Hausnerová Jitka, Slunečko Robert, Ovesná Petra, Bednaříková Markéta, Zlámalíková Lenka, Kosťun Jan, Stráník Petr, Smoligová Vendula, Viktora Libor, Koblížková Michaela, Presl Jiří, Weinberger Vít
Department of Pathology, University Hospital Brno and Masaryk University, Brno, Czech Republic.
Department of Pathology, Bioptická Laboratoř s.r.o, Pilsen, Czech Republic.
Cytopathology. 2025 Nov;36(6):578-588. doi: 10.1111/cyt.70022. Epub 2025 Sep 11.
High-grade serous carcinoma (HGSC), the most prevalent and lethal form of ovarian cancer, is increasingly recognised to originate in the fimbrial end of the fallopian tube (FT). Timely detection remains a critical unmet clinical need due to ineffective screening methods. This prospective observational study assesses the diagnostic potential of FT brush cytology by correlating cytomorphological and immunocytochemical findings with histologically confirmed HGSC.
A total of 134 FT from 89 patients undergoing salpingo-oophorectomy (with or without hysterectomy) were analysed. Liquid-based cytology samples were evaluated for morphological abnormalities and subjected to immunocytochemistry using p53 and Ki-67 markers. Cytological results were classified as benign, suspicious or malignant. Statistical analyses included sensitivity, specificity and odds ratio calculations via logistic regression (α = 0.05), performed using the R software.
Histopathology confirmed HGSC in 15 patients. Of these, brush cytology identified 12 as suspicious or malignant, demonstrating high diagnostic concordance. Aberrant p53 expression was found in 11 cases, and a high Ki-67 proliferation index was observed in 10. These findings underscore the strong correlation between cytological, immunocytochemical and histological features of tubal HGSC.
In conclusion, FT brush cytology combined with p53 and Ki-67 immunocytochemistry shows promise as a minimally invasive approach for early HGSC detection. Future research should focus on larger prospective cohorts, ideally incorporating in vivo hysteroscopic sampling.
高级别浆液性癌（HGSC）是卵巢癌最常见且致死率最高的形式，越来越多的研究认为其起源于输卵管（FT）的伞端。由于筛查方法无效，及时检测仍然是一项尚未满足的关键临床需求。这项前瞻性观察性研究通过将细胞形态学和免疫细胞化学结果与组织学确诊的HGSC相关联，评估了FT刷检细胞学的诊断潜力。
对89例行输卵管卵巢切除术（有或无子宫切除术）患者的134条FT进行了分析。对液基细胞学样本进行形态学异常评估，并使用p53和Ki-67标记物进行免疫细胞化学检测。细胞学结果分为良性、可疑或恶性。统计分析包括通过逻辑回归计算敏感性、特异性和比值比（α = 0.05），使用R软件进行。
组织病理学确诊15例HGSC。其中，刷检细胞学将12例鉴定为可疑或恶性，显示出较高的诊断一致性。11例发现p53表达异常，10例观察到高Ki-67增殖指数。这些发现强调了输卵管HGSC的细胞学、免疫细胞化学和组织学特征之间的密切相关性。
总之，FT刷检细胞学联合p53和Ki-67免疫细胞化学显示出作为早期HGSC检测的微创方法的潜力。未来的研究应集中在更大的前瞻性队列上，理想情况下纳入体内宫腔镜取样。
