Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada.
Int J Gynecol Pathol. 2012 Mar;31(2):103-10. doi: 10.1097/PGP.0b013e31822ea955.
Serous tubal intraepithelial carcinoma (STIC) has been implicated in the pathogenesis of pelvic serous carcinoma. We hypothesized that, if this is the case, the frequency of STIC should be substantially lower in endometrial serous carcinomas, in nonserous gynecologic malignancies, and in benign gynecologic neoplasms than in ovarian or peritoneal serous carcinomas. From 2007 to 2009 the fallopian tubes of 342 consecutive gynecologic cases were entirely submitted for histology using the Sectioning and Extensively Examining the FIMbriated end protocol. This study included 300 of these cases (277 TAH-BSO, 23 BSO) after exclusion. The hematoxylin and eosin-stained slides from the fallopian tubes were independently reviewed by 2 gynecologic pathologists who were blinded to all other findings; disagreements were resolved by a third pathologist. Among 46 cases of ovarian malignancies, STIC was identified in 6 (18.8%) of 32 cases of serous carcinoma, but not in any other subtype. Similarly, STIC coexisted in 4 (14.3%) of 28 cases of endometrial serous carcinoma; however, no STIC was identified in any of the 74 cases of nonserous endometrial malignancies. STIC was identified in 2 (28.6%) of 7 cases of peritoneal serous carcinoma. No STIC was identified among 15 nongynecologic malignancies, 90 cases of benign conditions, and 27 cases of other conditions including 4 cases of cervical adenocarcinoma in situ and high-grade cervical intraepithelial lesions, 8 cases of endometrial atypical complex hyperplasias, and 15 cases of ovarian borderline tumors. In conclusion, the fallopian tube may be the origin of some pelvic serous carcinomas. Other possibilities that may explain the origin of pelvic high-grade serous carcinoma are discussed. Given that STIC coexisted with 14% of endometrial serous carcinomas, a more unifying theory may be that gynecologic serous carcinomas and STIC are multifocal lesions.
输卵管上皮内浆液性癌（STIC）被认为与盆腔浆液性癌的发病机制有关。我们假设，如果是这种情况，那么在子宫内膜浆液性癌、非浆液性妇科恶性肿瘤和良性妇科肿瘤中，STIC 的频率应该明显低于卵巢或腹膜浆液性癌。 2007 年至 2009 年，连续 342 例妇科病例的输卵管全部采用分段广泛检查输卵管伞端活检（Sectioning and Extensively Examining the FIMbriated end protocol）进行组织学检查。在排除 277 例经腹全子宫切除术+双侧附件切除术（TAH-BSO）和 23 例单纯双侧附件切除术（BSO）病例后，本研究纳入了其中的 300 例病例。输卵管的苏木精和伊红染色切片由 2 位妇科病理学家独立审阅，他们对所有其他发现均不知情；意见分歧由第三位病理学家解决。在 46 例卵巢恶性肿瘤中，在 32 例浆液性癌中有 6 例（18.8%）发现 STIC，但在其他任何亚型中均未发现。同样，在 28 例子宫内膜浆液性癌中有 4 例（14.3%）共存 STIC；然而，在 74 例非浆液性子宫内膜恶性肿瘤中均未发现 STIC。在 7 例腹膜浆液性癌中有 2 例（28.6%）发现 STIC。在 15 例非妇科恶性肿瘤、90 例良性疾病和 27 例其他疾病中均未发现 STIC，包括 4 例宫颈原位腺癌和高级别宫颈上皮内病变、8 例子宫内膜非典型复杂增生和 15 例卵巢交界性肿瘤。总之，输卵管可能是一些盆腔浆液性癌的起源。还讨论了可能解释盆腔高级别浆液性癌起源的其他可能性。鉴于 STIC 与 14%的子宫内膜浆液性癌共存，一个更具统一性的理论可能是妇科浆液性癌和 STIC 是多灶性病变。
