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DOI: 10.1055/s-2002-35974
Georg Thieme Verlag Stuttgart · New York
Ein multifaktorielles Modell zur Ätiologie des Ovarialkarzinoms
A Multifactorial Model for Ovarian Cancer EtiologyPublication History
Eingang Manuskript: 12. April 2002
Eingang revidiertes Manuskript: 9. September 2002
Akzeptiert: 20. September 2002
Publication Date:
05 December 2002 (online)
![](https://www.thieme-connect.de/media/gebfra/200211/lookinside/thumbnails/10.1055-s-2002-35974-1.jpg)
Zusammenfassung
Für das Ovarialkarzinom (OK), die fünfthäufigste Krebserkrankung der Frau, ist eine Reihe verschiedener Risikofaktoren identifiziert worden. Diese führten zu drei unterschiedlichen Entstehungsmodellen, der Hyperovulations-, der Gonadotropin- und der Entzündungshypothese. Alle Modelle werden dabei unabhängig voneinander diskutiert. Erklärungsansätze aus dem Bereich der Psychoneuroimmunologie und -endokrinologie blieben bisher unberücksichtigt. In dem vorliegenden Artikel werden die unterschiedlichen Vorstellungen in ein dreidimensionales Prozessmodell (3DPOK-Modell) integriert, welches spezifische und generelle Risikofaktoren sowie unterschiedliche Ebenen kausaler Bedingungsfaktoren und den Verlauf der Erkrankung berücksichtigt. Das 3DPOK-Modell verbindet somit unterschiedliche Forschungsrichtungen zur Ätiologie des OK, setzt Variablen der Prävention, Behandlung und Nachsorge in eine mögliche Beziehung und erlaubt die zielgerichtete Generierung von Hypothesen für die weitere Forschung.
Abstract
The three major hypotheses that have been formulated to explain the etiology of ovarian cancer are the incessant ovulation hypothesis, the gonadotropin hypothesis, and the inflammation hypothesis. All models were formulated without reference to the others or to psychoneuroimmunologic approaches and psychoneuroendocrinology. We integrated the three hypotheses regarding the pathogenesis of ovarian cancer into a three-dimensional process model (3DPOK model). This model takes into account specific and general risk factors, and the concepts mentioned above. The model combines the different approaches to the etiology of ovarian cancer and illustrates possible relationships between the variables of prevention, treatment and follow-up. It may facilitate the generation of hypotheses for further research.
Schlüsselwörter
Ovarialkarzinom - Ätiologie - Entstehungsmodell - Prognose - 3DPOK-Modell
Key words
Ovarian carcinoma - etiology - hypothesis - prognosis - 3DPOK model
Literatur
- 1 Ader R, Cohen N, Felton D. Psychoneuroimmunology: interactions between the nervous system and the immune system. Lancet. 1995; 345 99-103
- 2 Akhmedkhanov A A, Toniolo P, Zeleniuch-Jacquotte A, Kato I, Koenig K L, Shore R E. Aspirin and risk of epithelial cancer. 32nd Annual Meeting of the Society of Gynecologic Oncologist (SGO). Nashville, Tennessee March 3 - 7, 2001.
- 3 Alagoz T, Buller R E, Berman M, Anderson B, Manetta A, DiSaia P. What is a normal CA125 level?. Gynecol Oncol. 1994; 53 93-97
- 4 Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland .Krebs in Deutschland. 3. erweiterte, aktualisierte Ausgabe. Saarbrücken; Arbeitsgemeinschaft Bevölkerungsbezogener Krebsregister in Deutschland 2002
- 5 Auersperg N, Wong A ST, Choi K-C, Kang S K, Leung P CK. Ovarian surface epithelium: biology, endocrinology and pathology. Endocr Rev. 2001; 22 255-289
- 6 Balkwill F R. Re: Possible role of ovarian epithelial inflammation in ovarian cancer. J Natl Cancer I. 2000; 92 162-163
- 7 Berchuk A, Carney M. Human ovarian cancer of the surface epithelium. Biochem Pharmacol. 1997; 54 541-544
- 8 Bergquist A, Bruse C, Carlberg M, Carlström K. Interleukin 1β, interleukin-6, and tumor necrosis factor-a in endometriotic tissue and in endometrium. Fertil Steril. 2001; 75 489-495
-
9 Biondi M.
Effects of stress on immune function: an overview. Ader E, Felten DL, Cohen N Psychoneuroimmunology. Vol. 2. 3rd ed. San Diego, San Francisco, New York, Boston, London, Sydney, Tokyo; Academic Press 2001: 189-226 - 10 Biondi M, Picardi A. Psychological stress and neuroendocrine function in humans: the last two decades of research. Psychother Psychosom. 1999; 68 114-150
-
11 Brinton L A, Hoover R N.
Epidemiology of gynecologic cancers. Hoskins WJ, Perez CA, Young RC Principles and Practice of Gynecologic Oncology. Philadelphia; Lippincott-Raven 1997: 3-29 - 12 Buller R E, Skilling J S, Sood A A, Plaxe S, Baergen R N, Lager D J. Field cancerization: why late “recurrent” ovarian cancer is not recurrent. Am J Obstet Gynecol. 1998; 178 641-649
- 13 Butow P N, Hiller J E, Price M A, Thackway S V, Kricker A, Tennat C C. Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer. J Psychosom Res. 2000; 49 169-181
- 14 Casagrande J T, Louie E W, Pike M C, Ross R K, Henderson B E. “Incessant ovulation” and ovarian cancer. Lancet. 1979; 2 170-173
- 15 Cella D F, Orav E J, Kornblith A B. et al . Socioeconomic status and cancer survival. J Clin Oncol. 1991; 9 1500-1509
- 16 Chakravarti S, Collins W P, Forecast J D, Newton J R, Oram D H, Studd J W. Hormonal profiles after the menopause. Brit Med J. 1976; 2 784-787
- 17 Chan Y M, Ngan H YS, Yip P SF, Li B YG, Lau O WK, Tang G WK. Psychosocial adjustment in gynecologic cancer survivors: a longitudinal study on risk factors for maladjustment. Gynecol Oncol. 2001; 80 387-394
- 18 Chiaffarino F, Parazzini F, Negri E. et al . Time since last birth and the risk of ovarian cancer. Gynecol Oncol. 2001; 81 233-236
- 19 Cohen S, Williamson G M. Stress and infectious disease in humans. Psychol Bull. 1991; 109 5-24
- 20 Conte D, Romanelli F, Fillo S. et al . Aspirin inhibits androgen response to chorionic gonadotropin in humans. Am J Physiol-Endoc M. 1999; 277 E1032-E1037
- 21 Cramer D W, Harlow B L, Titus-Ernstoff L, Bohlke K, Welch W R, Greenberg E R. Over-the-counter analgesics and risk of ovarian cancer. Lancet. 1998; 351 104-107
- 22 Cramer D W, Welch W R, Hutchison G B, Willett W, Scully R E. Dietary animal fat in relation to ovarian cancer risk. Obstet Gynecol. 1984; 63 833-838
- 23 Cramer D W, Welch W R. Determinants of ovarian cancer risk. II. Inferences regarding pathogenesis. J Natl Cancer I. 1983; 71 717-721
- 24 Dantzer R, Kelley K W. Stress and immunity: an integrated view of relationships between the brain and the immune system. Life Sci. 1989; 44 1995-2008
- 25 de la Fuente J R, Rosenbaum A H. Psychoneuroendocrinology. Mayo Clin Proc. 1979; 54 109-118
- 26 Del Priore G, Robischon K, Phipps W R. et al . Risk of ovarian cancer after treatment for infertility. N Engl J Med. 1995; 332 1300-1302
- 27 Eccles D M, Cranston G, Steel C M, Nakamura Y, Leonard R CF. Allele losses on chromosome 17 in human epithelial ovarian carcinoma. Oncogene. 1990; 5 1599-1601
- 28 Ellsworth L R, Allen H H, Nisker J A. Ovarian function after radical hysterectomy for stage Ib carcinoma of the cervix. Am J Obstet Gynecol. 1983; 145 185
- 29 Erzen M, Rakar S, Klancar B, Syrjänen S. Endometriosis-associated ovarian carcinoma (EAOC): an entity distinct from other ovarian carcinomas as suggested by a nested case-control study. Gynecol Oncol. 2001; 83 100-108
- 30 Eysenck H J. The biological basis of personality. Springfield, Illinois; Charles C. Thomas 1967
- 31 Eysenck H J. Sexualität und Persönlichkeit. Wien; Europaverlag 1977
- 32 Eysenck H J. The respective importance of personality, cigarette smoking and interaction effects for the genesis of cancer and coronary heart disease. Pers Indiv Differ. 1988; 9 453-464
-
33 Eysenck H J.
Personality and cancer. Cooper CL Handbook of Stress, Medicine, and Health. Volume 10. Boca Raton; CRC Press 1996: 193-215 - 34 Eysenck H J, Eysenck M W. Personality and individual differences. A natural science approach. New York, London; Plenum Press 1985
- 35 Eysenck H J, Eysenck S BG. Psychoticism as a dimension of personality. London, Sydney, Auckland, Toronto; Hodder Stroughton 1976
- 36 Faller H. Krankheitsbewältigung und Überlebenszeit bei Krebskranken. Psychotherapeut. 2001; 46 20-35
- 37 Fathalla M F. Incessant ovulation - A factor in ovarian neoplasia?. Lancet. 1971; 2 163
- 38 Frank T S. Testing for hereditary risk of breast and ovarian cancer. Community Genet. 2000; 3 193-197
- 39 Frentzel-Beyme R, Grossarth-Maticek R. The interaction between risk factors and self-regulation in the development of chronic diseases. Int J Hyg Environ Health. 2001; 204 81-88
- 40 Friedlander M L. Prognostic factors in ovarian cancer. Semin Oncol. 1998; 25 305-314
- 41 Fujimoto J, Hirose R, Sakaguchi H, Tamaya T. Clinical significance of expression of estrogen receptor α and β mRNAs in ovarian cancers. Oncology. 2000; 58 334-341
- 42 Gertig D M, Hunter D J, Cramer D W. et al . Prospective study of talc use and ovarian cancer. J Natl Cancer I. 2000; 92 249-252
- 43 Goldberg J M, Piver M S, Jishi M F, Blumenson L. Age at onset of ovarian cancer in woman with a strong family history of ovarian cancer. Gynecol Oncol. 1997; 66 3-9
- 44 Green A, Purdie D, Bain C, Siskind V, Webb P M. Cigarette smoking and risk of epithelial ovarian cancer (Australia). Cancer Cause Control. 2001; 12 713-719
- 45 Greenlee R T, Hill-Harmon M B, Murray T, Thun M. Cancer statistics, 2001. CA-Cancer J Clin. 2001; 51 15-36
- 46 Greggi S, Parazzini F, Paratore P P. et al . Risk factors for ovarian cancer in central Italy. Gynecol Oncol. 2000; 79 50-54
- 47 Grossarth-Maticek R, Eysenck H J, Heeb J, Costa S D, Diel I J. Interactions of psychosocial and physical risk factors in the causation of mammary cancer, and its prevention through psychological methods of treatment. J Clin Psychol. 2000; 56 33-50
- 48 Gwin M L, Lee N, Rhodes P H, Layde P M, Rubin G. Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer. J Clin Epidemiol. 1989; 43 559-568
- 49 Haberland J, Bertz J, Görsch B, Schön D. Krebsinzidenzschätzung für Deutschland mittels log-linearer Modelle. Gesundheitswesen. 2001; 63 556-560
- 50 Harlap S, Olson S, Akhmedkhanov A. et al . Epithelial ovarian carcinoma and European birthplace of grandparents. Gynecol Oncol. 2001; 81 25-32
- 51 Harlow B L, Hartge P A. A review of perineal talc exposure and risk of ovarian cancer. Regul Toxicol Pharm. 1995; 21 254-260
- 52 Harris R, Whittemore A S, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. III. Epithelial tumors of low malignant potential in white woman. Collaborative ovarian cancer group. Am J Epidemiol. 1992; 136 1204-1211
- 53 Jimbo H, Yoshikawa H, Onda T, Yasugi T, Sakamoto A, Taketani Y. Prevalence of ovarian endometriois in epithelial ovarian cancer. Int J Gynecol Obstet. 1997; 59 245-250
- 54 Katsnis W A, Shields L BE, Spinnato J A, Gercel-Taylor C, Taylor D D. Immune recognition of endometrial tumor antigens induced by multiparity. Gynecol Oncol. 1998; 70 33-39
- 55 Kavan M G, Engdahl B E, Kay S. Colon cancer: personality factors predictive of onset and stage of presentation. J Psychosom Res. 1995; 39 1031-1039
- 56 Konishi I, Kuroda H, Mandai M. Review: Gonadotropins and development of ovarian cancer. Oncology. 1999; 57 45-48
- 57 Kreitler S, Levavi H, Bornstein G. Personality factors and cervical premalignancy. Pers indiv Differ. 1996; 21 883-890
- 58 Kurihara T, Mizunuma H, Obara M, Andoh K, Ibuki Y, Nishimura T. Determination of a normal level of serum CA125 in postmenopausal women as a tool for preoperative evaluation and postoperative surveillance of endometrial carcinoma. Gynecol Oncol. 1998; 69 192-196
- 59 Langdon S P, Smyth J F. Growth factors and ovarian cancer. Endocr Relat Cancer. 1998; 5 283-291
- 60 Lingeman C H. Environmental factors in the etiology of carcinoma of the human ovary: a review. J Ind Med. 1983; 4 365-379
- 61 Löffler G, Petrides P E. Biochemie und Pathobiochemie. 6. korrig. Aufl. Berlin, Heidelberg, New York, Barcelona, Budapest, Hongkong, London, Mailand, Paris, Singapur, Tokio; Springer 1998
- 62 Lu J J, Zheng Y, Kang X. et al . Decreased luteinizing hormone receptor mRNA expression in human ovarian epithelial cancer. Gynecol Oncol. 2000; 79 158-168
- 63 Lynch H T, Schuelke G S, Wells I C, Cheng S C, Kimberling W J, Biscone K A. Hereditary ovarian carcinoma: biomarker studies. Cancer. 1985; 55 410-415
- 64 Maes M, Van Bockstaele D R, Van Gastel A V. et al . The effects of psychological stress on leukocyte subsets distribution in humans: evidence of immune activation. Neuropsychobiology. 1999; 29 1-9
- 65 Makar A P. Hormone therapy in epithelial ovarian cancer. Endocr Relat Cancer. 2000; 7 85-93
- 66 Mandai M, Konishi I, Kuroda H. et al . Messenger ribonucleic acid expression of LH/hCG receptor gene in human ovarian carcinomas. Eur J Cancer. 1997; 33 1501-1507
- 67 Marchbanks P A, Wilson H, Bastos E, Cramer D W, Schildkraut J M, Peterson H B. Cigarette smoking and epithelial ovarian cancer by histologic type. Obstet Gynecol. 1998; 81 283-287
-
68 Marchetti B, Guarcello G, Triolo G, Morale M C, Farinella Z, Scapagnini U.
Luteinizing hormone-releasing hormone (LHRH) as natural messenger in neuro-immune-endocrine communicatio. Hadden JW, Masek K, Nistico G Interactions Among Central Nervous System, Neuroendocrine and Immune System. Rome, Milan; Pythagora Press 1989: 127-145 -
69 Marchetti B, Morale M C, Gallo F. et al .
The hypothalamo-pituitary-gonadal axis and the immune system. Ader E, Felten DL, Cohen N Psychoneuroimmunology. Vol. 1. 3rd ed. San Diego, San Francisco, New York, Boston, London, Sydney, Tokyo; Academic Press 2001: 362-389 -
70 McNeilly A S.
Suckling and the control of gonadotropin secretion. Knobil E, Neill JD The Physiology of Reproduction. Vol. 2. 2nd ed. New York; Raven Press 1994: 1179-1212 - 71 Miyazaki M, Nagy A, Schally A V. et al . Growth inhibition of human ovarian cancers by cytotoxic analogues of luteinizing hormone-releasing hormone. J Natl Cancer I. 1997; 89 1803-1809
- 72 Modan B, Ron E, Lerner-Geva L. et al . Cancer incidence in a cohort of infertile women. Am J Epidemiol. 1998; 147 1038-1042
- 73 Mosgaard B J, Lidegaard O, Krüger Kjaer S. Infertility, fertility drugs, and invasive ovarian cancer: a case-control study. Fertil Steril. 1997; 67 1005-1012
- 74 Mosgaard B J, Lidegaard O, Krüger Kjaer S, Schou G, Andersen A N. Ovarian stimulation and borderline ovarian tumors: a case-control study. Fertil Steril. 1998; 10 1049-1055
- 75 Münstedt K, Steen J, Knauf A G, Buch T, von Georgi R, Franke F E. Steroid hormone receptors and long term survival in invasive ovarian cancer. Cancer. 2000; 89 1783-1791
- 76 Münstedt K, Lange S, Hadji P, von Georgi R. Möglichkeiten der Prävention von Tumorerkrankungen. Frauenarzt. 2001; 42 1083-1097
- 77 Murdoch W J. Proteolytic and cellular death mechanisms in ovulatory ovarian rupture. Biol Signal Recept. 2000; 9 102-114
- 78 Narod A S, Risch H, Moslehi R. et al . Oral contraceptives and the risk of hereditary ovarian cancer. N Engl J Med. 1998; 339 424-428
- 79 Nash M A, Ferrandina G, Gordinier M, Loercher A, Freedman R S. The role of cytokines in both the normal and malignant ovary. Endocr Relat Cancer. 1999; 6 98-107
- 80 Ness R B, Cottreau C. Possible role of ovarian epithelial inflammation in ovarian cancer. J Natl Cancer I. 1999; 91 1459-1467
- 81 O'Leary A. Stress, emotion, and the human immune function. Psychol Bull. 1990; 108 363-382
- 82 Ördög T, Chen M-D, O'Byrne K T. et al . On the mechanism of lactational anovulation in the rhesus monkey. Am J Physiol-Endoc M. 1998; 37 665-676
- 83 Persson I. Estrogens in the causation of breast, endometrial and ovarian cancers - evidence and hypotheses from epidemiological findings. J Steroid Biochem. 2000; 74 357-364
- 84 Peterson C M, Jolles C J, Carrell D T. et al . GnRH agonist therapy in human ovarian epithelial carcinoma (OVCAR-3) heterotransplanted in the nude mouse is characterized by latency and transience. Gynecol Oncol. 1994; 52 26-30
- 85 Pike M C, Spicer D V. Hormonal contraception and chemoprevention of female cancers. Endocr Relat Cancer. 2000; 7 73-83
- 86 Piver M S, Baker T, Piedmonte M, Sandecki A. Epidemiology and etiology of ovarian cancer. Semin Oncol. 1991; 78 177-185
- 87 Potashnik G, Lerner-Geva L, Genkin L, Chetrit A, Lunenfeld E, Porath A. Fertility drugs and the risk of breast and ovarian cancers: results of a long-term follow-up study. Fertil Steril. 1999; 71 853-859
- 88 Ramus S J, Fishman A, Pharoah P D, Yarkoni S, Altaras M, Ponder B A. Ovarian cancer survival in Ashkenazi Jewish patients with BRCA1 and BRCA2 mutations. Eur J Surg Oncol. 2001; 27 278-281
- 89 Redd W H, Montgomery G H, DuHamel K. Behavioral intervention for cancer treatment side effects. J Natl Cancer I. 1001; 93 810-823
- 90 Risch H A. Estrogen replacement therapy and risk of epithelial ovarian cancer. Gynecol Oncol. 1996; 63 254-257
- 91 Risch H A. Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer I. 1998; 90 1774-1786
- 92 Risch H A, Howe G R. Pelvic inflammatory disease and the risk of epithelial ovarian cancer. Cancer Epidem Biomar. 1995; 44 441-451
- 93 Risch H A, Marrett L D, Howe G R. Parity, contraception, infertility and the risk of epithelial ovarian cancer. Am J Epidemiol. 1994; 140 585-597
- 94 Rosenberg L, Palmer J R, Rao R S. et al . A case-control study of analgesic use and ovarian cancer. Cancer Epidem Biomar. 2000; 9 933-937
- 95 Rossing M A, Daling J R, Weiss N S, Moore D E, Self S G. Ovarian tumors in a cohort of infertile women. N Engl J Med. 1994; 331 (22) 771-776
- 96 Runnebaum I B, Stickeler E. Epidemiological and molecular aspects of ovarian cancer risk. J Cancer Res Clin. 2001; 127 73-79
- 97 Sainz de la Cuesta R, Eichhorn J H, Rice L W, Fuller A F, Nikrui N, Goff B A. Histologic transformation of benign endometriosis to early epithelial ovarian cancer. Gynecol Oncol. 1996; 60 238-244
- 98 Schildkraut J M, Bastos E, Berchuck A. Relationship between lifetime ovulatory cycles and overexpression of mutant p53 in epithelial ovarian cancer. J Natl Cancer I. 1997; 89 932-938
- 99 Schildkraut J M, Calingaert B, Marchbanks P A, Moorman P G, Rodriguez G C. Impact of progestin and estrogen potency in oral contraceptives on ovarian cancer risk. J Nat Cancer I. 2002; 94 32-38
- 100 Schmale A H, Iker H. Hopelessness as a predictor of cervical cancer. Soc Sci Med. 1971; 5 95-100
- 101 Schmale A H, Iker H P. The affect of hopelessness and the development of cancer. I. Identification of uterine cervical cancer in woman with atypical cytology. Psychosom Med. 1966; 28 714-721
- 102 Schneider D, Halperin R, Bukovsky I, Hadas E. Prediction of the survival of patients with advanced ovarian cancer according to a risk model based on a scoring system. Eur J Gynaecol Oncol. 1998; 19 547-662
- 103 Schuth W. Zur psychosozialen Situation der Patientin mit ausgedehntem oder fortgeschrittenem Ovarialkarzinom. Onkologie. 1984; 78 6-9
- 104 Sevelda P, Rosen A, Barrada M, Gober S, Vavra N, Salzer H. Ist die Verlaufskontrolle falsch negativer CA-125 Serumwerte in der Tumornachsorge des Ovarialkarzinoms sinnvoll?. Gynaekol Runds. 1990; 30 210-211
- 105 Shields L B, Gercel-Taylor C, Yashar C M. et al . Induction of immune responses to ovarian tumor antigens by multiparity. J Soc Gynecol Invest. 1997; 4 298-304
- 106 Shu X O, Brinton L A, Gao Y T, Yuan J M. Population-based case-control study of ovarian cancer in Shanghai. Cancer Res. 1989; 49 3670-3675
- 107 Shu X O, Gao Y T, Yuan J M. et al . Dietary factors and epithelial ovarian cancer. Brit J Cancer. 1989; 59 92-96
- 108 Shushan A, Paltiel O, Schenker J G. Induction of ovulation and borderline ovarian cancer - the hormonal connection?. Eur J Obstet Gyn R B. 1999; 85 71-74
- 109 Skirnisdottir I, Sorbe B, Seidal T. The growth factor receptors HER-2/neu and EGFR, their relationship, and their effects on the prognosis in early stage (FIGO I-II) epithelial ovarian carcinoma. Int J Gynecol Cancer. 2001; 11 119-129
- 110 Sklar L S, Anisman H. Stress and cancer. Psychol Bull. 1981; 89 369-406
- 111 Tavani A, Gallus S, La Vecchia C, Conti E, Montella M, Franceschi S. Aspirin and ovarian cancer: an Italian case-control study. Ann Oncol. 2000; 11 1171-1173
- 112 Taylor D D, Homesley H D, Doellgast G J. Identification of antigenic components recognized by “membran bound” antibodies from ovarian cancer patients. Am J Reprod Immunol. 1991; 15 369-377
- 113 Umesaki N, Tanaka T, Miyama M, Mizuno K, Kawamura N, Ogita S. Increased natural killer cell activities in patients treated with gonadotropin releasing hormone agonist. Gynecol Obstet Invest. 1999; 48 66-68
- 114 Van den Berghe H, Dal Cin P. Some genetic aspects of ovarian tumors. Eur J Obstet Gyn R B. 1998; 81 283-287
- 115 Van Leeuwen F E, Rookus M A. The role of exogenous hormones in the epidemiology of breast, ovarian and endometrial cancer. Eur J Cancer Clin On. 1989; 25 1961-1972
- 116 Venn A, Watson L, Bruinsma F, Giles G, Healy D. Risk of cancer after use of fertility drugs with in-vitro fertilisation. Lancet. 1999; 354 1586-1590
- 117 Vessey M, Metcalfe A, Wells C, Mcpherson K, Westhoff C, Yeates D. Ovarian neoplasms, functional ovarian cysts, and oral contraceptives. Br Med J. 1987; 294 1518-1520
- 118 von Georgi R, Schubert K, Franke F E, Münstedt K. Auswirkungen soziomedizinischer Risikofaktoren auf den Verlauf des Ovarialkarzinoms. Dtsch Med Wochenschr. 2002; 127 2001-2005
- 119 Webb P M, Bain C J, Purdie D M, Harvey P WJ, Green A. Milk consumption, galactose metabolism and ovarian cancer (Australia). Cancer Cause Control. 1998; 9 637-644
- 120 Weiss N S, Harlow B L. Why does hysterectomy without bilateral oophorectomy influence the subsequent incidence of ovarian cancer?. Am J Epidemiol. 1989; 124 856
- 121 Whiteman D C, Murphy M FG, Cook L S. et al . Multiple births and risk of epithelial ovarian cancer. J Natl Cancer I. 2000; 92 1172-1177
- 122 Whittemore A S, Harris R, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white woman. Collaborative ovarian cancer group. Am J Epidemiol. 1992; 136 1184-1203
- 123 Whittemore A S, Harris R, Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. IV. The pathogenesis of epithelial ovarian cancer. Collaborative ovarian cancer group. Am J Epidemiol. 1992; 136 1212-1220
- 124 Whittemore A S, Harris R, Itnyre J, Halpern J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. I. Methods. Collaborative ovarian cancer group. Am J Epidemiol. 1992; 136 1175-1183
- 125 Wise P M. Neuroendocrine modulation of the “menopause”: insights into the aging brain. Am J Physiol-Endoc M. 1999; 277 965-970
- 126 Wong C, Hempling R E, Piver M S, Natarajan N, Mettlin C J. Perineal talc exposure and subsequent epithelial ovarian cancer: a case-control study. Obstet Gynecol. 1999; 93 372-376
- 127 Wu M L, Whittemore A S, Paffenbarger R S. et al . Personal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive use. Am J Epidemiol. 1988; 128 1216-1227
- 128 Yu H, Rohan T. Role of the insulin-like growth factor family in cancer development and progression. J Natl Cancer I. 2000; 92 1472-1489
- 129 Zheng W, Lu J J, Luo F. et al . Ovarian epithelial tumor growth promotion by follicle-stimulating hormone and inhibition of the effect by luteinizing hormone. Gynecol Oncol. 2000; 76 80-88
- 130 Zuckermann M. Psychobiology of Personality. New York, Port Chester, Melbourne, Sydney; Cambridge University Press 1991
Dr. Richard von Georgi
Abteilung für Medizinische Soziologie, Justus-Liebig-Universität Gießen
Friedrichstraße 24
35392 Gießen
Email: richard.v.georgi@psycho.med.uni-giessen.de