Figures & data
Figure 1 Scheme of possible involvement in the development of endometriosis-associated ovarian cancer. Based on the observations discussed we propose that hemoglobin-, heme-, and iron-induced oxidative stress and antioxidants are two significant factors that overlap and presumably exacerbate each other in endometriosis-associated ovarian carcinogenesis. Hemoglobin, heme, and iron associated with oxidative stress can initially induce DNA damage, genomic instability, mutations, and aberrant pro-tumorigenic signaling. High ROS levels are toxic to cells, induce cell death, and potentially block tumorigenesis. To balance oxidative stress, macrophages increase their antioxidant capacity, which strongly suggests that a sublethal level of ROS plays a causal role in cancer progression. We propose the two-step theory for the scheme of possible involvement in the development of endometriosis-associated ovarian cancer. Abbreviations: Hb, hemoglobin; Hp, haptoglobin; HO-1, heme oxygenase-1; CO, carbon monoxide; Nrf2, nuclear factor, erythroid 2; ROS, reactive oxygen species.
