Among malignant tumors of the female reproductive system ovarian cancer (OC) is one of the most complex problems. This is due to the completely obscure its etiology and pathogenesis, the absence of symptoms in the early stages, late diagnosis and the aggressive clinical course of the disease. In 2013 in Ukraine 4190 female patients with ovarian neoplasms have been registered for the first time (17,1 cases per 100 thousand of the female population). Very disturbing is the fact that in our country the lethality of OC patients in the first year after diagnosis was made constitutes 40 %. OC affects women of all age groups, but the largest percentage of cases occurs in the period of sexual maturity and increased gonadotropins stimulation. The incidence of OC has two age peaks of 50–54 years and 65–69 years. The average age of patients is 54 years thus the majority of cases are diagnosed in postmenopausal women. The sharp increase in incidence after the age of 40 is associated mainly with a hormonal imbalance, especially of the pituitary-ovarian system. Mortality due to OC in different countries worldwide, including Ukraine, tends to increase over the past 10 years. In accordance with data of population cancer-registers in the countries of Europe 1-year survival rate of OC patients constitutes 63 %; 3-year – 41 %; 5-year – 35 %.

Several hypotheses exist to explain malignant transformation in the ovaries epithelium,where no genetic predisposition to OC appearance is determined owing to BRCA1 and BRCA2 genes mutation. Hypothesis of ovarian hyperstimulation (incessant ovulation) was suggested by M. F. Fathalla (1971) that is based on OC risk increasing among the women with great number of ovulations. It is assumed that during the ovulations submergence and damage of superficial epithelial cells of ovarium occurs, and subsequent reparative processes in such cells increase a risk of developing mutations with further malignization. Gonadotropic hypothesis, according to which stimulation of ovarian superficial epithelium by follicle-stimulating (FSH) and luteinizing (LH) hormones can increase the risk of its malignization. Hormonal stimulation hypothesis give evidence that progesterone, its derivatives and combined oral contraceptives decrease the risk of OC. States associated with increased androgens level (polycystic ovary syndrome PCOS), enhance the risk of OC. The highest androgens concentration is created inside of growing follicles which makes cells proliferation more intense via the receptor apparatus of superficial epithelium of ovaries. Hypothesis of inflammation shows the etiological significance of inflammation in ovarian carcinogenesis which accompanies each ovulation, resulting in the release of cytokines, and as a consequence – leads to tissue changes, which predisposes the superficial epithelium cells to genetic damage and malignant transformation. The follicledepletion hypothesis predicts that follicle preservation and delaying reproductive ageing might prevent ovarian cancer or decrease the risk of developing this disease, and that menopause timing might correlate with ovarian cancer incidence.

The literature data, including own res earches indicate that Na+,K+-AТPase is involved in the pathogenesis of malignant transformation of ovarian epithelium. The significant decrease of ouabain-sensitive Na+,K+-AТPase enzymatic activity in peripheral blood lymphocytes of patients with ovarian cancer in comparison with the clinically healthy women was observed. It is shown that ouabain and other cardiac glycosides can be used for the development of anticancer drugs as simultaneous inhibitors of Na+,K+-AТPase and antagonists of estrogen receptors.

Keywords: ovarian cancer, risk factors, pathogenesis, Na+, K+-AТPase

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