Department of Diagnostic Pathology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
Department of Gynecology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
Cytopathology. 2020 Mar;31(2):122-129. doi: 10.1111/cyt.12796. Epub 2020 Feb 3.
Cases of pelvic high-grade serous carcinoma (HGSC) with incidentally detected cancer cells (ICCs) in endometrial and/or cervicovaginal cytology have been reported. This study aimed to clarify the incidence and characteristics of pelvic HGSC with ICCs and to determine whether ICCs have a negative prognostic impact.
Patients with ovarian/tubal/peritoneal HGSC who underwent pre-treatment uterine (endometrial/cervicovaginal) cytology or biopsy between January 2007 and May 2017 were included. We reviewed the frequencies of ICCs and compared the clinicopathological features and survival outcome between the ICC-positive and ICC-negative groups.
Of the 160 patients evaluated, 69 (43.2%) had positive ICCs in at least one uterine specimen. There were no significant differences in clinicopathological characteristics, such as age, FIGO stage, serum CA125 level, ascites, and tubal lesion, between the two groups. Moreover, ICCs had no significant survival impact on progression-free survival or overall survival.
Our study showed a high rate of pelvic HGSC with ICCs in pre-treatment uterine specimens. The ICCs per se had no negative impact on survival outcomes of pelvic HGSC. Furthermore, uterine biopsy and cytology can be useful and less-invasive methods to obtain tubo-ovarian/peritoneal cancer cells before treatment.
已有报道称，在子宫内膜和/或宫颈阴道细胞学检查中偶然发现癌细胞（ICCs）的盆腔高级别浆液性癌（HGSC）病例。本研究旨在阐明 ICC 阳性的盆腔 HGSC 的发生率和特征，并确定 ICC 是否具有负面预后影响。
纳入了 2007 年 1 月至 2017 年 5 月期间接受预处理子宫（子宫内膜/宫颈阴道）细胞学或活检的卵巢/输卵管/腹膜 HGSC 患者。我们回顾了 ICC 的频率，并比较了 ICC 阳性和 ICC 阴性组的临床病理特征和生存结局。
在评估的 160 例患者中，69 例（43.2%）至少有一个子宫标本 ICC 阳性。两组之间在年龄、FIGO 分期、血清 CA125 水平、腹水和输卵管病变等临床病理特征方面无显著差异。此外，ICC 对无进展生存期或总生存期没有显著的生存影响。
我们的研究显示，预处理子宫标本中 ICC 阳性的盆腔 HGSC 发生率较高。ICC 本身对盆腔 HGSC 的生存结局没有负面影响。此外，子宫活检和细胞学检查可以在治疗前获得输卵管卵巢/腹膜癌细胞的有用且微创方法。
