Association of Epithelial Changes in Fallopian Tube and Epithelial Neoplasms of Ovary using p53 Tumour Marker- A Cross-sectional Study in a Tertiary Care Centre

Abstract

Introduction: Ovarian cancer is one of the major reasons of mortality in women due to gynaecological malignancies. The origin of ovarian carcinomas was considered to be de novo previously. But recent studies have shown that the type II ovarian carcinomas, majority constituting of High Grade Serous Carcinomas (HGSCs) originate from the fimbrial end of the fallopian tubes. Aim: To establish an association of epithelial changes of fallopian tube with epithelial neoplasms of ovary in light of p53 expression. Materials and Methods: An observational, descriptive, crosssectional study was done in the Department of Pathology in a tertiary care centre of Eastern India for a period of 18 months from July 2019 to December 2020. Informed written consent was taken from all patients prior to the study. The epithelial ovarian neoplasms and fimbrial ends of the fallopian tubes using Sectioning and Extensively Examining the FIMbrial (SEE-FIM) end technique were submitted in 51 cases. The sections were stained with Haematoxylin and Eosin (H&E) and p53 tumour marker. The obtained results were tabulated and data analysis was done using Chi-square test and Fisher’s-exact test with the help of statistical software International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) version 25.0. A p-value of <0.05 was considered statistically significant. Results: On histopathological examination, 84.31% (43/51) cases were found to be serous tumours of the ovary, out of which 54.9% (28/51) cases showed histological features of HGSCs, 100% of these HGSCs were p53 positive. Thirteen cases (46.42%) of fimbrial ends of HGSCs showed nuclear atypia, pleomorphism and stratification and p53 positivity were categorised as Serous Tubal Intra Epithelial Carcinomas (STIC). Total 10 cases (10/28=35.71%) of fimbrial ends which showed p53 positive in minimum of 12 cells in the fimbrial ends were labelled as ‘p53 signatures’. The remaining five cases did not show any significant finding. Conclusion: Overall, the fimbrial end of the fallopian tube could be considered as the origin of these HGSCs and these lesions are precancerous in nature.

Keywords

• fimbria
• ovarian high grade serous carcinoma
• serous tubal intraepithelial carcinoma