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Table 1 FF factors and their role in follicle development and cancer pathogenesis

From: The hormonal composition of follicular fluid and its implications for ovarian cancer pathogenesis

Factor Role in follicle development Potential role in pathogenesis Mouse knockout model effect
Estradiol Follicle development (specifically mid-follicular to pre-ovulatory phases) [28, 29] Direct proliferatory effect [32], free radical generation [32], epidemiological risk factor for breast and uterine cancers [30] Failure to develop mature follicles [28]
Progesterone End stage follicle development [28, 29] Progestin containing oral contraceptives decrease ovarian cancer risk [41] Failure to ovulate [28]
Androgens Stimulates early follicle development [28] Unknown Decrease in fertility, granulosa cell number [28]
FSH Stimulation of primordial follicles, dominant follicle selection [45] Hormonal regulator of estrogen, progestrone, testosterone, FSH and its signaling pathways highly expressed in OVCAR cell lines [46, 51] Failure to ovulate, failure of primordial follicles to mature [46]
AMH Inhibits primordial follicle growth [56]. Promotes growth and differentiation [54], elevated in granulosa cell tumors [62]. Unlikely player in HGSOC as matched controls have no difference in serum AMH, no correlation to stage or prognosis [63] Fertile but with shorter period of fertility [56]
LH Supports thecal steroidogenesis, induces ovulation and corpus luteum formation [64] Promotes angiogenesis in EOC through PI3K/AKT-mTOR pathway, inhibits apoptosis and cisplatin mediated apoptosis in EOC [69, 70] Atrophied ovaries, hypogonadism, malformed antral follicles, no corpus lutea [66]