PMid:20606085 PMCid:PMC2917312

10. Schrader KA, Hurlburt J, Kalloger SE, Hansford S, Young S, Huntsman DG et al. 2012. Germline BRCA1 and BRCA2 mutations in ovarian cancer: utility of a histology-based referral strategy. Obstet Gynecol. 120:235–40. http://dx.doi.org/10.1097/AOG.0b013e31825f3576; PMid:22776961

11. Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, Hopper JL et al. 2003. Average risks of breast and ovarian cancer associated with BRCA1 or BRCA2 mutations detected in case series unselected for family history: a combined analysis of 22 studies. Am J Hum Genet. 72:1117–30. http://dx.doi.org/10.1086/375033; PMid:12677558

12. van der Kolk DM, de Bock GH, Leegte BK, Schaapveld M, Mourits MJ, de Vries J et al. 2010. Penetrance of breast cancer, ovarian cancer and contralateral breast cancer in BRCA1 and BRCA2 families: high cancer incidence at older age. Breast Cancer Res Treat. 124:643–51. http://dx.doi.org/10.1007/s10549-010-0805-3; PMid:20204502

13. Mavaddat N, Peock S, Frost D, Ellis S, Platte R, Fineberg E et al. 2013. EMBRACE. Cancer risks for BRCA1 and BRCA2 mutation carriers: results from prospective analysis of EMBRACE. J Natl Cancer Inst. 105:812–22. http://dx.doi.org/10.1093/jnci/djt095; PMid:23628597

14. Liu J, Cristea MC, Frankel P, Neuhausen SL, Steele L, Engelstaedter V et al. 2012. Clinical characteristics and outcomes of BRCA-associated ovarian cancer: genotype and survival. Cancer Genet. 205:34–41. http://dx.doi.org/10.1016/j.cancergen.2012.01.008; PMid:22429596 PMCid:PMC3337330

15. Cristea M, Han E, Salmon L, Morgan RJ. 2010. Practical considerations in ovarian cancer chemotherapy. Ther Adv Med Oncol. 2:175–87. http://dx.doi.org/10.1177/1758834010361333; PMid:21789133 PMCid:PMC3126016

16. Cancer Research UK. Ovarian cancer survival statistics http://www.cancerresearchuk.org/cancer-info/cancerstats/types/ovary/survival/ovarian-cancer-survival-statistics. Accessed 2014 Aug 20.

17. Fathalla MF. Incessant ovulation—a factor in ovarian neoplasia? Lancet. 1971.ii:163. http://dx.doi.org/10.1016/S0140-6736(71)92335-X

18. Risch HA, Marrett LD, Howe GR. 1994. Parity, contraception, infertility, and the risk of epithelial ovarian cancer. Am J Epidemiol. 140:585–97. PMid:7942759

19. Shu XO, Brinton LA, Gao YT, Yuan JM. 1989. Population-based case-control study of ovarian cancer in Shanghai. Cancer Res. 49:3670–4. PMid:2731180

20. Cramer DW, Welch WR. 1983. Determinants of ovarian cancer risk. II. Inferences regarding pathogenesis. J Natl Cancer Inst. 71:717–21. PMid:6578367

21. Risch HA. 1998. Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst. 90:1774–86. http://dx.doi.org/10.1093/jnci/90.23.1774; PMid:9839517

22. Worley MJ Jr, Welch WR, Berkowitz RS, Ng SW. 2013. Endometriosis-associated ovarian cancer: a review of pathogenesis. Int J Mol Sci. 14:5367–79. http://dx.doi.org/10.3390/ijms14035367; PMid:23466883 PMCid:PMC3634491

23. Crum CP, Herfs M, Ning G, Bijron JG, Howitt BE, Jimenez CA et al. 2013. Through the glass darkly: intraepithelial neoplasia, top-down differentiation, and the road to ovarian cancer. J Pathol. 231:402–12. http://dx.doi.org/10.1002/path.4263; PMid:24030860 PMCid:PMC3947463

24. Woolas R, Jacobs I, Davies AP, Leake J, Brown C, Grudzinskas JG et al. 1994. What is the true incidence of primary fallopian tube carcinoma? Int J Gynecol Cancer 4:384–8. http://dx.doi.org/10.1046/j.1525-1438.1994.04060384.x; PMid:11578438

25. Finch A, Shaw P, Rosen B, Murphy J, Narod SA, Colgan TJ. 2006. Clinical and pathologic findings of prophylactic salpingo-oophorectomies in 159 BRCA1 and BRCA2 carriers. Gynecol Oncol. 100:58–64. http://dx.doi.org/10.1016/j.ygyno.2005.06.065; PMid:16137750

26. Medeiros F, Muto MG, Lee Y, Elvin JA, Callahan MJ, Feltmate C et al. 2006. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol. 30:230–6. http://dx.doi.org/10.1097/01.pas.0000180854.28831.77; PMid:16434898

27. Callahan MJ, Crum CP, Medeiros F, Kindelberger DW, Elvin JA, Garber JE et al. 2007. Primary fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction. J Clin Oncol. 25:3985–90. http://dx.doi.org/10.1200/JCO.2007.12.2622; PMid:17761984

28. Lee Y, Miron A, Drapkin R, Nucci MR, Medeiros F, Saleemuddin A et al. 2007. A candidate precursor to serous carcinoma that originates in the distal fallopian tube. J Pathol 211:26–35. http://dx.doi.org/10.1002/path.2091; PMid:17117391

29. Ahmed AA, Etemadmoghadam D, Temple J, Lynch AG, Riad M, Sharma R et al. 2010. Driver mutations in TP53 are ubiquitous in high grade serous carcinoma of the ovary. J Pathol. 221:49–56. http://dx.doi.org/10.1002/path.2696; PMid:20229506 PMCid:PMC3262968

30. Crum CP, Drapkin R, Miron A, Ince TA, Muto M, Kindelberger DW et al. 2007. The distal fallopian tube: a new model for pelvic serous carcinogenesis. Curr Opin Obstet Gynecol. 19:3–9. http://dx.doi.org/10.1097/GCO.0b013e328011a21f; PMid:17218844

31. Kuhn E, Kurman RJ, Vang R, Sehdev AS, Han G, Soslow R et al. 2012. TP53 mutations in serous tubal intraepithelial carcinoma and concurrent pelvic high-grade serous carcinoma – evidence supporting the clonal relationship of the two lesions. J Pathol. 226:421–6. http://dx.doi.org/10.1002/path.3023; PMid:21990067

32. Paik DY, Janzen DM, Schafenacker AM, Velasco VS, Shung MS, Cheng D et al. 2012. Stem-like epithelial cells are concentrated in the distal end of the fallopian tube: a site for injury and serous cancer initiation. Stem Cells 30:2487–97. http://dx.doi.org/10.1002/stem.1207; PMid:22911892 PMCid:PMC4442093

33. Levanon K, Ng V, Piao HY, Zhang Y, Chang MC, Roh MH et al. 2010. Primary ex vivo cultures of human fallopian tube epithelium as a model for serous ovarian carcinogenesis. Oncogene 29:1103–13. http://dx.doi.org/10.1038/onc.2009.402; PMid:19935705 PMCid:PMC2829112

34. Karst AM, Drapkin R. 2010. Ovarian cancer pathogenesis: a model in evolution. J Oncol. 2010:932371. http://dx.doi.org/10.1155/2010/932371; PMid:19746182 PMCid:PMC2739011

35. Salvador S, Gilks B, Kobel M, Huntsman D, Rosen B, Miller D. 2009. The fallopian tube: primary site of most pelvic high-grade serous carcinomas. Int J Gynecol Cancer 19:58–64. http://dx.doi.org/10.1111/IGC.0b013e318199009c; PMid:19258943

36. Carlson JW, Miron A, Jarboe EA, Parast MM, Hirsch MS, Lee Y et al. 2008. Serous tubal intraepithelial carcinoma: its potential role in primary peritoneal serous carcinoma and serous cancer prevention. J Clin Oncol. 26:4160–5. http://dx.doi.org/10.1200/JCO.2008.16.4814; PMid:18757330 PMCid:PMC2654373

37. Tavassoli FA, Devilee P, editors. 2003. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Breast and Female Genital Organs. Lyon: IARC Press. PMCid:PMC3957561

38. Kauff ND, Satagopan JM, Robson ME, Scheuer L, Hensley M, Hudis CA et al. 2002. Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation. N Engl J Med. 346:1609–15. http://dx.doi.org/10.1056/NEJMoa020119; PMid:12023992

39. Tone AA, Salvador S, Finlayson SJ, Tinker AV, Kwon JS, Lee CH et al. 2012. The role of the fallopian tube in ovarian cancer. Clin Adv Hematol Oncol. 10:296–306. PMid:22706539

40. Morelli M, Venturella R, Mocciaro R, Di Cello A, Rania E, Lico D et al. 2013. Prophylactic salpingectomy in premenopausal low-risk women for ovarian cancer: primum non nocere. Gynecol Oncol. 129:448–51. http://dx.doi.org/10.1016/j.ygyno.2013.03.023; PMid:23558052

41. McAlpine JN, Hanley GE, Woo MM, Tone AA, Rozenberg N, Swenerton KD et al. 2014. Ovarian Cancer Research Program of British Columbia. Opportunistic salpingectomy: uptake, risks, and complications of a regional initiative for ovarian cancer prevention. Am J Obstet Gynecol. 210:471.e1–e11. http://dx.doi.org/10.1016/j.ajog.2014.01.003 
PMid:24412119

42. Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Managing the adnexae at the time of hysterectomy for benign gynaecological disease. College Statement C-Gyn 25. Melbourne. Australia: RANZCOG. 2012.

43. Society of Gynecologic Oncology. SGO Clinical Practice Statement: Salpingectomy for Ovarian Cancer Prevention. Chicago, SGO. 2013 https://www.sgo.org/clinical-practice/guidelines/sgo-clinical-practice-statement-salpingectomy-for-ovarian-cancer-prevention.

44. Narod SA. 2013. Salpingectomy to prevent ovarian cancer: A Countercurrents Series. Curr Oncol. 20:145–7. http://dx.doi.org/10.3747/co.20.1471; PMid:23737681 PMCid:PMC3671018

45. Kim J, Coffey DM, Creighton CJ, Yu Z, Hawkins SM, Matzuk MM. 2012. High-grade serous ovarian cancer arises from fallopian tube in a mouse model. Proc Natl Acad Sci USA 109:3921-6. http://dx.doi.org/10.1073/pnas.1117135109; PMid:22331912 PMCid:PMC3309733

46. Kwon JS, Tinker A, Pansegrau G, McAlpine J, Housty M, McCullum M et al. 2013. Prophylactic salpingectomy and delayed oophorectomy as an alternative for BRCA mutation carriers. Obstet Gynecol. 121:14–24. http://dx.doi.org/10.1097/AOG.0b013e3182783c2f; PMid:23232752

47. Leblanc E, Narducci F, Farre I, Peyrat JP, Taieb S, Adenis C et al. 2011. Radical fimbriectomy: a reasonable temporary risk-reducing surgery for selected women with a germ line mutation of BRCA 1 or 2 genes? Rationale and preliminary development. Gynecol Oncol. 121:472–6. http://dx.doi.org/10.1016/j.ygyno.2011.02.012; PMid:21411127