The fallopian tubes may be the origin site of ovarian cancer


Ovarian cancer is one of the commonest causes of cancer-related mortality among women. The overall survival rate of ovarian cancer has remained low, although numerous efforts have been undertaken to design novel diagnostic and therapeutic methods. Why is ovarian cancer so hard to fight? One reason is that much is unknown about the natural history of the disease.

A recent research has suggested that some serious cases of ovarian cancers originate in the fallopian tubes, the long narrow tubes that connect the ovaries and the uterus. The results were made in 9 cases of ovarian cancer, so larger scale studies are needed to verify the discoveries. A paper describing the research by a multinational team of researchers from Harvard Medical School, Johns Hopkins University School of Medicine (JHUSOM), Personal Genome Diagnostics, the University of Pennsylvania Perelman School of Medicine in the USA, Geneva University Hospital in Switzerland, and Hamamatsu University School of Medicine in Japan, appears online 23 Oct. 2017 in the journal Nature Communications.

According to Dr. Victor Velculescu, a corresponding author of the study and a professor of oncology at JHUSOM, if future research confirms that most ovarian cancers arise in the fallopian tubes, it will revolutionize the management of this disease.

Dr. Velculescu is known for his great genomic discoveries in human cancer. In the new study, his team analyzed tissue samples from 9 patients with high-grade serous ovarian carcinoma (HGSOC), the most frequent ovarian cancer type that often correlates with poor prognosis. Exome-wide sequencing and structural analyses of the samples indicated that ovarian cancer is a disease of the fallopian tubes, and the development of p53 signatures and serous tubal intraepithelial carcinomas (STICs) are early events in ovarian cancer. It appeared that a combination of tumor-specific alterations in genes like TP53, BRCA1, BRCA2 and PTEN is needed for the initiation of STICs.

Although the study has potential limitations, it would have profound implications for the prevention, diagnosis, and treatment of ovarian cancer, the researchers concluded.
 
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