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癌前病变的管理

Management of Preinvasive Lesions.

作者信息

Patrono Maria G, Corzo Camila, Iniesta Maria, Ramirez Pedro T

机构信息

*Department of Gynecology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina †Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.

出版信息

Clin Obstet Gynecol. 2017 Dec;60(4):771-779. doi: 10.1097/GRF.0000000000000316.

Abstract

Serous tubal intraepithelial carcinoma is considered the precursor lesion of high-grade serous carcinoma, and found in both low-risk and high-risk populations. Isolated serous tubal intraepithelial carcinomas in patients with BRCA1/2 mutations are detected in ∼2% of patients undergoing risk-reducing bilateral salpingo-oophorectomy and even with removal of the tubes and ovaries the rate of developing primary peritoneal carcinoma following remains up to 7.5%. Postoperative recommendations after finding incidental STICs remain unclear and surgical staging, adjuvant chemotherapy, or observation have been proposed. Discovery of STIC should prompt consideration of hereditary cancer program referral for BRCA1/2 mutation screening.

摘要

浆液性输卵管上皮内癌被认为是高级别浆液性癌的前驱病变,在低风险和高风险人群中均有发现。在接受降低风险的双侧输卵管卵巢切除术的患者中,约2%检测到携带BRCA1/2突变的孤立性浆液性输卵管上皮内癌,即使切除了输卵管和卵巢,随后发生原发性腹膜癌的几率仍高达7.5%。发现偶然的浆液性输卵管上皮内癌后的术后建议仍不明确,有人提出进行手术分期、辅助化疗或观察。发现浆液性输卵管上皮内癌应促使考虑将患者转诊至遗传性癌症项目进行BRCA1/2突变筛查。

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