Loss of tubal ciliated cells as a risk for “ovarian” or pelvic serous carcinoma

Background Recent advances suggest the fallopian tube as the main anatomic site for high-grade ovarian or pelvic serous carcinoma (O/PSC). Human fallopian tube is mainly lined by two cell types, secretory and ciliated cells. Large number of studies on the biologic role of tubal secretory cells in O/PSC have been performed in the last decade. However, the role of tubal ciliated cells in relation to the development of O/PSC has rarely been explored. The purpose of this study was to determine if change of the tubal ciliated cells shows difference in age and location and to examine their association with serous neoplasia. Methods Three groups (low-risk or benign control, high-risk, and O/PSC) of patients were age matched. The age data was stratified by 10-year intervals ranging from age 20 to older than 80. Ciliated cells from both tubal fimbria and ampulla segments were counted by microscopy and by tubulin immunohistochemical staining. The data was analyzed by standard contingency table, Poisson distribution methods, nonparametric Mann–Whitney U-tests and Spearman correlation analysis after age justification. Results The study revealed that the absolute number of tubal ciliated cells decreased significantly with age within each group. A reduction in ciliated cells within the fallopian tube remained a significant risk factor for serous neoplasia after age adjustment. A dramatic decrease of tubal ciliated cells in both tubal segments was identified in patients with high-risk and with O/PSC compared to those in the low-risk (benign control) group (p < 0.001). Further, within the fimbria segment, a reduced number of tubal ciliated cells was more prevalent in the high-risk group when compared to those in O/PSC group. Conclusion Our findings suggest that reduced number of ciliated cells within the fallopian tube represents a hallmark of early serous carcinogenesis. Findings also support a relationship between loss of tubal ciliated cells and aging, the presence of high-risk factors, and co-existing ovarian or pelvic high-grade serous cancers. This represents an early study identifying the role of tubal ciliated cells in the process of high-grade O/PSC development.