(October 30, 2017) Until recently, it was thought that high-grade serous ovarian carcinomas (HGSOCs) arose from the ovarian surface epithelium, but recent data from two studies published in Nature Communications suggest that all high grade serous ovarian cancers do in fact originate in the fallopian tube. These findings have implications for ovarian cancer detection and prevention.
Using genomic analysis, the first study confirmed that both types of HGSOCs, those with precursor lesions known as serous tubal intra-epithelial carcinoma and those without the precursor lesions, originated in the fallopian tube. “We report that there are no genomic differences between established ovarian cancers with and without precursor lesions suggesting that, from a molecular perspective, these cases are indistinguishable and therefore most of them appear to have the same origin that is likely the fallopian tube,” stated Doug Levine, MD, OCRFA Scientific Advisory Committee Member and senior author at New York University.
The second study traced the origins HGSOC, the most frequent type of ovarian cancer that is often diagnosed at advanced stages, back to fallopian tube lesions known as ‘p53 signatures’ and serous tubal intraepithelial carcinomas (STICs) that harbor the TP53 gene mutations. On average, the timing of the progression from the STICs to ovarian cancer in the five patients analyzed was 6.5 years, with the cancer spreading to other areas quickly thereafter. The same TP53 gene mutations showed up in both the tube lesions and ovarian tumors of the women, all of whom also carried other high-risk mutations, such as BRCA or PTEN.
“These data provide much-needed insights into the etiology of ovarian cancer and have important implications for prevention, early detection and therapeutic intervention of the disease,” said author Ronny Drapkin, MD, PhD, OCRFA Scientific Advisory Committee Member and director of the Penn Ovarian Cancer Research Center. “It points us to a signature in the tubes to look for, and shows us a window of time to spot these cancers before they morph into something more sinister in the ovaries.”