Proliferation of the fallopian tube fimbriae and cortical inclusion cysts: Effects of the menstrual cycle and the levonorgestrel intrauterine contraceptive system Journal Article


Authors: Park, K. J.; Broach, V.; Chi, D. S.; Linkov, I.; Stanczyk, F. Z.; Patel, P.; Jotwani, A.; Pearce, C. L.; Pike, M. C.; Kauff, N. D.
Article Title: Proliferation of the fallopian tube fimbriae and cortical inclusion cysts: Effects of the menstrual cycle and the levonorgestrel intrauterine contraceptive system
Abstract: Background: The objectives of this study were (i) to explore whether differences in cell proliferation may help explain why most high-grade serous ovarian cancers (HGSOC) arise in the fallopian tube fimbriae (FTF) rather than in ovarian cortical inclusion cysts (CIC); (ii) to compare premenopausal and postmenopausal FTF proliferation as a reason why the age incidence of HGSOC increases at a slower rate after menopause; and (iii) to compare FTF proliferation in cycling women and women using the levonorgestrel intrauterine contraceptive system (Lng-IUS) to see whether proliferation on the Lng-IUS was lower. Methods We studied 60 women undergoing a salpingo-oophorectomy. We used Ki67, paired-box gene 8 (PAX8, Mullerian € marker), and calretinin (mesothelial marker) to study FTF and CIC proliferation. Results: FTF Ki67%+ was greater in the follicular than in the luteal phase (4.9% vs. 1.5%; P 1⁄4 0.003); postmenopausal Ki67%+ was 1.7%. Ki67%+ in PAX8 negative (PAX8-) CICs was extremely low. Proliferation in PAX8+ CICs did not vary by menstrual phase or menopausal status. Follicular Ki67%+ was 2.6-fold higher in FTF than PAX8+ CICs. FTF Ki67%+ from 10 women using the Lng-IUS was not lower than in cycling women. Conclusions: Overall FTF Ki67%+ is greater than overall CIC Ki67%+. Overall FTF Ki67%+ in postmenopausal women is lower than in premenopausal women. The Lng-IUS is not associated with lower FTF Ki67%+. Impact: Ki67%+ provides an explanation of the preponderance of FTF-derived HGSOCs, and of the slower increase of HGSOCs after menopause. The Lng-IUS may not be associated with a protective effect against HGSOCs. ©2022 American Association for Cancer Research.
Keywords: human tissue; major clinical study; comparative study; salpingooophorectomy; ki 67 antigen; cell proliferation; ki-67 antigen; incidence; premenopause; menopause; risk reduction; postmenopause; calretinin; fallopian tubes; ovary cyst; cyst; cysts; levonorgestrel; menstrual cycle; luteal phase; transcription factor pax8; epidermoid cyst; fallopian tube; contraceptive agent; humans; human; female; article; intrauterine contraceptive device; contraceptive agents; ovarian cortex; intrauterine devices, medicated
Journal Title: Cancer Epidemiology Biomarkers and Prevention
Volume: 31
Issue: 9
ISSN: 1055-9965
Publisher: American Association for Cancer Research  
Date Published: 2022-09-01
Start Page: 1823
End Page: 1829
Language: English
DOI: 10.1158/1055-9965.Epi-22-0217
PUBMED: 35700017
PROVIDER: scopus
PMCID: PMC9444882
DOI/URL:
Notes: Article -- Export Date: 3 October 2022 -- Source: Scopus
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MSK Authors
  1. Malcolm Pike
    189 Pike
  2. Dennis S Chi
    707 Chi
  3. Kay Jung Park
    305 Park
  4. Irina Linkov
    73 Linkov
  5. Prusha   Patel
    16 Patel
  6. Vance Andrew Broach
    115 Broach