Association of high-grade serous ovarian carcinoma with intraepithelial carcinoma of fallopian tube

Vijay Chaudhary, Ranjana Solanki
2016 International Journal of Medical Science and Public Health  
It has now become clear that the biggest obstacle in early detection of ovarian cancer was poor understanding of its pathogenesis. Although many theories have been proposed to describe how the ovarian mesothelium could undergo metaplasia and dysplasia, perhaps the greatest gap in understanding the process of ovarian carcinogenesis from ovarian surface epithelium (OSE) is the recognition of a true precursor lesion of high-grade carcinoma in the ovary. For decades, researchers kept their focus on
more » ... kept their focus on ovary for early detection of high-grade serous ovarian carcinoma; in spite of efforts for its early detection, the overall survival of such cases have not improved much in last 50 years. In recent past, many histopathological studies have provided new evidence that fallopian tube mucosa may be the source of most high-grade serous ovarian carcinomas. The basis for this hypothesis was the finding of a lesion in the fallopian tubes of women with genetic predisposition for ovarian carcinoma, designated as "serous tubal intraepithelial carcinoma" (STIC), which has molecular, Objective: To study the association between ovarian serous carcinoma and STIC. Material and Methods: We studied 44 consecutive cases of epithelial ovarian carcinomas from February 2013 to January 2015, including 29 serous, 12 mucinous, and 3 endometrioid. Complete examination of fallopian tubes from each case was done according to serial sectioning and extensive examination of fimbria (SEEFIM) protocol. All the cases were grouped into high-grade serous (27 cases), and non-high-grade serous (17 cases) groups. Immunostaining for p53 and MIB-1 was done on the sections from ovary and fallopian tube. Results: STIC lesion was identified in fallopian tubes from 10 cases of high-grade serous group (37%) while no STIC was identified in non-high-grade serous group. Eighty percent% of the STIC identified were confined to the fimbria of fallopian tube. Results from both groups were compared using chi square test. A statistically significant association was found between high-grade serous carcinoma group and STIC (P = 0.013). Conclusion: STIC coexists with a significant number of high-grade serous carcinoma cases and further studies are needed to elucidate etiological significance of STIC in high-grade serous carcinoma. KEY WORDS: High grade serous carcinoma (HG-SC), serous tubal intraepithelial carcinoma (STIC), fallopian tube, SEE-FIM. Abstract
doi:10.5455/ijmsph.2016.05052016465 fatcat:r5tixsoy5ng3vjm6n3aiiig274