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Open access - 2 Case Reports
Background
It is known that elevated serum levels of steroid hormones including estradiol (E2) are present in postmenopausal women with common epithelial ovarian tumors [1–4].
Such ovarian tumor stroma exhibiting lutein-like or theca-like cells,
or both, is frequently detected with morphological studies and has been
termed “ovarian tumors with functioning stroma” [1].
Recently, from a pathogenic perspective, it has been reported that P450
aromatase, which converts androgens to estrogens, was exclusively
expressed in stromal cells, although not all serum estrogens are
produced in functioning stroma [5].
However, the mechanism of the initiation and development of ovarian
tumors with functioning stroma and the significance of the expression of
P450 aromatase in functioning stroma are still unclear.....
.... A meta-analysis showed that ovarian cancer risk was significantly
greater in ever-users than in never-users of hormone therapy. However,
regarding histopathological type, risk was definitely increased only for
the two most common types, serous and endometrioid, but not mucinous
and clear adenocarcinoma [21]....
Conclusions
The present case showed that some elderly women with common epithelial tumors have an extremely high E2
level. Immunohistochemical and RT-qPCR evaluations showed that SF-1 may
promote estrogen biosynthesis through regulation of P450 aromatase
expression in ovarian tumors with functioning stroma, and that this in
turn induces a high serum E2 level.
Further
large-scale studies should provide additional insights into the
mechanism whereby ovarian tumors, which contain functioning stroma with a
high serum estrogen level and high expressions of P450 aromatase and
SF-1, affect the prognosis and clinical outcomes of ovarian tumor
patients. These studies have the potential to identify new biomarkers
for anti-angiogenetic therapy and new treatments for some ovarian
tumors.
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