Division of Women's & Perinatal Pathology, Department of Pathology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA.
Department of Pathology, Sunnybrook Health Sciences Centre, 2075 Bayview Ave. Toronto, Ontario, M4N 3M5, Canada.
Gynecol Oncol. 2017 Jul;146(1):69-73. doi: 10.1016/j.ygyno.2017.04.015. Epub 2017 May 4.
Objective The purpose of this study was to determine the prevalence of incidentally discovered serous tubal intraepithelial carcinoma in women without a genetic risk for or history of high grade serous carcinoma (HGSC) in the gynecologic tract.
All pathology reports at our institution that included bilateral salpingectomies from January 2006-December 2011 were examined in women >50years old in which the entire tube or the distal one-third was examined histologically with the complete (proximal and distal fallopian tube) or modified (distal one third of the tube) SEE-FIM protocol. Cases were divided into: Group 1, a history of or known risk factors (BRCA1 or BRCA2 mutations) for HGSC and Group 2, those without these attributes for whom a STIC would be unexpected (incidental). Women undergoing unspecified "risk-reducing" procedures were included in Group 1.
Of 4051 identified total, 2268 had complete examination of the distal fallopian tube and were age 50 or above. Of these, 1747 were in group 2. Two STICs were identified (0.1%), one associated with a grade 2 endometrial endometrioid adenocarcinoma and one with a low-grade ovarian serous carcinoma in the setting of a serous borderline tumor.
Incidental STICs in women over age 50 are uncommon. However, the significance of lesser tubal atypias (0.3% in this study), risk of STIC in women with no epithelial pathology and the risk imposed by coexisting endometrioid neoplasia are unclear and require further study.
本研究旨在确定在妇科生殖道无高级别浆液性癌（HGSC）遗传风险或病史的女性中，偶然发现的输卵管浆液性上皮内癌的发生率。
我们机构 2006 年 1 月至 2011 年 12 月间所有>50 岁的女性患者中，对所有病理学报告进行了检查，这些患者接受了双侧输卵管切除术，且整个输卵管或远端三分之一通过完整（近端和远端输卵管）或改良（输卵管远端三分之一）SEE-FIM 方案进行了组织学检查。病例分为两组：组 1，有 HGSC 的病史或已知风险因素（BRCA1 或 BRCA2 突变）；组 2，无这些特征，因此预计不会发生输卵管内原位癌（意外）。因不明原因接受“降低风险”手术的女性被归入组 1。
在确定的 4051 例患者中，有 2268 例接受了完整的输卵管远端检查，年龄在 50 岁或以上。其中 1747 例属于组 2。发现了 2 例输卵管内原位癌（0.1%），其中 1 例与 2 级子宫内膜子宫内膜样腺癌相关，另 1 例与浆液性交界性肿瘤背景下的低级别卵巢浆液性癌相关。
50 岁以上女性偶然发生的输卵管内原位癌并不常见。然而，较小的输卵管不典型增生（本研究中为 0.3%）的意义、无上皮病理的女性发生输卵管内原位癌的风险以及共存的子宫内膜样肿瘤带来的风险尚不清楚，需要进一步研究。
