Laboratory of Gynecologic Oncology, Division of Gynecologic Oncology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA.
School of Medicine, Griffith Health Institute, Griffith University, Meadowbrook, QLD 4131, Australia.
Gynecol Oncol. 2014 Feb;132(2):316-21. doi: 10.1016/j.ygyno.2013.12.007. Epub 2013 Dec 13.
The origins and clinical significance of endosalpingiosis (ES), ectopic tubal epithelium, are not well understood. These investigations aim to characterize ES as it relates to normal fallopian tube, ovarian surface and serous neoplasms.
A retrospective review of pathology reports from all prophylactic gynecologic surgeries from 2000 to 2010 was performed to assess the frequency of ES. Twenty-one archival specimens of ES, 6 normal fallopian tubes, 9 normal ovaries, 21 serous neoplasms and a commercially available ovarian tissue microarray were subjected to immunohistochemistry (IHC) with 11 tubal and Müllerian antigens. IHC staining was evaluated with a quantitative scoring system and scores were analyzed using MINITAB statistical software.
ES was noted in 3.5% of pathologic specimens from 464 prophylactic surgeries. The majority of antigens showed no significant differences (p > 0.05) in median IHC scores between ES and normal fallopian tube epithelium (nFTE), while they were significantly different (p < 0.05) from the ovarian surface epithelium (OSE). Median IHC scores were unchanged in ES tissues regardless of the location of ES or the presence of a concurrent serous neoplasm. Three antigens emerged as contemporary tubal and ES biomarkers: phospho-Smad2, BCL2 and FOXJ1. All 3 biomarkers were expressed in ES, nFTE and serous neoplasms, but not in OSE or other tumor types.
This study provides immunophenotypic evidence that ES is more similar to the nFTE than OSE. Further, ES biomarker expression closely resembles serous neoplasms strengthening the growing body of evidence that all Müllerian serous carcinomas arise from tubal-like epithelium.
内 （腔） 子宫内膜异位症（ES），即异位的输卵管上皮，其起源和临床意义尚不清楚。这些研究旨在研究 ES 与正常输卵管、卵巢表面和浆液性肿瘤的关系。
回顾性分析 2000 年至 2010 年所有预防性妇科手术的病理报告，以评估 ES 的发生率。21 例 ES 存档标本、6 例正常输卵管、9 例正常卵巢、21 例浆液性肿瘤和一个市售卵巢组织微阵列，进行 11 种输卵管和 Müller 抗原的免疫组织化学（IHC）检测。采用 MINITAB 统计软件对免疫组织化学染色进行定量评分，并对评分进行分析。
在 464 例预防性手术的病理标本中，发现 ES 占 3.5%。大多数抗原的免疫组织化学评分中位数在 ES 和正常输卵管上皮（nFTE）之间无显著差异（p > 0.05），而与卵巢表面上皮（OSE）有显著差异（p < 0.05）。ES 组织的免疫组织化学评分中位数不变，无论 ES 的位置如何，或是否存在同时存在的浆液性肿瘤。有 3 种抗原成为当代输卵管和 ES 的生物标志物：磷酸化 Smad2、BCL2 和 FOXJ1。所有 3 种生物标志物均在 ES、nFTE 和浆液性肿瘤中表达，但在 OSE 或其他肿瘤类型中不表达。
本研究提供了免疫表型证据，表明 ES 与 nFTE 更相似，而不是 OSE。此外，ES 生物标志物的表达与浆液性肿瘤相似，进一步证实了越来越多的证据表明所有 Müllerian 浆液性癌均起源于输卵管样上皮。
