Secretory cell outgrowths, p53 signatures, and serous tubal intraepithelial carcinoma in the fallopian tubes of patients with sporadic pelvic serous carcinoma.
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Date
2016-10
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Abstract
Context: High‑grade serous carcinomas of ovarian, tubal, and peritoneal origin are
together referred as pelvic serous carcinoma. The fallopian tubes, ovarian surface
epithelium, and the tuboperitoneal junctional epithelium are all implicated in pelvic
serous carcinogenesis. Aims: The aim of this study is to identify putative precursor
lesions of serous carcinoma including secretory cell outgrowths (SCOUTs), serous
tubal intraepithelial carcinoma (STIC), and p53 signatures and assign its probable
site of origin. Settings and Design: Prospective case–control study of consecutive
specimen comprising 32 serous carcinomas and 31 controls (10 normal adnexa,
10 benign and 6 atypically proliferative surface epithelial tumors, and 5 other
carcinomas). Subjects and Methods: Sectioning and extensive examination of
the fimbrial end (SEE‑FIM) protocol along with immunohistochemistry for Bcl‑2,
p53, and Ki‑67 was employed for evaluating invasive carcinoma and precursor
lesions in cases versus controls. Results: SCOUT, p53 signatures, and STIC
were most frequent in the serous carcinomas. p53 signatures and STIC were
always seen in the fimbrial end. STICs were exclusively present in serous
carcinomas, more common in ipsilateral tubes of cases with dominant ovarian
mass. Multifocal p53 signatures with STIC were seen in 7 (21.9%) cases. STIC
was present with or without an invasive carcinoma in 25% and in 6.25% of cases
of pelvic serous carcinomas, respectively. The junctional epithelia did not show
any lesion in any group. Conclusions: SEE‑FIM protocol is recommended for
evaluation of sporadicpelvic (ovarian/tubal/peritoneal) serous carcinoma. Based
on the presence of STIC or invasive carcinoma, nearly 60% of all pelvic serous
carcinomas are of fallopian tubal origin.
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Keywords
Fallopian tube, p53 signature, secretory cell outgrowths, sectioning and extensively examining the fimbria protocol, serous carcinoma, serous tubal intraepithelial carcinoma
Citation
Mittal Neha, Srinivasan Radhika, Gupta Nalini, Rajwanshi Arvind, Nijhawan Raje, Gautam Upasana, Sood Swati, Dhaliwal Lakhbir. Secretory cell outgrowths, p53 signatures, and serous tubal intraepithelial carcinoma in the fallopian tubes of patients with sporadic pelvic serous carcinoma. Indian Journal of Pathology & Microbiology. 2016 Oct-Dec 59(4): 481-488.