Genetics and biology of gynecologic cancer

Gynecologic epithelial tumors can be grouped into two major categories depending on whether they are derived embryologically from squamous epithelium of the urogenital sinus or from müllerian ducts. Ovarian carcinomas appear morphologically similar to those arising in müllerian-derived organs, and molecular genetic defects present in tumors from these different sources appear to reflect more their histologic subtypes than their organ of origin. The possibility that ovarian epithelial tumors arise from remnants of müllerian ducts in the vicinity of the ovary therefore merits further investigation. Recent advances in our understanding of the state of clonality of various gynecologic tumors, of the influence of age and ovulatory activity on their genetic characteristics, and of their overall molecular genetic features, provide important clues about their initial underlying mechanisms. Novel strategies based on these advances are being tested for their potential utility in treating and monitoring gynecologic tumors.