Figure 4.

Molecular alterations associated with tumor progression from p53 signature to serous tubal intraepithelial carcinoma (STIC) to high-grade serous carcinoma (HGSC). After initial clonal expansion, p53 signatures and some STICs become dormant as they lose a proliferative advantage. But some STICs continue to proliferate, gain additional cancer-promoting events, and progress to HGSC spreading to fallopian tubes, ovaries, and other pelvic organs. Compared to p53 signatures, STICs gain several features as listed, and may be involved in the progression. Similarly, as compared to STICs, HGSCs are more frequently characterized by features related to genomic instability, maintenance of telomere length, and immune cell infiltration. LINE, long-interspersed element; LOH, loss of heterozygosity.