Ovarian Cancer Stroma: Pathophysiology and the Roles in Cancer Development

Abstract

Ovarian cancer represents one of the cancers with the worst prognostic in adult women. More than half of the patients who present with clinical signs such as abdominal bloating and a feeling of fullness already show advanced stages. The majority of ovarian cancers grow as cystic masses, and cancer cells easily spread into the pelvic cavity once the cysts rupture or leak. When the ovarian cancer cells disseminate into the peritoneal cavity, metastatic nests may grow in the cul-de-sac, and in more advanced stages, the peritoneal surfaces of the upper abdomen become the next largest soil for cancer progression. Ascites is also produced frequently in ovarian cancers, which facilitates distant metastasis. Clinicopathologic, epidemiologic and molecular studies on ovarian cancers have improved our understanding and therapeutic approaches, but still further efforts are required to reduce the risks in the patients who are predisposed to this lethal disease and the mortality of the patients in advanced stages. Among various molecules involved in ovarian carcinogenesis, special genes such as TP53, BRCA1 and BRCA2 have been well investigated. These genes are widely accepted as the predisposing factors that trigger malignant transformation of the epithelial cells of the ovary. In addition, adnexal inflammatory conditions such as chronic salpingitis and ovarian endometriosis have been great research interests in the context of carcinogenic background of ovarian cancers. In this review, I discuss the roles of stromal cells and inflammatory factors in the carcinogenesis and progression of ovarian cancers.

Human Ovarian Cancer Stroma Contains Luteinized Theca Cells Harboring Tumor Suppressor Gene GT198 Mutations

“…Breast and ovarian cancer genes such as BRCA1 and BRCA2 are identified through analyzing germ line mutations in familial cases (13,14), and their somatic mutations are largely undetectable in advanced tumors (15), which is evidence against the possibility for clonal expansion of a mutant progenitor into tumor parenchyma. In contrast, mounting evidence supports a link of cancer initiation to altered tumor microenvironment in tumor stroma (16,17); stroma is the particular natural habitat of progenitor cells. In ovarian cancer, steroid hormone-producing cells have been observed in tumor stroma promoting inclusion cysts and epithelial tumor cells (18).…”

Immunohistochemical Analysis of Mesothelin in Epithelial Tumours of Ovary

“…Hence, the cells are immunoreactive for some of the epithelial and mesothelial cell markers. (14) The few studies done in recent past on mesothelin expression in ovarian tumours and present study suggest that ovarian epithelial tumours show variable mesothelin expression. The present study revealed mesothelin positivity (100%) in all benign and malignant serous tumours.…”

Diagnostic value of derived neutrophil‐to‐lymphocyte ratio in patients with ovarian cancer

“…The inflammatory response is one of the signature features of tumor development and plays an important role in tumor progression . Research on the diagnosis and prognosis of various inflammatory cells has become a targeted area of interest in recent years.…”

“…Inflammation plays an important role in the occurrence and development of cancer . Therefore, cancer is also widely considered a cause chronic inflammation.…”