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Updated: Jul 17, 2026
Tubal Cytology of the Fallopian Tube as a Promising Tool for Ovarian Cancer Early Detection
Published on: July 25, 2017
The distal fallopian tube: a new model for pelvic serous carcinogenesis
Christopher P Crum1, Ronny Drapkin, Alexander Miron
1Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. ccrum@partners.org
Purpose Of Review:
Research over the past 50 years has yielded little concrete information on the source of pelvic serous cancer in women, creating a knowledge gap that has adversely influenced our ability to identify, remove or prevent the earliest stages of the most lethal form of ovarian cancer.
Recent Findings:
The distal fallopian tube is emerging as an established source of many early serous carcinomas in women with BRCA mutations (BRCA+). Protocols examining the fimbrial (SEE-FIM) end have revealed a noninvasive but potentially lethal form of tubal carcinoma, designated tubal intraepithelial carcinoma. Tubal intraepithelial carcinoma is present in many women with presumed ovarian or peritoneal serous cancer. A candidate precursor to tubal intraepithelial carcinoma, entitled the 'p53 signature', suggests that molecular events associated with serous cancer (p53 mutations) may be detected in benign mucosa.
Summary:
A fully characterized precursor lesion is a first and necessary step to pelvic serous cancer prevention. The emerging data offer compelling evidence for a model of 'fimbrial-ovarian' serous neoplasia, and call attention to the distal fallopian tube as an important source for this disease, the study of which could clarify pathways to cancer in both organs and generate novel strategies for cancer prevention.
Insights
The distal fallopian tube is the source of early serous cancer in women, particularly those with BRCA mutations. Identifying precursor lesions like tubal intraepithelial carcinoma is key for pelvic serous cancer prevention.
Area of Science:
- Gynecologic Oncology
- Pathology
- Molecular Biology
Background:
- Pelvic serous cancer, a lethal form of ovarian cancer, lacks clear origin information.
- A 50-year knowledge gap hinders early detection, removal, and prevention strategies.
Purpose of the Study:
- To investigate the origin of pelvic serous cancer.
- To identify precursor lesions for early cancer prevention.
Main Methods:
- Review of research over the past 50 years.
- Analysis of protocols examining the fimbrial end (SEE-FIM).
- Identification of molecular markers like the 'p53 signature'.
Main Results:
- The distal fallopian tube is identified as the origin of early serous carcinomas, especially in BRCA-positive women.
- Tubal intraepithelial carcinoma, a noninvasive precursor, is found in women with serous cancer.
- 'p53 signature' suggests early molecular events in benign mucosa.
Conclusions:
- A characterized precursor lesion is essential for pelvic serous cancer prevention.
- The 'fimbrial-ovarian' serous neoplasia model highlights the distal fallopian tube's role.
- Understanding these pathways can lead to novel cancer prevention strategies.
