Fallopian tube lavage sampling for early detection of pre-invasive ovarian cancer

ABSTRACT: Background Ovarian cancer (OC) is the most lethal gynaecological malignancy, primarily due to late-stage diagnosis. Most high-grade serous OC cases arise from pre-invasive fallopian tube (FT) lesions, known as serous tubal intraepithelial carcinomas (STICs), yet no clinical test exists for detecting these at an early, treatable stage. Here, we introduce FT lavage as a novel sampling approach that avoids the fimbrial ends, enabling analysis of early tumour-associated molecular changes in FTderived biofluids, while remaining compatible with emerging in vivo sampling tools. Methods Proteomic profiling was performed on FT lavage samples from high-risk BRCA1/2 mutation carriers, OC patients, and control individuals with benign gynaecological conditions. A subset of the identified proteins was assessed by immunofluorescent staining in STIC lesions from an independent cohort. Results We identified an 82-protein signature featuring key factors implicated in OC progression and dysregulated in early disease. Using this signature, we retrospectively identified a previously undetected STIC lesion in a high-risk patient. Immunofluorescent staining confirmed dysregulation of select proteins in STIC lesions. Notably, detection of this signature away from the fimbrial region suggests molecular changes occur throughout the FT lumen, including proximal areas, making this approach accessible via next-generation falloposcopy platforms. Conclusions Our findings support FT lavage sampling as a minimally invasive method for detecting premalignant lesions in high-risk individuals, with potential for fertility-preserving early detection. This approach could inform screening, risk stratification, and chemoprevention strategies. Larger studies are needed to validate its diagnostic performance and clinical utility for asymptomatic screening.

INSTRUMENT(S):

ORGANISM(S): Homo Sapiens (human)

DISEASE(S): Malignant Neoplasm Of Ovary

SUBMITTER: Sarah Harbach  

LAB HEAD: Christine Schmidt

PROVIDER: PXD072299 | Pride | 2026-01-07

REPOSITORIES: Pride