A Case Control Study on Histomorphological Changes of Fallopian Tube in Surface Epithelial Tumors of Ovary at a Tertiary Care Center
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Abstract
Background: Ovarian cancer, specifically high-grade serous carcinoma, is among the top causes of cancer-related mortality in women, and there is no reliable screening test for its early detection. New evidence indicates that the fallopian tube, and more precisely its fimbrial part, may be the origin of most ovarian serous carcinomas, thereby going against the conventional belief placing the site of origin in the ovarian surface epithelium. Aim and objective: The aim of this research was to examine the relationship of histomorphological changes in the epithelium of the fallopian tubes with ovarian surface epithelial tumors. The main objective was to compare the epithelial changes in the Fallopian tube from panhysterectomy specimen of cases with different types of surface epithelial ovarian tumors (benign, borderline, or malignant) and cases with benign uterine lesions. Material and Methods: A case-control study was done during November 2020 to November 2021 at Lakeshore Hospital and Research Center, Kochi. Forty-eight patients were recruited: 24 cases of epithelial ovarian tumors (10 benign, 5 borderline, 9 malignant) and 24 controls of benign uterine lesions. Fallopian tubes from panhysterectomy specimens were graded for tubal involvement, epithelial stratification, atypia, mitosis, intraepithelial vacuoles, and other changes histologically. Statistical significance was determined using a p-value cut-off of 0.05. Results: The case group had significantly greater frequencies of epithelial stratification (37.5% vs. 4.2%, p<0.05), atypia (12.5% vs. 0.0%, p<0.05), mitosis (20.8% vs. 0.0%, p<0.05), and intraepithelial vacuoles (12.5% vs. 0.0%, p<0.05) compared with the control group. Tube involvement occurred in 4 of 9 malignant cases (44.4%), and serous tubal intraepithelial carcinoma (STIC) occurred in one high-grade serous carcinoma case (11.1%). No secretory cell outgrowth occurred in either group. Conclusion: The research establishes a significant correlation between histomorphological changes in the epithelium of the fallopian tube and ovarian serous carcinomas and thereby supports the postulate that the fallopian tube (fimbrial end) is a potential site of origin of the neoplasms. The research emphasizes the importance of examining fallopian tubes in the context of ovarian cancer and has preventive surgical implications such as salpingectomy.
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Copyright (c) 2025 Shahseena Abdulla, Iona Leekha Mathew, Rosmy John, Chithrathara K, Pushpa Mahadevan, Ami Maria Emmanuel
This work is licensed under a Creative Commons Attribution 4.0 International License.
Creative Commons License All articles published in Annals of Medicine and Medical Sciences are licensed under a Creative Commons Attribution 4.0 International License.
Iona Leekha Mathew, Department of Pathology, Karuna Medical College, Vilayodi, Chittur, Palakkad, Kerala, 678103, India.
Department of Pathology, Lakeshore Hospital and Research Centre, Kochi, Kerala, INDIA
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