The Origin of Ovarian Cancer Species and Precancerous Landscape.

The Origin of Ovarian Cancer Species and Precancerous Landscape. Am J Pathol. 2020 Oct 01;: Authors: Shih IM, Wang Y, Wang TL Abstract Unlike other human cancers, in which all primary tumors arise de novo, ovarian epithelial cancers are primarily imported from either endometrial or fallopian tube epithelium. The prevailing paradigm in the genesis of high-grade serous carcinoma (HGSC), the most common ovarian cancer, posits development in fallopian tubes through stepwise tumor progression. In recent years, progress has been made not only in gathering terabytes of omics data but also in detailing the histologic-molecular correlations required to look into and make sense of the tissue origin of HGSC. This emerging paradigm is changing many facets of ovarian cancer research and routine gynecology practice. The precancerous landscape in fallopian tubes contains multiple concurrent precursor lesions including serous tubal intraepithelial carcinoma (STIC), with genetic heterogeneity providing a platform for HGSC evolution. Mathematical models imply that a prolonged time (decades) elapses from appearance of a TP53 mutation, the earliest known molecular alteration, to appearance of a STIC, followed by a shorter span (6 years) for progression to a HGSC. Genetic predisposition accelerates the trajectory, but this time line may allow for early diagnosis of HGSC and STIC, reasonably followed by an intention-to-cure surgery. In this review, we dis...
Source: The American Journal of Pathology - Category: Pathology Authors: Tags: Am J Pathol Source Type: research