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Cited by 110Ovarian cancer diagnosis and treatmentBRCA gene mutations in cancerIntraperitoneal and Appendiceal Malignancies

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The fallopian tube, “precursor escape” and narrowing the knowledge gap to the origins of high-grade serous carcinoma

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Soong, Thing Rinda, Howitt, Brooke E., Horowitz, Neil, Nucci, Marisa R., Crum, Christopher P.·2019·Gynecologic Oncology
DOI 10.1016/j.ygyno.2018.11.033
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Abstract

Most ovarian carcinomas are high-grade serous carcinomas (HGSC) that contain TP53 mutations, present at advanced stage, and eventually become resistant to chemotherapy. The rapid evolution of this disease has been attributed to an origin in the distal fallopian tube, in the form of serous tubal intraepithelial carcinomas (STICs). This has led to a disease model where malignancy develops first in the tube and spreads to the peritoneum or regional lymph nodes. However, although most early or incidentally discovered HGSCs manifest in the tube with STICs, many advanced HGSCs are not accompanied by a malignancy in the fimbria. To resolve this paradox, the focus has shifted to earlier, premalignant serous proliferations (ESPs) in the tubes, which lack the cytomorphologic features of malignancy but contain TP53 mutations. These have been termed p53 signatures or serous tubal intraepithelial lesions (STILs). Although they have not been presumed to have cancer-causing potential by themselves, some ESPs have recently been shown to share identical TP53 mutations with concurrent HGSCs, indicating a shared lineage between these early mucosal changes and metastatic malignancy. This discovery supports a paradigm by which HGSCs can emerge not only from STICs but also from exfoliated precursor cells (precursor escape) that eventually undergo malignant transformation within the peritoneal cavity. This paradigm unifies both localized and widespread HGSCs to a visible pre-existing cellular alter…

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Metadata

Authors
Soong, T. R., Howitt, B. E., Horowitz, N., Nucci, M. R., & Crum, C. P.
Affiliations
  • University of Washington Medical Center (US)
  • Stanford Medicine (US)
  • Brigham and Women's Hospital (US)
ORCID
Venue
Gynecologic Oncology
Publisher
Elsevier BV
Published
2019-02
Volume
152
Issue
2
Pages
426-433
ISSN
0090-8258 (ISSN-L)
DOI
10.1016/j.ygyno.2018.11.033
OpenAlex
W2902728878
Cited by
110
References
0
Citations by year
2026: 7 · 2025: 10 · 2024: 17 · 2023: 16 · 2022: 18 · 2021: 15 · 2020: 20 · 2019: 7
FWCI
1.58
Type
journal article
Language
en
Open access
Licence
Locations
  • Gynecologic Oncology (acceptedVersion)
  • PubMed (publishedVersion)
Funders
Department of Defense (OC130500)
Topics
  • Health Sciences › Medicine › Oncology › Ovarian cancer diagnosis and treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
  • Health Sciences › Medicine › Surgery › Intraperitoneal and Appendiceal Malignancies
Keywords
high-grade serous carcinoma, oviduct, serous tubal intraepithelial carcinoma, TP53 mutation, tumor origin, malignant transformation, peritoneal carcinomatosis, ovarian cancer
MeSH terms
Carcinoma in Situ, Fallopian Tube Neoplasms, Female, Humans, Mutation, Genes, p53, Tumor Suppressor Protein p53, Cystadenocarcinoma, Serous, Neoplasm Grading

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