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浆液性输卵管上皮内癌对卵巢、输卵管及腹膜高级别浆液性癌患者预后的临床影响。

The clinical impact of serous tubal intraepithelial carcinoma on outcomes of patients with high-grade serous carcinoma of the ovary, fallopian tube, and peritoneum.

作者信息

Toptas Tayfun, Pestereli Elif, Simsek Tayup, Bozkurt Selen, Erdogan Gulgun, Karaveli Seyda

机构信息

Department of Obstetrics and Gynecology, Division of Gynecologic Oncological Surgery, Akdeniz University School of Medicine, Antalya, Turkey.

Department of Pathology, Division of Gynecopathology, Akdeniz University School of Medicine, Antalya, Turkey.

出版信息

J Cancer Res Ther. 2018 Apr-Jun;14(3):587-592. doi: 10.4103/0973-1482.172130.

Abstract

AIMS

To investigate whether the presence of serous tubal intraepithelial carcinoma (STIC) is associated with clinical outcomes in a nonselected (unknown BRCA status) cohort of patients with a high-grade serous carcinoma (HGSC) of the ovary, fallopian tube, and peritoneum.

SETTINGS AND DESIGN

A prospective case-series with planned data collection.

SUBJECTS AND METHODS

The study was conducted in a total of 131 patients, who underwent primary cytoreductive surgery between 2007 and 2012. Histological examination of the fallopian tubes included the "sectioning and extensively examining the fimbriated end" protocol. The diagnosis of STIC was based on the combination of morphology and immunohistochemistry. The patients were divided into two groups according to the absence or presence of STIC and compared clinicopathologically.

STATISTICAL ANALYSIS USED

Analyses were performed using PASW 18 (SPSS/IBM, Chicago, IL, USA) software. The primary outcome was progression-free survival (PFS), and the secondary outcome was overall survival (OS).

RESULTS

STIC was identified in 20.6% of patients. Median follow-up time was 49.5 months for the STIC-positive group and 38.0 months for the STIC-negative group. Study groups were comparable in terms of clinicopathological characteristics with the exception that patients with STIC had less lymph node involvement (55.0% vs. 65.4%, P = 0.001), and more diagnosis of primary tubal carcinoma (29.6% vs. 3.8%, P = 0.001) compared to those without STIC. No statistically significant differences in terms of PFS (P = 0.462) and OS (P = 0.501) were observed between the groups.

CONCLUSIONS

The absolute identification of the origin of tumor cell does not seem to significantly affect the clinical course of the patients with HGSC.

摘要

目的

在一组未选择(BRCA状态未知)的卵巢、输卵管及腹膜高级别浆液性癌(HGSC)患者队列中,研究浆液性输卵管上皮内癌(STIC)的存在是否与临床结局相关。

设置与设计

一项进行计划数据收集的前瞻性病例系列研究。

研究对象与方法

该研究共纳入131例患者,这些患者在2007年至2012年间接受了初次肿瘤细胞减灭术。输卵管的组织学检查采用“对伞端进行切片并广泛检查”方案。STIC的诊断基于形态学和免疫组化相结合的方法。根据是否存在STIC将患者分为两组,并进行临床病理比较。

所用统计分析方法

使用PASW 18(SPSS/IBM,美国伊利诺伊州芝加哥)软件进行分析。主要结局为无进展生存期(PFS),次要结局为总生存期(OS)。

结果

20.6%的患者被诊断为STIC。STIC阳性组的中位随访时间为49.5个月,STIC阴性组为38.0个月。研究组在临床病理特征方面具有可比性,但与无STIC的患者相比,STIC患者的淋巴结受累较少(55.0%对65.4%,P = 0.001),原发性输卵管癌的诊断更多(29.6%对3.8%,P = 0.001)。两组之间在PFS(P = 0.462)和OS(P = 0.501)方面未观察到统计学显著差异。

结论

肿瘤细胞起源的明确认定似乎并未显著影响HGSC患者的临床病程。

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