Abstract
High grade serous ovarian cancer (HGSC), the most lethal and frequent type of epithelial ovarian cancer (EOC), has poor long term prognosis due to a combination of factors: late detection, great metastatic potential and the capacity to develop resistance to available therapeutic drugs. Furthermore, there has been considerable controversy concerning the etiology of this malignancy. New studies, both clinical and molecular, strongly suggest that HGSC originates not from the surface of the ovary, but from the epithelial layer of the neighboring fallopian tube fimbriae. In this paper we summarize data supporting the central role of fallopian tube epithelium in the development of HGSC. Specifically, we address cellular pathways and regulatory mechanisms which are modulated in the process of transformation, but also genetic changes which accumulate during disease progression. Similarities between fallopian tube mucosa and the malignant tissue of HGSC warrant a closer analysis of homeostatic mechanisms in healthy epithelium in order to elucidate key steps in disease development. Finally, we highlight the importance of the cancer stem cell (CSC) identification and understanding of its niche regulation for improvement of therapeutic strategies.
Highlights
Epithelial ovarian cancer (EOC) represents a very heterogeneous disease with widely varying histology, pathogenesis and clinical presentation, resulting in greatly different outcomes
As no cilia are found in malignant tissues of either histological types of serous ovarian cancer (LGSC and High grade serous ovarian cancer (HGSC)), it is difficult to reconcile how conversion of ovarian surface epithelium (OSE) cells into fallopian tube cells would first lead to the creation of both ciliated and secretory cells only for the former ones to be lost at later stages of the process (Figure 2B)
The identification of fallopian tube epithelium as the tissue of origin of HGSC provides a basis for critical evaluation of the molecular mechanisms of pathology behind this deadly disease
Summary
Epithelial ovarian cancer (EOC) represents a very heterogeneous disease with widely varying histology, pathogenesis and clinical presentation, resulting in greatly different outcomes. It is the fourth leading cause of cancer deaths among women in industrialized countries. In comparison to serous ovarian cancer, other histological subtypes present a distinct molecular and genetic profile (Figure 1B). This is in congruence with clear differences in morphology. Understanding the regulatory mechanisms and signaling pathways in fallopian tube epithelium is becoming a focal point of serous ovarian cancer research. In this paper we provide an overview of the current findings about the genetic makeup and cellular phenotype of ovarian cancer tissue, and focus on the importance of the fallopian tube in its etiology
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
