title: The distal fallopian tube: a new model for pelvic serous carcinogenesis.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Women's and Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. ccrum@partners.org
authors.forename: Christopher P
authors.initials: CP
authors.lastname: Crum
authors.forename: Ronny
authors.initials: R
authors.lastname: Drapkin
authors.forename: Alexander
authors.initials: A
authors.lastname: Miron
authors.forename: Tan A
authors.initials: TA
authors.lastname: Ince
authors.forename: Michael
authors.initials: M
authors.lastname: Muto
authors.forename: David W
authors.initials: DW
authors.lastname: Kindelberger
authors.forename: Yonghee
authors.initials: Y
authors.lastname: Lee
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000209:etiology* / Q000473:pathology; D002278:Carcinoma in Situ / Q000209:etiology / Q000473:pathology; D002471:Cell Transformation, Neoplastic; D005185:Fallopian Tube Neoplasms / Q000235:genetics / Q000473:pathology*; D005260:Female; D019398:Genes, BRCA1; D006801:Humans; D010051:Ovarian Neoplasms / Q000209:etiology / Q000473:pathology; D010534:Peritoneal Neoplasms / Q000209:etiology* / Q000473:pathology; D011230:Precancerous Conditions / Q000235:genetics / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000378:metabolism
chemical_list: D016159:Tumor Suppressor Protein p53