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Ovarian Epithelial Tumors Traced to Fallopian Tubes

  • Posted: 04/30/2008

Adapted from the NCI Cancer Bulletin 1.

Researchers at Dana-Farber Cancer Institute in Boston, Mass., have found that the source of disease in many cases of the most aggressive form of ovarian cancer, serous carcinoma, may not be the ovary at all, but rather the fimbria of the fallopian tube. Dr. Keren Levanon reported these findings at the American Association for Cancer Research annual meeting on April 14, 2008.

"Until now, there was no understanding of the basic pathogenesis or carcinogenesis of [ovarian] serous carcinoma," said Dr. Levanon at the meeting. Noting that the majority of ovarian cancers are diagnosed at an advanced stage, she continued: "We didn't really know what the early cancer lesion or precursor lesion looks like, so we couldn't analyze what went wrong."

Her team, which included collaborators at Brigham and Women's Hospital, searched for these early lesions by identifying cells with a "p53 signature" - mutations in the p53 gene and buildup of p53 protein in cells - in the tissues of women who, due to a high risk for developing ovarian and other cancers, volunteered to have their ovaries and fallopian tubes removed.

The team found a p53 signature most often in the secretory cells lining the finger-like appendages, called fimbria, at the ends of fallopian tubes. Dr. Levanon's team then developed an ex vivo model that they are using to continue studying these cells and the molecular events that lead to cancer. They hope this research will lead to targeted therapies and biomarkers for early detection.

Though they were surprised by their findings, explained Dr. Levanon, they were not surprised that ovarian cancer could begin in the fallopian tubes. "When we look at patients who are diagnosed with later-stage ovarian cancer," she said, "we find that they have these lesions in their fallopian tubes in close to 100 percent of cases." She also noted that patients who have prophylactic surgery to remove their ovaries sometimes develop tumors in other parts of their abdomen, which could result from shed cancer cells when the fallopian tubes are left intact.

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Glossary Terms

abdomen (AB-doh-men)
The area of the body that contains the pancreas, stomach, intestines, liver, gallbladder, and other organs.
biomarker (BY-oh-MAR-ker)
A biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition. Also called molecular marker and signature molecule.
carcinogenesis (KAR-sih-noh-JEH-neh-sis)
The process by which normal cells are transformed into cancer cells.
ex vivo (ex VEE-voh)
Outside of the living body. Refers to a medical procedure in which an organ, cells, or tissue are taken from a living body for a treatment or procedure, and then returned to the living body.
fallopian tube (fuh-LOH-pee-in...)
A slender tube through which eggs pass from an ovary to the uterus. In the female reproductive tract, there is one ovary and one fallopian tube on each side of the uterus.
lesion (LEE-zhun)
An area of abnormal tissue. A lesion may be benign (not cancer) or malignant (cancer).
mutation (myoo-TAY-shun)
Any change in the DNA of a cell. Mutations may be caused by mistakes during cell division, or they may be caused by exposure to DNA-damaging agents in the environment. Mutations can be harmful, beneficial, or have no effect. If they occur in cells that make eggs or sperm, they can be inherited; if mutations occur in other types of cells, they are not inherited. Certain mutations may lead to cancer or other diseases.
ovary (OH-vuh-ree)
One of a pair of female reproductive glands in which the ova, or eggs, are formed. The ovaries are located in the pelvis, one on each side of the uterus.
p53 gene (… jeen)
A tumor suppressor gene that normally inhibits the growth of tumors. This gene is altered in many types of cancer.
prophylactic surgery (PROH-fih-LAK-tik SER-juh-ree)
Surgery to remove an organ or gland that shows no signs of cancer, in an attempt to prevent development of cancer of that organ or gland. Prophylactic surgery is sometimes chosen by people who know they are at high risk for developing cancer.
targeted therapy (TAR-geh-ted THAYR-uh-pee)
A type of treatment that uses drugs or other substances, such as monoclonal antibodies, to identify and attack specific cancer cells. Targeted therapy may have fewer side effects than other types of cancer treatments.

Table of Links

1http://www.cancer.gov/ncicancerbulletin
2http://www.cancer.gov/cancertopics/types/ovarian