Ovulatory Factor in Ovarian Carcinogenesis
Ovaries of mammals are covered by a simple layer of epithelial cells that originate from the coelomic mesothelium during embryonic development. The surface epithelium is supported over the ovarian cortical interstitium by a basement membrane, and is adjoined by desmosomes and gap or tight junctional complexes. Although the surface epithelium represents only a small fraction of the diverse cell types that populate the ovary, it is thought to account for approximately 90% of its malignancies (1).
Common cancer of the ovary is an ovulation-related disease. It has been known for decades that circumstances that avert ovulation, namely oral contraceptive use and pregnancy/lactation, protect against ovarian cancer (2–5). Until recently, it was unclear how the processes of ovulation and carcinogenesis might be linked.
A follicle selected to ovulate emerges from the ovarian cortex and comes into apposition with the surface epithelium. A complex interplay of proteolytic enzymes and inflammatory mediators liberated within the formative site of ovulation (i.e., at the follicular-ovarian surface interface) degrade collagen matrices and provoke cellular death. Surface epithelial cells within a limited diffusion radius become committed to apoptosis and are sloughed. In the finale, a physical force sustained by contractile elements within the basal wall of the follicle ruptures the devitalized fabric at the apex and expels the ovum (6).
KeywordsOvarian Cancer Ovarian Surface Epithelium Ovarian Surface Ovarian Cancer Risk Surface Epithelial Cell
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