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原发性输卵管癌:临床病理分析及文献复习。

Primary fallopian tube carcinoma: a clinicopathologic analysis and literature review.

机构信息

Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, ROC; Department of Obstetrics and Gynecology, National Yang-Ming University, Taipei, Taiwan, ROC.

出版信息

J Chin Med Assoc. 2013 Oct;76(10):583-7. doi: 10.1016/j.jcma.2013.06.010. Epub 2013 Jul 25.

Abstract

BACKGROUND

Primary fallopian tube carcinoma (PFTC) is a rare tumor, and it is very difficult to diagnose preoperatively. The aims of this study were to evaluate the clinicopathologic features of primary fallopian tube carcinoma (PFTC) and to review the current available literature on PFTC.

METHODS

The medical records of 16 patients who were diagnosed with PFTC at Taipei Veterans General Hospital between January 2001 and December 2011 were analyzed retrospectively.

RESULTS

The mean age at diagnosis was 63 years (range, 41-86 years), and the mean follow-up period was 39.8 months (range, 4.0-102.8 months). Fourteen (87.5%) patients were menopausal women. The most common clinical presentation was nonspecific pelvic pain (37.5%), followed by abnormal vaginal bleeding (31.2%), pelvic mass (18.8%), and gastrointestinal symptoms (12.5%). One patient was diagnosed with PFTC preoperatively; 11 (68.6%) patients were diagnosed as having adnexal mass of unknown origin, but primarily in the ovary. Other diagnoses included endometrial cancer, cervical cancer, colon cancer, and rectum cancer in one patient each. Three (18.8%) patients were in Stage I, two (12.5%) in Stage II, nine (56.2%) in Stage III, and two (12.5%) in Stage IV. The serous type was histologically predominant (75%), and six patients were of a high grade (37.5%). The 5-year disease-free survival rate was 73.3%.

CONCLUSION

PFTC is infrequently diagnosed preoperatively or intraoperatively due to its rarity, and has a varied and nonspecific presentation. Only 6.3% of the patients had typical symptoms suggestive of tubal carcinoma. This report may benefit surgeons by providing additional information about the clinicopathologic behavior of PFTC so that patients can be appropriately counseled.

摘要

背景

原发性输卵管癌(PFTC)是一种罕见的肿瘤,术前诊断非常困难。本研究的目的是评估原发性输卵管癌(PFTC)的临床病理特征,并复习目前关于 PFTC 的文献。

方法

回顾性分析 2001 年 1 月至 2011 年 12 月期间在台北荣民总医院诊断为 PFTC 的 16 例患者的病历。

结果

诊断时的平均年龄为 63 岁(范围,41-86 岁),平均随访时间为 39.8 个月(范围,4.0-102.8 个月)。14 例(87.5%)患者为绝经后妇女。最常见的临床表现为非特异性盆腔痛(37.5%),其次为异常阴道出血(31.2%)、盆腔肿块(18.8%)和胃肠道症状(12.5%)。1 例患者术前诊断为 PFTC;11 例(68.6%)患者诊断为卵巢来源不明的附件肿块,但主要位于卵巢。其他诊断包括子宫内膜癌、宫颈癌、结肠癌和直肠癌各 1 例。3 例(18.8%)患者处于Ⅰ期,2 例(12.5%)患者处于Ⅱ期,9 例(56.2%)患者处于Ⅲ期,2 例(12.5%)患者处于Ⅳ期。组织学上以浆液型为主(75%),6 例为高级别(37.5%)。5 年无病生存率为 73.3%。

结论

由于其罕见性,PFTC 术前或术中诊断率较低,临床表现多样且无特异性。仅有 6.3%的患者有典型症状提示输卵管癌。本报告可为外科医生提供关于 PFTC 的临床病理行为的附加信息,以便对患者进行适当的咨询。

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