Aromatase expression in endometriotic tissues and its relationship to clinical and analytical findings

Acién, Pedro; Velasco, Irene; Gutierrez, M.A.; Martínez-Beltrán, Monserrat

doi:10.1016/j.fertnstert.2006.11.188

Cited by 35 publications

(30 citation statements)

References 33 publications

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“…Estrogens seem to be a mitogen for both endometriosis and ovarian cancer [15] since most endometriotic tissues and several endometrioid carcinomas have a functional stroma and in situ estrogen production [39,40,41]. So, although there is evidence supporting a role for estrogens in the etiology of endometriosis and the enhancement of inflammation [42,43], a plausible mechanism that links estrogens to ovarian carcinogenesis, as well as the steps for malignant transformation in ectopic endometrium has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

Epithelial Ovarian Cancers and Endometriosis

Acién

Velasco²,

Acién³

et al. 2015

Gynecol Obstet Invest

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Aims: To determine the prevalence of endometriosis in epithelial ovarian cancers (EOC) and the association among their histological subtypes and with endometrial carcinoma. Methods: An observational cohort study performed in 192 patients operated on for EOC, 30 women with atypical endometriosis and 17 with p53 positive endometriosis. Data on associated endometriosis and endometrial carcinomas, histological subtypes, tumor stage, clinical and pathological characteristics and survival were analyzed. Results: Twenty cases of EOC (10.4%) had also endometriosis (12.7 in borderline and 9.3% in invasive cases), being a synchronous finding in most cases. Endometriosis associated with serous or mucinous EOC was observed in 2.2 and 2.7% of cases, respectively. However, this association was observed in 50 of endometrioid and 23% of clear cell EOC. Age, parity and tumor stage were lower in endometriosis-associated EOC patients; and all associated cases were type I (Kurman and Shih's classification) and showed better results in survival rate. Endometrial carcinoma was more frequently associated with endometrioid EOC (25%). Conclusions: There is a significant association between endometriosis, including atypical forms, and endometrioid and clear cell carcinomas, but not with other EOC histotypes. The presence of endometriosis in EOC suggests a better prognosis and an intermediate stage within the progression endometriosis-carcinoma.

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Section: Discussionmentioning

confidence: 99%

Epithelial Ovarian Cancers and Endometriosis

Acién

Velasco²,

Acién³

et al. 2015

Gynecol Obstet Invest

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“…We reported the presence of aromatase in the ectopic endometrium in 70% of the patients, whereas aromatase was absent in the eutopic endometrium [31]. This enzymatic activity may be regulated by a complex interaction of peritoneal macrophage-derived products as shown by its in vitro stimulation by IL-6, TNF- α or peritoneal fluid [31, 32], causing increased disease activity, disease severity and pelvic pain in these patients [74]. Therefore, aromatase inhibitors combined with GnRH analogues [75] or oral contraceptives [76] may be the next generation of endometriosis therapy.…”

Section: Evolutive Biology: Etiopathogenesis and Physiopathologymentioning

confidence: 99%

Endometriosis: A Disease That Remains Enigmatic

Acién

Velasco

2013

ISRN Obstetrics and Gynecology

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Endometriosis, a gynecologic pathology, is defined by the presence of a tissue similar to uterine endometrium, which is located in places other than physiologically appropriate. These endometrial heterotopic islets contain glands and stroma and are functionally capable of responding to exogenous, endogenous, or local hormonal stimuli. Endometriosis affects 8%–10% of women of reproductive age; in 30% of the women, the condition is associated with primary or secondary infertility. In several instances, endometriosis persists as a minimal or mild disease, or it can resolve on its own. Other cases of endometriosis show severe symptomatology that ends when menopause occurs. Endometriosis can, however, reactivate in several postmenopausal women when iatrogenic or endogenous hormones are present. Endometriosis is occasionally accompanied by malignant ovarian tumors, especially endometrioid and clear cell carcinomas. Its pathogenesis is widely debated, and its variable morphology appears to represent a continuum of individual presentations and progressions. Endometriosis has no pathognomonic signs or symptoms; it is therefore difficult to diagnose. Because of its enigmatic etiopathogenesis, there is currently no satisfactory therapy for all patients with endometriosis. Treatments include medications, surgery, or combined therapies; currently, the only procedures that seem to cure endometriosis are hysterectomy and bilateral salpingo-oophorectomy. In this paper, we review the most controversial and enigmatic aspects of this disease.

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“…Its abnormal expression in eutopic and ectopic endometria of women with endometriosis (11)(12)(13) is regulated in a similar manner as the ovarian gene through promoter II by steroid factor 1 (SF-1), a 67-kDa monomer that positively regulates steroidogenic genes, and negatively by the 90-kDa homodimer chicken ovalbumin upstream transcription factor (COUP-TF) (14,15). Steroid factor 1 competes with higher affinity for the same upstream site on promoter II than COUP-TF (14).…”

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confidence: 99%

“…Therefore, the aberrant expression of P 450 Arom described in ectopic and in eutopic endometria would depend on the transcription factors available in the tissue (4,9,12,14,(17)(18)(19)(20)(21)(22)(23).…”

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confidence: 99%