During recent years, there is an accumulating evidence that high grade ovarian carcinoma is developed from the fallopian tube epithelial lesions. However, is not yet completely understood and still represents the subject of investigation. We investigated the immunohistochemical phenotype of matched fallopian tubes from the patients with different types and malignancy grades of ovarian carcinoma. Matched fallopian tubes from ovarian cancer patients were available in 260 cases, including mucinous borderline tumor (n=25), mucinous carcinoma (n=15), serous borderline tumor (n=90), low grade serous carcinoma (n=72) and high grade serous carcinoma (n=48). Immunohistochemical investigation included markers of proliferation (Ki67), apoptosis (Bcl2, p53), hormone receptors (ER, PR), epithelial differentiation (CK7), mesenchymal differentiation (vimentin, calretinin) and stem cells (CD44). The results indicate that the presence of fallopian tube carcinoma in situ is significantly correlated with the presence of high grade ovarian serous carcinoma (r=0.44, p<0.001), whilst there was no significant association with low grade and borderline serous tumors or mucinous tumors.

The etiology and pathogenesis of ovarian serous carcinomas as well as prognoses and clinical management are still under vigorous research. The data provided by many studies support the idea that ovarian serous carcinomas are mainly influenced by the changes occurring in the fallopian tube epithelium. This theory is supported by molecular lesions present in high-grade ovarian cancers and fallopian tube neoplasms. This topic needs some additional studies using pathogenetic characteristics like proliferative and apoptotic changes, which will further support and even may take it under suspicious the theory that ovarian carcinomas are originating from the fallopian tube. It is also crucial to study hormonal expressions while there is a lot of information that steroid hormones have a huge role in the pathogenesis of ovarian carcinomas but there is almost very little data on how these influences are related to the fallopian tube neoplasms. A deeper understanding of ovarian tumours and their etiological pathways are important to prevent and determine prognoses, which will enable better therapeutic methods. It has utmost importance to study additional characteristics like stem cell distribution in the fallopian tube epithelium and in ovarian neoplasms. The cancer heterogeneity need also further discussion regarding ovarian cancer novel classifications. This will finally aid the modification of better-personalized treatment.

No abstract