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. 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 287fallopian tubes (3-4 fimbrial fragments). Results. The increase in SCE and SCOUT with age was observedfor 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 eff iciency) was 98.2%. The sensitivity of the used function was 92.8%; the specif icity was 100.0%.

secretory cell proliferation, serous tubal intraepithelial carcinoma, high-grade serous ovarian carcinoma