Tubal and ovarian pathways to pelvic epithelial cancer: A pathological perspective

E. A. Jarboe, A. K. Folkins, R. Drapkin, T. A. Ince, E. S. Agoston, C. P. Crum

Research output: Contribution to journalReview article

80 Scopus citations

Abstract

Prolongation of ovarian epithelial cancer survival depends on early detection or improved responses to chemotherapy. Gains in either have been modest at best. Understanding the diverse pathogenesis of this disease is critical to early intervention or prevention. This review addresses six important variables, including (i) cell of origin, (ii) site of origin, (iii) initial genotoxic events, (iv) risks imposed by hereditary and other promoting conditions, (v) subsequent factors that promote different patterns of metastatic spread, and (vi) prospects for intervention. This review proposes two distinct pathways to pelvic epithelial cancer. The first initiates in ovarian surface epithelium (OSE), Mullerian inclusions or endometriosis in the ovary. The second arises from the endosalpinx and encompasses a subset of serous carcinomas. The serous carcinogenic sequence in the distal fallopian tube is described and contrasted with lower grade serous tumors based on tumour location, earliest genetic change and ability (or lack of) to undergo terminal (ciliated) differentiation. Ultimately, a clear understanding of tumour origin and the mechanism(s) leading to the earliest phases of the serous and endometrioid carcinogenic sequences may hold the greatest promise for designing prevention strategies and/or developing new therapies.

Original languageEnglish (US)
Pages (from-to)127-138
Number of pages12
JournalHistopathology
Volume53
Issue number2
DOIs
StatePublished - Aug 2008

Keywords

  • Breast cancer gene
  • Ovarian neoplasms
  • Serous carcinoma
  • Tubal intraepithelial carcinoma
  • Tubal neoplasms

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Cell Biology

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