Before talking about the “next door king”, let’s talk about the icy clean “master” — ovaries. Ovaries are the female gonads, belonging to the internal reproductive organs, located deep in the pelvic cavity, the size and two thumbs stacked up can not be found, seniors said more like a large date. Although the ovary is a “small place”, but the energy is super: secretion of female sex hormones (mainly estrogen, progesterone and a moderate amount of androgens) and the production of eggs, is responsible for maintaining the female morphological characteristics and youthfulness and beauty, to bear the heavy responsibility of human reproduction. To a certain physiological age, the ovarian function is bound to gradually decline until the complete loss of women from menopause into old age, no matter how to maintain are difficult to stop, this is the law of life, even if it is a variety of “ice ice”, but also escape. Moreover, with age, the chance of ovarian malignant tumors also increases, from the health point of view, the ovary has been reduced to “right and wrong place”. Ovarian cancer is currently the most difficult treatment of gynecological malignant tumors, the reason is that the location of the ovaries is very deep, found that 70% of the late stage. However, compared with common diseases such as cardiovascular and cerebrovascular diseases, ovarian cancer is a rare disease, so ovarian cancer screening is not advocated at present, and it is not economical or feasible. However, with the new discoveries in the etiology of ovarian cancer, it is possible to prevent ovarian cancer from certain angles. The variety of ovarian cancers is the largest in the human body! There are more than 40 kinds of malignant tumors occurring in the ovary of the size of a red date. Simply speaking, it can be divided into epithelial cancer, malignant germ cell tumor, sex cord mesenchymal tumor, metastatic ovarian cancer and so on. Among them, ovarian epithelial carcinoma is the most common type, accounting for more than 70%, and ovarian epithelial carcinoma can be divided into plasma carcinoma, mucinous carcinoma, endometrioid carcinoma, clear cell carcinoma, and so on, among which 70% of ovarian epithelial carcinoma is plasma carcinoma. After 2004, plasmacytoid ovarian cancer has been categorized into low-grade plasmacytoid carcinoma (type I ovarian plasmacytoid carcinoma) and high-grade plasmacytoid carcinoma (type II ovarian carcinoma), which accounts for 90% of the cases, and which are very different in many ways. But in any case, unlike bacterial and parasitic infections, etc., there is no dispute that cancer is a malignant transformation of cells originating in one’s own organs! There is no problem with malignant germ cell tumors and mesenchymal tumors originating from the germ cells and mesenchyme of the gonads of the ovary, respectively, but with epithelial carcinoma of the ovary, the question arises. As the name suggests, the source of ovarian epithelial cancer should be the ovarian surface epithelium. Unfortunately, the surface of the ovary is not epithelial. The ovary is a retroperitoneal organ and is covered with a membrane which, along with the membrane covering the surface of the bowel, bladder, etc., is part of the peritoneal mesothelium. Pathologically, mesothelium and epithelium have different morphologies. In this way, the origin of ovarian epithelial cancer is in question! Where exactly does ovarian epithelial cancer originate? After much research, scientists have come up with a “dichotomy” of the origin of ovarian epithelial cancer: the high-grade plasma carcinoma (type II ovarian epithelial cancer), which accounts for the majority of ovarian cancers, is caused by the epithelium of the next-door neighbor fallopian tubes, in particular the umbilical end, and does not originate from the ovary itself! It is the next door neighbor in the animal world, not the ovary itself! In addition, the traditional “dualism” theory is that low-grade plasma cancer (type I ovarian cancer) is due to the formation of “inclusion bodies” by the depression of “surface cells” of the ovary, which then become cancerous. However, newer research suggests that the sunken “cells” may also originate from the epithelium of the fallopian tubes, which is still the “king of the next door”! Of course, more evidence is needed for this idea. It has also been suggested that some ovarian plasma cancers are derived from plasma cancers of the endometrium, which metastasize to the ovaries through the fallopian tubes, and that ovarian clear cell carcinomas and ovarian endometrioid carcinomas are derived from malignant changes in the endometrium, which are caused by the endometrium returning through the fallopian tubes into the abdominal cavity, where it takes root, grows, and becomes diseased on the surfaces of the organs in the abdominal cavity. Fortunately, the revelation of this dangerous relationship also provides scientists with a new way of thinking about the prevention of ovarian cancer – since the fallopian tubes are either the “king next door” or the “queen next door” in the occurrence of ovarian cancer, then the fallopian tubes can be used as the “king next door” or the “queen next door”. Since the fallopian tube is either the “old king next door” or the “old lady next door” in the occurrence of ovarian cancer, can the incidence of ovarian cancer be reduced if the old king or the old lady is “done” and the fallopian tube is removed or ligated? The answer is yes! A study from Denmark found that bilateral tubectomy can reduce the risk of ovarian cancer by 42%, unilateral tubectomy: 10% reduction in ovarian cancer risk; another meta-analysis showed that tubal ligation reduces the risk of ovarian cancer, where the risk reduction is endometrioid > clear cell carcinoma > mucinous > plasma carcinoma, which is a complex expression that simply means that tubal ligation reduces the risk of ovarian cancer from uterine sources. This complex expression simply means that tubal ligation reduces ovarian epithelial cancer originating from the uterus, but constantly prevents cancer originating from the umbilical end of the fallopian tube. In fact, China should have the most to say in this regard. Tubal ligation used to be a method of birth control in rural areas during the implementation of the family planning policy. It can therefore be hypothesized that women of a certain age should have a lower incidence of ovarian cancer than other age groups. A recent study (cohort study) from Sweden with even greater strength of evidence showed that tubectomy, hysterectomy, and tubal ligation all reduced the risk of ovarian cancer. Based on these findings, the American College of Obstetricians and Gynecologists (ACOG) committee recommends that: for women undergoing total hysterectomy who are at risk for ovarian cancer but wish to keep their ovaries, removal of the fallopian tubes needs to be communicated and discussed; and for women wishing to be sterilized, bilateral salpingo-oophorectomy is an effective method of sterilization. Prophylactic tubectomy offers patients a way to prevent ovarian cancer. All these, however, need to be communicated to the patient and the decision made after weighing the pros and cons.