Associations of Lipid Metabolism Abnormalities and Obesity With Endometriosis-Associated Ovarian Cancer

To investigate the differences in lipid metabolism and obesity between patients with ovarian endometrioid carcinoma (OEC) and ovarian clear cell carcinoma (OCCC), both of which are classified as endometriosis-associated Type I ovarian cancers.

This retrospective study included 133 patients who underwent surgery for OEC (n = 50) or OCCC (n = 83) between 2010 and 2022. Preoperative serum lipid markers (total cholesterol [TC], low-density lipoprotein cholesterol [LDL-C], and high-density lipoprotein cholesterol [HDL-C]) and body mass index (BMI) were compared between the two groups. Associations with menopausal status and disease stage were examined, and independent predictors were evaluated by multivariate logistic regression.

Patients with OEC had significantly higher TC (215 vs. 199.5 mg/dL, p = 0.040), LDL-C (139 vs. 120.6 mg/dL, p = 0.026), and BMI (22.1 vs. 20.4 kg/m², p = 0.020) compared with those with OCCC. No significant differences were observed for HDL-C. In premenopausal women, TC and LDL-C were significantly higher in patients with OEC, whereas no intergroup differences were found in postmenopausal women. Among patients with OEC, those with advanced-stage disease had higher TC and LDL-C, whereas no stage-related differences were observed in patients with OCCC. Multivariate analysis identified BMI and LDL-C as independent factors associated with OEC.

Lipid metabolism abnormalities and obesity were more strongly associated with OEC than with OCCC, suggesting subtype-specific metabolic mechanisms of carcinogenesis and progression. These findings highlight the importance of metabolic factors in OEC, warranting further prospective studies.