Samimi Goli, Trabert Britton, Geczik Ashley M, Duggan Máire A, Sherman Mark E
Division of Cancer Prevention.
Division of Cancer Epidemiology and Genetics.
JNCI Cancer Spectr. 2018 Dec 14;2(4):pky061. doi: 10.1093/jncics/pky061. eCollection 2018 Oct.
Frequent detection of serous tubal intraepithelial carcinoma (STIC) among 2 mutation carriers undergoing risk-reducing surgery prompted the hypothesis that many adnexal high-grade serous carcinomas (HGSCs) arise from the fallopian tube, rather than the ovary, as supposed. The changing paradigm has important implications for HGSC prevention. Most data related to the frequency of STIC are derived from case series and estimates vary widely. Therefore, we analyzed population-based data from 10 523 surgeries including salpingectomy (Jan 2014-Dec 2016) that were examined using the "Sectioning and Extensively Examining the Fimbria" protocol, which optimizes STIC detection. Overall, STIC was detected in 40 (0.38%) specimens, including 32 diagnosed with concurrent gynecologic cancer. STIC was detected in 8 (<0.01%) of 9392 cases with benign diagnoses. We conclude that the relative rarity of STIC diagnoses in routine pathology practice has critical implications for research aiming to elucidate the pathogenesis of HGSC and developing prevention strategies.
在2名接受降低风险手术的基因突变携带者中频繁检测到浆液性输卵管上皮内癌（STIC），这促使人们提出一种假设，即许多附件高级别浆液性癌（HGSC）起源于输卵管，而非如之前所认为的那样起源于卵巢。这种范式的转变对HGSC的预防具有重要意义。大多数与STIC频率相关的数据来自病例系列研究，估计值差异很大。因此，我们分析了10523例手术（包括输卵管切除术，时间为2014年1月至2016年12月）的基于人群的数据，这些手术采用了“切片并广泛检查伞端”方案，该方案可优化STIC的检测。总体而言，在40个（0.38%）标本中检测到STIC，其中32例同时被诊断为妇科癌症。在9392例良性诊断病例中，有8例（<0.01%）检测到STIC。我们得出结论，在常规病理实践中STIC诊断相对罕见，这对旨在阐明HGSC发病机制和制定预防策略的研究具有关键意义。
