Lum Deirdre, Guido Richard, Rodriguez Erika, Lee Ted, Mansuria Suketu, D'Ambrosio Lori, Austin R Marshall
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
Department of Obstetrics, Gynecology, and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh School of Medicine, Pittsburgh.
J Minim Invasive Gynecol. 2014 Sep-Oct;21(5):851-6. doi: 10.1016/j.jmig.2014.03.017. Epub 2014 Apr 5.
To determine whether fallopian tube epithelial cells adequate for cytopathology can be obtained via a minimally invasive approach using brush cytology.
Prospective feasibility study (Canadian Task Force classification II-1).
Tertiary-care university-based teaching hospital.
Ten patients who underwent laparoscopic hysterectomy, with or without adnexal surgery, because of benign indications.
Attempted hysteroscopic and laparoscopic brush cytologic sampling of the fallopian tubes.
ThinPrep slides and cell blocks were prepared and analyzed. P53 and KI-67 immunostaining was performed on cell block specimens if adequate cellularity was present. The first 5 patients underwent attempted hysteroscopic sampling of the fallopian tube, with successful collection only in 1 patient. The protocol was then modified to enable sampling of the fallopian tube laparoscopically as well as hysteroscopically. In the other 5 patients sampling of the fallopian tubes was successful laparoscopically, including successful sampling hysteroscopically in 1 patient. The brush biopsy catheter could not be passed through the entire length of the fallopian tube in either the hysteroscopic or laparoscopic approach. All cytologic findings were interpreted as benign, although findings of nuclear overlapping, crowding, and small nucleoli were initially considered benign atypia. Immunohistochemistry for P53 and KI-67 yielded uniformly negative findings.
To our knowledge, this is the first study to describe endoscopic brush cytology of the fallopian tubes with correlated cytologic narrative. In the future, cytologic sampling of the fallopian tube may have implications for an ovarian cancer screening test.
确定能否通过使用刷检细胞学的微创方法获取适用于细胞病理学检查的输卵管上皮细胞。
前瞻性可行性研究（加拿大工作组分类II-1）。
基于大学的三级护理教学医院。
10例因良性指征接受腹腔镜子宫切除术（伴或不伴附件手术）的患者。
尝试对输卵管进行宫腔镜和腹腔镜刷检细胞学取样。
制备并分析了ThinPrep玻片和细胞块。如果细胞数量充足，则对细胞块标本进行P53和KI-67免疫染色。前5例患者尝试进行输卵管宫腔镜取样，仅1例成功采集。随后修改方案，以便同时通过腹腔镜和宫腔镜对输卵管进行取样。在另外5例患者中，腹腔镜下输卵管取样成功，其中1例患者宫腔镜取样也成功。在宫腔镜或腹腔镜检查中，刷检活检导管均无法通过输卵管全长。所有细胞学检查结果均被解释为良性，尽管核重叠、拥挤和小核仁的表现最初被认为是良性异型性。P53和KI-67免疫组化结果均为阴性。
据我们所知，这是第一项描述输卵管内镜刷检细胞学并伴有相关细胞学描述的研究。未来，输卵管细胞学取样可能对卵巢癌筛查试验具有重要意义。
