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Christopher Paul Crum, MD
Senior Pathologist, Brigham and Women's Hospital
Professor of Pathology, Harvard Medical School

Brigham and Women's Hospital
Department of Pathology
75 Francis Street
Boston, MA 02115

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Research Narrative:

Our laboratory focuses on the pathogenesis of gynecologic cancer and how it informs strategies for prevention. In the past two decades we have focused on cervical and ovarian carcinogenesis. In 2012 we described a putative cell of origin for cervical carcinoma in the squamo columnar junction (SCJ) and in subsequent publications postulated that pre-emptive cryoablation of the SCJ cells would lower the risk of cervical cancer. This concept is currently being tested in an ongoing clinical trial sponsored by the IARC/WHO. Our interests have centered on the novel concept that high-grade pelvic serous cancer, the most lethal "ovarian" cancer in women, arises from the distal fallopian tube. In 2005 we developed the SEE-FIM dissection protocol for examination of the fallopian tubes in women with germ-line BRCA mutations. This protocol, when applied to both low and high risk women revealed the presence of not only early carcinomas but a spectrum of “early serous precursors” (ESPs) in the fimbria, further linking the tube to serous cancer. We hypothesized that disseminated serous cancer arises not only via 1) the development of an early tubal cancer that subsequently metastasizes, but also 2) via detachment of precursor cells that subsequently become malignant in the peritoneal cavity (precursor escape). We have several funded studies in progress to 1) establish a stronger association between ESPs and concurrent disseminated malignancies, 2) determine if ESPs from both uterus and fallopian tube contribute to eventual serous carcinomas, and 3) track the evolution from ESP to cancer in the peritoneal cavity.  Currently, opportunistic salpingectomy is being practiced as a strategy to potentially lower the incidence rate of serous cancer. Our goal is to develop a clearer picture of the molecular and physical landscape integral to cancer development to complete this narrative and address novel strategies in serous cancer prevention.


Lab Members:
Wa Xian, PhD, Postdoctoral Research Fellow
Karishma Mehra, MD, Postdoctoral Research Fellow
Mitra Mehtrad, MD, Research Fellow
Eleanor Chen, MD, PhD, Clinical Fellow

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