Department of Obstetrics and Gynecology, University of British Columbia, British Columbia Women's Hospital, Vancouver, British Columbia, Canada.
Int J Gynecol Pathol. 2011 Jan;30(1):12-21. doi: 10.1097/PGP.0b013e3181f45f3e.
It is currently a controversial issue whether epithelial ovarian cancers arise in the ovarian surface epithelium (OSE) or the fimbrial epithelium of the oviduct. The hypothesis presented here aims to reconcile these 2 views and provides a possible explanation for 2 questions arising: first, why tumors originating in the fimbriae and OSE, which are parts of different organs, express common features; second, why these epithelia are prone to neoplastic transformation whereas the remaining oviduct and the extraovarian mesothelium are not. We hypothesize that these questions relate to the common origin of the OSE and fimbriae in that region of the embryonic coelomic epithelium, which will eventually link the extraovarian mesothelium to the epithelium of the oviductal ampulla. OSE and fimbriae become separated during embryonic development but, like other transitional, interepithelial junctions in adults, this region might remain incompletely committed and thus prone to neoplastic progression. To define differentiation at the OSE-tubal junction, salpingo-oophorectomy specimens were stained immunohistochemically for mesenchymal differentiation markers of OSE and for epithelial markers and Pax8, characterizing oviductal fimbriae and ampullae. OSE and ampullae were distinctly different, but there was no sharp boundary between OSE and fimbriae. Rather, both mesenchymal and epithelial markers overlapped, and Pax8 and fimbrial epithelial markers diminished distally, near the OSE. The results support the hypothesis that the OSE and fimbriae are parts of a transitional epithelium of common origin rather than 2 independent sources of ovarian cancer, and suggest that their immature, incompletely determined phenotype contributes to their propensity to neoplastic transformation.
目前，关于卵巢上皮性癌（epithelial ovarian cancers）是起源于卵巢表面上皮（ovarian surface epithelium，OSE）还是输卵管伞部的纤毛上皮，存在争议。本假说旨在调和这两种观点，并为两个出现的问题提供可能的解释：首先，为什么起源于不同器官的输卵管伞部和 OSE 的肿瘤会表达共同的特征；其次，为什么这些上皮容易发生肿瘤转化，而其余的输卵管和卵巢外间皮却不会。我们假设这些问题与 OSE 和输卵管伞部在胚胎体腔上皮的共同起源有关，这最终将使卵巢外间皮与输卵管壶腹部的上皮相连。OSE 和输卵管伞部在胚胎发育过程中分离，但与成人其他过渡性上皮交界处一样，该区域可能仍然不完全定型，因此容易发生肿瘤进展。为了定义 OSE-输卵管交界处的分化，对输卵管卵巢切除术标本进行了免疫组织化学染色，以检测 OSE 的间充质分化标志物以及上皮标志物和 Pax8，以表征输卵管伞部和壶腹部。OSE 和壶腹部明显不同，但 OSE 和输卵管伞部之间没有明显的界限。相反，间充质和上皮标志物重叠，Pax8 和输卵管伞部上皮标志物在靠近 OSE 的远端逐渐减少。研究结果支持 OSE 和输卵管伞部是共同起源的过渡性上皮的一部分，而不是卵巢癌的两个独立来源的假说，并表明它们不成熟、不完全确定的表型有助于其肿瘤转化倾向。
