Endometriozis ve Jinekolojik Kanserler
Özet
Endometriozis, endometrium tabakasının uterus dışında yerleşmesi ile tanımlanan kronik bir hastalıktır. Lokalizasyonuna bağlı olarak; kronik pelvik ağrı, disparoni, dizüri, diskezi ve infertiliteye neden olabilen ciddi bir toplum sağlığı sorunu olarak kabul edilmektedir. Endometriozisin tahmini prevelansı reprodüktif çağdaki kadınlarda %7-15 iken fertilite problemi olanlarda ise bu oran %50’ye kadar çıkmaktadır. Çoğunlukla benign bir hastalık olarak kabul edilmesine rağmen, son yıllarda endometriozisin ve özellikle ovaryan endometriomaların malign potansiyele sahip olabileceği düşünülmeye başlanmıştır. Yapılan geniş ölçekli çalışmalar sonucunda endometriozis zemininde ovaryan karsinom görülme oranının yaklaşık %2’ civarında olduğu bildirilmiştir. Etiyolojide çeşitli moleküler, immün, genetik ve çevresel faktörler suçlanmaktadır. Risk faktörleri arasında ileri yaş, kitle boyutu, artmış östrojenik aktivite, artmış oksidatif radikaller suçlanmakta ve endometriozis cerrahisinin bu riskleri en aza indirdiği bildirilmektedir. Epidemiyolojik çalışmalar çoğunlukla endometriozisin özellikle berrak hücreli ve endometrioid tip ovaryan karsinom ile birlikte olabileceğini bildirmiştir. Her ne kadar şu ana kadar kesin tanı koyduran net bir biyobelirteç olmasa da HE4 ve ARID1 A umut vaad etmektedir. Erken yaşta tanı alması nedeni ile diğer epitelyal over kanserlerine göre prognozunun daha iyi olduğu düşünülmektedir.
Endometriosis is a chronic disease defined by the settlement of the endometrium layer outside the uterus. Depending on its localization; It is considered a serious public health problem that can cause chronic pelvic pain, dyspareunia, dysuria, dyschezia and infertility. While the estimated prevalence of endometriosis is 7-15% in women of reproductive age, this rate rises to 50% in those with fertility problems. Although it is mostly considered a benign disease, in recent years it has begun to be thought that endometriosis, and especially ovarian endometriomas, may have malignant potential. As a result of large-scale studies, it has been reported that the incidence of ovarian carcinoma on the basis of endometriosis is approximately 2%. Various molecular, immune, genetic and environmental factors are blamed in etiology. Advanced age, mass size, increased estrogenic activity, and increased oxidative radicals are blamed among the risk factors, and it is reported that endometriosis surgery minimizes these risks. Epidemiological studies have mostly reported that endometriosis may be associated with ovarian carcinoma, especially clear cell and endometrioid type. Although there is no clear biomarker that provides a definitive diagnosis so far, HE4 and ARID1 A are promising. It is thought to have a better prognosis than other epithelial ovarian cancers because it is diagnosed at an early age.
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Sayfalar
137-150
Gelecek
21 Ocak 2025
Telif Hakkı (c) 2025 Akademisyen Yayınevi Kitap DOI Portalı
