Epidemiologic, clinical, molecular and translational research findings support an interrelationship between Chlamydia trachomatis, pelvic inflammatory disease (PID), and epithelial ovarian cancer (EOC). Overall, the link between C. trachomatis, PID, and EOC seems to be relatively weak, although nondifferential misclassification bias may have attenuated the results. The predominant tubal origin of EOC and the role of chronic inflammation in tumorigenesis suggest that the association is biologically plausible. Thus, C. trachomatis and PID may represent potential risk factors or risk markers for EOC. However, many steps in this chain of events are still poorly understood and need to be addressed in future studies. Research gaps include time of exposure in relation to the long-term consequences and lag time to EOC. Data of differential risk for EOC between chlamydial and nonchlamydial PID is also needed. Another major research gap has been the absence of high-performance biomarkers for C. trachomatis, PID, and EOC, as well as EOC precursors. Biomarkers for C. trachomatis and PID leading to increased risk of EOC should be developed. If the association is confirmed, C. trachomatis and PID prevention efforts may play a role in reducing the burden of EOC.

中文翻译：

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沙眼衣原体、盆腔炎和上皮性卵巢癌

流行病学、临床、分子和转化研究结果支持沙眼衣原体、盆腔炎 (PID) 和上皮性卵巢癌 (EOC) 之间的相互关系。总体而言，沙眼衣原体、PID 和 EOC 之间的联系似乎相对较弱，尽管非差异性错误分类偏差可能会削弱结果。EOC 的主要输卵管起源和慢性炎症在肿瘤发生中的作用表明这种关联在生物学上是合理的。因此，沙眼衣原体和 PID 可能代表 EOC 的潜在风险因素或风险标志物。然而，这一系列事件中的许多步骤仍然知之甚少，需要在未来的研究中加以解决。研究差距包括与长期后果相关的暴露时间和 EOC 的滞后时间。还需要衣原体和非衣原体 PID 的 EOC 风险差异数据。另一个主要的研究空白是缺乏针对沙眼衣原体、PID 和 EOC 以及 EOC 前体的高性能生物标志物。应开发导致 EOC 风险增加的沙眼衣原体和 PID 的生物标志物。如果这种关联得到证实，沙眼衣原体和 PID 预防工作可能在减轻 EOC 负担方面发挥作用。