For many years, doctors have struggled with a question: where does the most dangerous form of ovarian cancer actually begin? A new study may finally have the answer.
This discovery could help doctors find the cancer earlier and offer better treatment options to save more lives.
The type of cancer in question is called high-grade serous carcinoma. It is the most common and the most deadly kind of ovarian cancer. The main reason it is so dangerous is because it is very hard to detect early.
Most women are only diagnosed after the cancer has already spread. At that point, treatment becomes harder, and the chances of survival drop sharply. Sadly, most people with this cancer do not live more than five years after their diagnosis.
For a long time, scientists believed this cancer started in the ovaries themselves. But this new study, led by Professor Alexander Nikitin at Cornell University, shows something surprising: it most likely begins in the fallopian tubes. These are the thin tubes that carry eggs from the ovaries to the uterus.
The researchers found that a special kind of cell in the fallopian tube seems to be the starting point for this cancer. These cells are called pre-ciliated tubal epithelial cells. They are not fully developed cells. Instead, they are in the middle of becoming mature cells that have tiny hairs (called cilia) that help move eggs through the tube.
It turns out these pre-ciliated cells are more likely to turn into cancer than other cells. The study was done in mice, which have a similar reproductive system to humans. In mice, the fallopian tube is called the uterine tube, but it works in much the same way.
The scientists looked at all the different types of cells in the fallopian tube. They wanted to find out which cells became cancerous when key genes were turned off. The two genes they focused on are TP53 and RB1. These genes normally help prevent cancer. In nearly all human cases of this cancer, the TP53 gene is damaged, and the RB1 pathway is also affected.
When the researchers turned off these genes in stem cells of the fallopian tube, the stem cells died. But when they turned off the same genes in the pre-ciliated cells, cancer quickly formed. This was a big surprise—and a key finding. It means these in-between cells are the real source of the cancer.
The team used a method called single-cell sequencing to study the genes inside each type of cell. This let them find out exactly which genes were active. They found two important markers: one called Pax8, which is often seen in this kind of cancer, and another called Krt5, which helped them pinpoint the risky cells.
This finding is a big step forward. Because scientists already know a lot about how cilia are made, they now have a good starting point to look for ways to detect or even stop this cancer before it grows.
In the future, this could lead to new tests that find high-grade serous carcinoma early—maybe even before it spreads. Doctors may even be able to prevent it in people who are at high risk.
While more research is needed, this discovery brings new hope. It gives scientists and doctors a clearer target and opens the door to earlier diagnosis and better treatment. After years of uncertainty, we are finally closer to stopping one of the deadliest forms of ovarian cancer.
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