Early Serous Proliferations in Fallopian Tube and Advanced High-Grade Ovarian Cancer
Posted: Tuesday, September 4, 2018
Researchers have found that “normal”-appearing Fallopian tubes from some women with metastatic high-grade serous carcinomas actually contain early serous proliferations that share identical TP53 mutations with the metastatic tumors. The study, reported in The Journal of Pathology, reportedly is the first to identify a lineage between early serous proliferations in the distal tube and disseminated high-grade serous carcinomas via a site-specific mutation.
The study “supports a novel serous carcinogenic sequence in which an early serous proliferation could eventually culminate in a metastatic serous cancer via ‘precursor escape’ and would explain the apparent sudden onset of cancers without coexisting intraepithelial carcinomas,” stated Thing Rinda Soong, MD, PhD, MPH, of Brigham and Women’s Hospital, Boston, and colleagues.
In 32 patients with high-grade serous carcinomas, the investigators performed serial sectioning of the fallopian tubes, which had no obvious malignancy involving the endosalpinx. The analysis revealed previously unrecognized intraepithelial carcinomas or high-grade serous carcinomas in 3 patients (9.3%) and early serous proliferations in 13 patients (40.6%). Of the 13 early serous proliferations, 12 contained TP53 mutations, and 9 (75%) shared identical TP53 mutations with the concurrent serous cancer.
“This could tie a very high percentage of high-grade serous carcinomas to the fallopian tube,” stated lead investigator Christopher P. Crum, MD, in a Brigham and Women’s Hospital press release. He concluded that if the study’s findings are validated, “this will be an important advance in our understanding of the pathogenesis of high-grade serous carcinomas, with obvious implications for prevention of this disease.”