Ovarian cancer of low malignant potential is not associated with positive familial history
1996; Elsevier BV; Volume: 175; Issue: 2 Linguagem: Inglês
10.1016/s0002-9378(96)70181-3
ISSN1097-6868
AutoresAsher Shushan, Ora Paltiel, Lois Gordon, Joseph G. Schenker,
Tópico(s)Cancer-related molecular mechanisms research
ResumoTo the Editors:Much attention has recently been focused on the familial risk of common adult cancers. A strong hereditary component has been reported in the etiology of ovarian cancer, and numerous epidemiologic studies have described an increased risk of ovarian cancer among women with a positive family history of breast and ovarian cancer. A recent study estimated that the 185delAG mutation might account for 39% of ovarian cancers (range 22% to 49%) diagnosed in Ashkenazi women before age 50 years.1Struewing JP Abeliovich D Peretz T Avishai N Kaback MM Collins FJ et al.The carrier frequency of the BRCA1 185delAG mutation is approximately 1 percent in Ashkenazi Jewish individuals.Nature Genet. 1995; 11: 198-200Crossref PubMed Scopus (599) Google Scholar However, it appears that not all histologic categories share an inherited basis. For example, Narod et al.2Narod S Tonin P Lynch H Watson P Feunteun J Lenoir G Histology of BRCA1-associated ovarian tumors.Lancet. 1994; 343: 236Abstract PubMed Scopus (24) Google Scholar found that mucinous carcinomas of the ovary were underrepresented among carriers of mutant BRCA1 alleles. Furthermore, there is a paucity of etiologic research concerning ovarian tumors of low malignant potential. It is unclear whether these ovarian tumors, which carry a favorable prognosis and are seen at a younger age than invasive ovarian tumors, differ from the latter in terms of other risk factors. Most studies report similarities between the two regarding reproductive and personal characteristics. Moreover, we could not find any specific focus in any of these studies on family history apart from five cases in one study.Recently we conducted a nation-wide epidemiologic study in Israel to investigate the epidemiologic and reproductive characteristics of women with ovarian cancer.3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar Further analysis of these data reveals that among 63 women <50 years old with invasive ovarian cancer 8 (12.7%) had a positive family history of ovarian cancer compared with 8 of 222 (3.6%) controls and 1 of 35 (2.9%) women with ovarian tumors of low malignant potential in the same age group (p = 0.01). The 1 case with a positive family history had an affected distant relative, whereas 4 of the 8 women with invasive tumors had a first-degree relative (mother or sister) affected.These data suggest that, in contrast to invasive ovarian cancer, family history may play a minor, if any, role in the development of low-malignant-potential ovarian tumors. If these results are confirmed by further studies, then an etiologic difference may be added to the differences between invasive and low-malignant-potential ovarian tumors. The lack of familial influence on the incidence of low-malignant-potential ovarian tumors suggests that the rate of mutant BRCA1 alleles should not be different among these women compared with healthy controls. Given our recent finding of an association between induction of ovulation and low-malignant-potential tumors3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar and another study reporting that estrogen receptor expression is a common feature of these ovarian tumors, we postulate that the pathophysiologic mechanisms of low-malignant-potential tumors might be related to hormonal stimulation rather than to genetic predisposition. We intend to conduct a study to test this hypothesis.6/8/74944 To the Editors:Much attention has recently been focused on the familial risk of common adult cancers. A strong hereditary component has been reported in the etiology of ovarian cancer, and numerous epidemiologic studies have described an increased risk of ovarian cancer among women with a positive family history of breast and ovarian cancer. A recent study estimated that the 185delAG mutation might account for 39% of ovarian cancers (range 22% to 49%) diagnosed in Ashkenazi women before age 50 years.1Struewing JP Abeliovich D Peretz T Avishai N Kaback MM Collins FJ et al.The carrier frequency of the BRCA1 185delAG mutation is approximately 1 percent in Ashkenazi Jewish individuals.Nature Genet. 1995; 11: 198-200Crossref PubMed Scopus (599) Google Scholar However, it appears that not all histologic categories share an inherited basis. For example, Narod et al.2Narod S Tonin P Lynch H Watson P Feunteun J Lenoir G Histology of BRCA1-associated ovarian tumors.Lancet. 1994; 343: 236Abstract PubMed Scopus (24) Google Scholar found that mucinous carcinomas of the ovary were underrepresented among carriers of mutant BRCA1 alleles. Furthermore, there is a paucity of etiologic research concerning ovarian tumors of low malignant potential. It is unclear whether these ovarian tumors, which carry a favorable prognosis and are seen at a younger age than invasive ovarian tumors, differ from the latter in terms of other risk factors. Most studies report similarities between the two regarding reproductive and personal characteristics. Moreover, we could not find any specific focus in any of these studies on family history apart from five cases in one study.Recently we conducted a nation-wide epidemiologic study in Israel to investigate the epidemiologic and reproductive characteristics of women with ovarian cancer.3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar Further analysis of these data reveals that among 63 women <50 years old with invasive ovarian cancer 8 (12.7%) had a positive family history of ovarian cancer compared with 8 of 222 (3.6%) controls and 1 of 35 (2.9%) women with ovarian tumors of low malignant potential in the same age group (p = 0.01). The 1 case with a positive family history had an affected distant relative, whereas 4 of the 8 women with invasive tumors had a first-degree relative (mother or sister) affected.These data suggest that, in contrast to invasive ovarian cancer, family history may play a minor, if any, role in the development of low-malignant-potential ovarian tumors. If these results are confirmed by further studies, then an etiologic difference may be added to the differences between invasive and low-malignant-potential ovarian tumors. The lack of familial influence on the incidence of low-malignant-potential ovarian tumors suggests that the rate of mutant BRCA1 alleles should not be different among these women compared with healthy controls. Given our recent finding of an association between induction of ovulation and low-malignant-potential tumors3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar and another study reporting that estrogen receptor expression is a common feature of these ovarian tumors, we postulate that the pathophysiologic mechanisms of low-malignant-potential tumors might be related to hormonal stimulation rather than to genetic predisposition. We intend to conduct a study to test this hypothesis. Much attention has recently been focused on the familial risk of common adult cancers. A strong hereditary component has been reported in the etiology of ovarian cancer, and numerous epidemiologic studies have described an increased risk of ovarian cancer among women with a positive family history of breast and ovarian cancer. A recent study estimated that the 185delAG mutation might account for 39% of ovarian cancers (range 22% to 49%) diagnosed in Ashkenazi women before age 50 years.1Struewing JP Abeliovich D Peretz T Avishai N Kaback MM Collins FJ et al.The carrier frequency of the BRCA1 185delAG mutation is approximately 1 percent in Ashkenazi Jewish individuals.Nature Genet. 1995; 11: 198-200Crossref PubMed Scopus (599) Google Scholar However, it appears that not all histologic categories share an inherited basis. For example, Narod et al.2Narod S Tonin P Lynch H Watson P Feunteun J Lenoir G Histology of BRCA1-associated ovarian tumors.Lancet. 1994; 343: 236Abstract PubMed Scopus (24) Google Scholar found that mucinous carcinomas of the ovary were underrepresented among carriers of mutant BRCA1 alleles. Furthermore, there is a paucity of etiologic research concerning ovarian tumors of low malignant potential. It is unclear whether these ovarian tumors, which carry a favorable prognosis and are seen at a younger age than invasive ovarian tumors, differ from the latter in terms of other risk factors. Most studies report similarities between the two regarding reproductive and personal characteristics. Moreover, we could not find any specific focus in any of these studies on family history apart from five cases in one study. Recently we conducted a nation-wide epidemiologic study in Israel to investigate the epidemiologic and reproductive characteristics of women with ovarian cancer.3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar Further analysis of these data reveals that among 63 women <50 years old with invasive ovarian cancer 8 (12.7%) had a positive family history of ovarian cancer compared with 8 of 222 (3.6%) controls and 1 of 35 (2.9%) women with ovarian tumors of low malignant potential in the same age group (p = 0.01). The 1 case with a positive family history had an affected distant relative, whereas 4 of the 8 women with invasive tumors had a first-degree relative (mother or sister) affected. These data suggest that, in contrast to invasive ovarian cancer, family history may play a minor, if any, role in the development of low-malignant-potential ovarian tumors. If these results are confirmed by further studies, then an etiologic difference may be added to the differences between invasive and low-malignant-potential ovarian tumors. The lack of familial influence on the incidence of low-malignant-potential ovarian tumors suggests that the rate of mutant BRCA1 alleles should not be different among these women compared with healthy controls. Given our recent finding of an association between induction of ovulation and low-malignant-potential tumors3Shushan A Paltiel O Iscovich J Elchalal U Peretz T Schenker JG Human menopausal gonadotropin and the risk of epithelial ovarian cancer.Fertil Steril. 1996; 65: 8-13Google Scholar and another study reporting that estrogen receptor expression is a common feature of these ovarian tumors, we postulate that the pathophysiologic mechanisms of low-malignant-potential tumors might be related to hormonal stimulation rather than to genetic predisposition. We intend to conduct a study to test this hypothesis. 6/8/74944
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