Mutation in Fallopian Tube Lesions May Help Catch Ovarian Cancer Years Earlier

Source: University of Pennsylvania School of Medicine

Summary: A new study suggests, screening the fallopian tubes of women for tumor cells at high risk for ovarian cancer may help to detect cancer and its further development years earlier.

Previous research has shown that Ovarian cancer can begin in the fallopian tubes and from there moves to the ovaries where it is diagnosed clinically. But it was unclear how and when these cancers develop or detecting them before their progression to the ovaries. The new study by the researchers at University of Pennsylvania School of Medicine suggests and traces the origins of high-grade serous ovarian carcinoma (HGSOC) – the most common type cancer with a poor outcome. HGSOC is often diagnosed in the advanced stages as it shows no symptoms are mild symptoms. The fallopian tube lesions called the p53 signatures and serous tubal intraepithelial carcinomas (STICs) that harbor the TP53 gene mutations leading to ovarian cancer. The study was published in the journal Nature Communications.

High-grade serous ovarian carcinoma

                       CREDIT: University of Pennsylvania School of Medicine

The average time for the progression of STICs to ovarian cancer which was analyzed in 5 patients was 6.5 years with the spread of cancer to other areas quickly thereafter. Both tube lesion and ovarian tumors of the patients showed same TP53 gene mutations, all of whom carried other high-risk mutations – BRCA (BRCA 1 and BRCA2 gene mutations) and PTEN (Phosphatase and tensin homolog protein encoded by PTEN gene). The study supports the recommendation for BRCA carriers and non-carrier to remove fallopian tubes instead of ovaries to reduce the risk significantly as it eliminates the precursors of ovarian cancer and preservation of ovaries for long-term benefits, especially in younger women. The insights provide new approaches for screening, given the limited therapeutic option currently available for ovarian cancer.

Ass. Prof. Ronny Drapkin, “These results represent an important step forward that helps fills a knowledge gap on the evolution of this cancer” “More studies with a larger cohort of patients are needed to better understand these lesions and the progression into ovarian cancer, but this latest one suggests that examination of the fallopian tubes should become common practice in pathology, and not confined to just academic centers.”

More Information: S. Intidhar Labidi-Galy et al. “High grade serous ovarian carcinomas originate in the fallopian tube”, Nature Communications, (2017). DOI: 10.1038/s41467-017-00962-1

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