A change in the cellular composition of the fallopian tube epithelium as a predictor for high-grade serous ovarian carcinoma
Objective. To study whether the development of high-grade serous ovarian carcinoma (HGSOC) can be predicted using an estimate of changes in the cellular composition of the fallopian tube epithelium (secretory cell expansion (SCE) and secretory cell outgrowth (SCOUT)) depending on patients’ age.Asaturova A.V., Adamyan L.V., Ezhova L.S., Faiullina N.M., Khabas G.N., Sannikova M.V.
Subjects and methods. Examinations were made in 287 patients with benign extraovarian pathological changes (n = 70), serous ovarian cystadenomas/cystadenofibromas (n = 75), serous borderline ovarian tumors (n = 73), and HGSOC (n = 69). Morphological, immunohistochemical (the markers p53 and Ki-67), and statistical (the Kruskal-Wallis test, the Mann-Whitney test, the pairwise linear regression method with an estimate of the tightness of Pearson’s correlation, and discriminant analysis) studies were used to investigate 287 fallopian tubes (3-4 fimbrial fragments).
Results. The increase in SCE and SCOUT with age was observed for all studied pathological changes (p < 0.001), although the number of SCE in all the groups was higher than that of SCOUT; and the correlation between age and the number of SCE was stronger than that of SCOUT (Pearson’s correlation coefficients, 0.86 and 0.35, respectively). Comparing the groups of patients with different diseases revealed that the number of SCE and SCOUT in the HGSOC group was significantly higher than that in the other groups (p < 0.001). The predictive formula HGSOC = 0.22*SCE + 0.055*SCOUT – 0.068*AGE + 0.72) was derived. A woman with HGSOC and more than 1.663 belonged to a group at high risk for ovarian serous carcinomas; a woman with less than 1.663 formed a low-risk group. To avoid false-negative results, the age limit for applying the formula was proposed to be 47 years of age.
Conclusion. The findings have led to the conclusion that age is an important independent risk factor for HGSOC. In addition, SCE as an isolated marker has a greater efficiency than SCOUT; however, a joint estimation of SCE, SCOUT, and patients’ age has the highest efficiency, as demonstrated in the present study using the proposed prognostic formula. The overall percentage of the original observations correctly classified by the proposed formula (diagnostic efficiency) was 98.2%. The sensitivity of the used function was 92.8%; the specificity was 100.0%.
Keywords
secretory cell proliferation
serous tubal intraepithelial carcinoma
high-grade serous ovarian carcinoma
Supplementary Materials
- Table. The results of the classification of women under study on the basis of the risk of development of serous ovarian carcinoma of high degree of malignancy with the use of the discriminant function
- Fig. 1. SCE SCOUT and Characteristics. A, B - morphological study (A - SCE, x 400 B - SCOUT, x 630 (staining with hematoxylin and eosin)). B-E - the incidence of SCE and SCOUT, depending on the pathological changes of the reproductive system and the age of patients
- Fig. 2. Statistical analysis of the incidence of SCE and SCOUT, depending on the pathological changes of the reproductive system and the age of patients. A-B - The dependence of amounts of SCE (A) and SCOUT (B) on the age of patients with serous carcinomas highly malignant ovary; B-T - The number to the SCE (B) and SCOUT (T) in different types of ovarian tumors and extra ovarian pathological changes
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Received 21.10.2016
Accepted 11.11.2016
About the Authors
Asaturova A.V., PhD, senior scientific researcher of department 1-st anatomic pathology, Research Center of Obstetrics, Gynecology and Perinatology,Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: a_asaturova@oparina4.ru
Leila Vladimirovna Adamyan, MD, professor, academician of RAS; deputy director on science, head of department of operative gynecology, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; head of department of reproductive medicine and surgery, faculty of postgraduate education,
Moscow State University. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954387783. E-mail: l_adamyan@oparina4.ru
Ezhova L.S., PhD, senior scientific researcher of 1st anatomic pathology department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: l_ezhova@oparina4.ru
Fayzullina Nafisa Munavarovna, PhD, senior scientific researcher of 1st anatomic pathology department, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954382311. E-mail: n_faizullina@oparina4.ru
Khabas Grigory Nikolaevich, Head of the Department of innovative oncogynecology and surgery, Research Center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954388540. E-mail: g_khabas@oparina 4.ru
Sannikova Maya Viktorovna, scientific researcher of the Department of innovative oncogynecology and surgery, Research Center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954388540. E-mail: m_sannikova@oparina4.ru
For citations: Asaturova A.V., Adamyan L.V., Ezhova L.S., Faiullina N.M.,
Khabas G.N., Sannikova M.V. A change in the cellular composition of the fallopian
tube epithelium as a predictor for high-grade serous ovarian carcinoma.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 83-90. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.83-90
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