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Tsutomu Ida,Hiroyuki Fujiwara,Takahiro Kiriu,Yoshimi Taniguchi,Akira Kohyama 대한부인종양학회 2019 Journal of Gynecologic Oncology Vol.30 No.6
Objective: To investigate the relationship between the precursors of high grade serousovarian cancer (HGSOC) and the characteristics of patients with a low HGSOC risk in termsof the effects of pregnancy. Methods: We prospectively examined consecutive cases in which the bilateral fallopian tubeswere removed during benign gynecological or obstetric surgery and assessed the relationshipbetween the patient characteristics, including parity and pregnancy, and the incidence ofHGSOC precursors. All the fallopian tubes were examined by applying the Sectioning andExtensively Examining the Fimbriated End (SEE-FIM) Protocol. Results: Of the 113 patients enrolled, 67 were gynecological and 46 were obstetric. The p53signature was identified in 21 patients. No other precursors were identified. In a comparisonof the p53 signature-positive and negative groups, parous women and pregnant womenwere significantly fewer in the p53 signature-positive group (53% vs. 86%, p=0.002, 10%vs. 47%, p=0.001, respectively). Current pregnancy was also associated with a significantlylower incidence of the p53 signature after multivariate adjustment (odds ratio [OR]=0.112;95% confidence interval [95% CI]=0.017–0.731; p=0.022). Among gynecological patients,parous women were fewer in the p53 signature-positive group on univariate (47% vs. 73%,p=0.047) and multivariate analysis (OR=0.252; 95% CI=0.069–0.911; p=0.036). No othercharacteristics were associated with p53 signature positivity. Conclusions: The incidence of the p53 signature was significantly lower in parous womenand pregnant women. This decreased incidence of early phase serous carcinogenesis may beone of the possible mechanisms underlying HGSOC risk reduction among parous women.