孤立性浆液性输卵管上皮内癌（STIC）诊断后盆腔高级别浆液性癌的发病率：文献系统评价
Incidence of pelvic high-grade serous carcinoma after isolated STIC diagnosis: A systematic review of the literature.
作者信息
Linz Valerie Catherine, Löwe Amelie, van der Ven Josche, Hasenburg Annette, Battista Marco Johannes
机构信息
Department of Gynaecology and Obstetrics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany.
出版信息
Front Oncol. 2022 Aug 31;12:951292. doi: 10.3389/fonc.2022.951292. eCollection 2022.
OBJECTIVE
Serous tubal intraepithelial carcinoma (STIC) is a precursor lesion of pelvic high-grade serous carcinoma (HGSC). Information on treatment and outcome of isolated STIC is rare. Therefore, we reviewed systematically the published literature to determine the incidence of subsequent HGSC in the high- and low-risk population and to summarize the current diagnostic and therapeutic options.
METHODS
A systematic review of the literature was conducted in MEDLINE-Ovid, Cochrane Library and Web of Science of articles published from February 2006 to July 2021. Patients with an isolated STIC diagnosis and clinical follow-up were included. Study exclusion criteria for review were the presence of synchronous gynaecological cancer and/or concurrent non-gynaecological malignancies.
RESULTS
3031 abstracts were screened. 112 isolated STIC patients out of 21 publications were included in our analysis with a pooled median follow-up of 36 (interquartile range (IQR): 25.3-84) months. 71.4% of the patients had peritoneal washings (negative: 62.5%, positive: 8%, atypic cells: 0.9%). Surgical staging was performed in 28.6% of all STICs and did not show any malignancies. 14 out of 112 (12.5%) patients received adjuvant chemotherapy with Carboplatin and Paclitaxel. Eight (7.1%) patients developed a recurrence 42.5 (IQR: 33-72) months after isolated STIC diagnosis. Cumulative incidence of HGSC after five (ten) years was 10.5% (21.6%). Recurrence occurred only in carriers (seven out of eight patients, one patient with unknown status).
CONCLUSION
The rate of HGSC after an isolated STIC diagnosis was 7.1% with a cumulative incidence of 10.5% (21.6%) after five (ten) years. HGSC was only observed in carriers. The role of adjuvant therapy and routine surveillance remains unclear, however, intense surveillance up to ten years is necessary.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42021278340.
目的
浆液性输卵管上皮内癌（STIC）是盆腔高级别浆液性癌（HGSC）的前驱病变。关于孤立性STIC的治疗及预后的信息较为罕见。因此，我们系统回顾了已发表的文献，以确定高危和低危人群中后续HGSC的发生率，并总结当前的诊断和治疗选择。
方法
在MEDLINE - Ovid、Cochrane图书馆和科学网中对2006年2月至2021年7月发表的文章进行系统的文献回顾。纳入孤立性STIC诊断且有临床随访的患者。文献回顾的研究排除标准为存在同步性妇科癌症和/或并发非妇科恶性肿瘤。
结果
筛选了3031篇摘要。我们的分析纳入了21篇出版物中的112例孤立性STIC患者，汇总后的中位随访时间为36（四分位间距（IQR）：25.3 - 84）个月。71.4%的患者进行了腹水检查（阴性：62.5%，阳性：8%，非典型细胞：0.9%）。28.6%的所有STIC患者进行了手术分期，未发现任何恶性肿瘤。112例患者中有14例（12.5%）接受了卡铂和紫杉醇辅助化疗。8例（7.1%）患者在孤立性STIC诊断后42.5（IQR：33 - 72）个月出现复发。5年（10年）后HGSC的累积发生率为10.5%（21.6%）。复发仅发生在携带者中（8例患者中有7例，1例患者状态未知）。
结论
孤立性STIC诊断后HGSC的发生率为7.1%，5年（10年）后的累积发生率为10.5%（21.6%）。仅在携带者中观察到HGSC。辅助治疗和常规监测的作用仍不明确，然而，长达10年的密切监测是必要的。
系统评价注册
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