Molecular Diagnosis of Ovary Cancer

The National Cancer Institute (NCI) defines cancer as a group of diseases marked by the abnormal and uncontrolled growth of cells, which can invade surrounding tissues and spread to other parts of the body. Ovarian cancer originates in the ovaries, a critical part of the female reproductive system. Ovarian serous adenocarcinoma, a subtype of epithelial ovarian cancer, constitutes around ۹۰% of all ovarian cancer cases, primarily affecting women aged ۶۳ and older. Unfortunately, most cases are detected only at an advanced stage due to the lack of effective screening methods. Ovarian cancer remains a leading cause of cancer-related deaths among women. Despite a gradual decline in incidence over the past few decades, early-stage ovarian cancer often presents without symptoms, leading to late-stage diagnoses. Survival rates are closely tied to the stage of diagnosis, with early-stage patients having significantly better outcomes compared to those diagnosed later. Epithelial ovarian cancer is the leading cause of death among gynecological cancers, usually affecting postmenopausal women and manifesting with symptoms such as abdominal pain and bloating. Similar tissue origins characterize primary peritoneal cancer and fallopian tube cancer, which are treated using the same approaches. Germ cell tumors, while uncommon, primarily affect younger women, and sex cord-stromal tumors can be benign or malignant, with granulosa cell tumors being the most common. Borderline ovarian tumors consist of abnormal cells and are generally treatable with surgery. Molecular diagnosis focuses on detecting genetic mutations that drive tumor development, offering valuable guidance for treatment and preventive measures. Recent studies underscore the significance of genetic testing, particularly the influence of specific oncogenes and tumor suppressor genes in ovarian cancer. High-grade serous carcinomas are frequently associated with p۵۳ mutations and BRCA deficiencies, while other mutations, including those in K-ras and HER-۲/neu, are linked to prognosis. Expression microarrays have improved the ability to analyze numerous genes simultaneously, providing potential breakthroughs in understanding and treating ovarian cancer. However, challenges persist in fully grasping the range of genetic alterations and their relevance, especially in sporadic cases, which constitute the majority of ovarian cancer diagnoses. Continued research is essential to refine diagnostic and therapeutic strategies. The molecular diagnosis of ovarian cancer has progressed significantly, transforming the understanding of the disease into distinct subtypes rather than a single condition. Traditional biomarkers, such as CA۱۲۵, have limitations, but proteomic approaches—especially SELDI-TOF—show promise for identifying novel biomarkers. Genetic testing for mutations in BRCA۱, BRCA۲, and DNA repair genes can detect hereditary cases, which represent a small percentage of ovarian cancers. In type I epithelial ovarian cancers, profiling mutations in genes like KRAS, NRAS, and BRAF is critical for diagnosis and therapeutic decision-making. Integrating molecular diagnostics with morphological data is increasingly essential for accurate diagnosis and the development of personalized treatment strategies in ovarian cancer care.

کلیدواژه ها:

Ovary ، Cancer ، Molecular Diagnosis ، Biomarkers