Frontiers in the Pathology and Pathogenesis of Ovarian Cancer: Cancer Precursors and "Precursor Escape"

Thing Rinda Soong; Daniela M Dinulescu; Wa Xian; Christopher P Crum

doi:10.1016/j.hoc.2018.07.013

Frontiers in the Pathology and Pathogenesis of Ovarian Cancer: Cancer Precursors and "Precursor Escape"

Hematol Oncol Clin North Am. 2018 Dec;32(6):915-928. doi: 10.1016/j.hoc.2018.07.013.

Authors

Thing Rinda Soong¹, Daniela M Dinulescu², Wa Xian³, Christopher P Crum⁴

Affiliations

¹ Department of Pathology, University of Washington Medical Center, 1959 North Pacific Street, Box 356100, Seattle, WA 98195, USA.
² Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
³ The University of Texas Health Center at Houston, Institute of Molecular Medicine Center for Stem Cell and Regenerative Medicine, Houston, TX 77030, USA.
⁴ Department of Pathology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: ccrum@bwh.harvard.edu.

PMID: 30390765
DOI: 10.1016/j.hoc.2018.07.013

Abstract

This article summarizes the pathogenesis of ovarian carcinoma, focusing on the paradox of high-grade serous carcinogenesis. The fallopian tube is the prime site of origin in early serous cancers. Because a subset of serous cancers is associated with early serous proliferations absent intramucosal carcinomas, "precursor escape" is emerging, whereby some advanced cancers trace their roots to early serous proliferations. This has parallels in the endometriosis model and opens up a novel mechanism by which advanced malignancy could emerge without an obvious tubal carcinoma. The impact of this concept on classification of serous cancer and expectations from preventive strategies are discussed.

Keywords: Endometriosis; High-grade serous carcinoma; Precursor escape; Serous tubal intraepithelial carcinoma; Serous tubal intraepithelial lesion.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Review

MeSH terms

Cystadenocarcinoma, Serous* / immunology
Cystadenocarcinoma, Serous* / metabolism
Cystadenocarcinoma, Serous* / pathology
Fallopian Tube Neoplasms* / immunology
Fallopian Tube Neoplasms* / metabolism
Fallopian Tube Neoplasms* / pathology
Female
Humans
Neoplastic Stem Cells* / immunology
Neoplastic Stem Cells* / metabolism
Neoplastic Stem Cells* / pathology
Ovarian Neoplasms* / immunology
Ovarian Neoplasms* / metabolism
Ovarian Neoplasms* / pathology
Tumor Escape / immunology*