Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: Evidence for a causal relationship
Intraepithelial carcinoma of the fimbria and pelvic serous carcinoma: Evidence for a causal relationship
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DOI：
10.1097/01.pas.0000213335.40358.47
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发表时间：
2007-02-01
影响因子：
5.6
通讯作者：
Crum, Christopher P.
中科院分区：
文献类型：
--
作者：
Kindelberger, David W.;Lee, Yonghee;Crum, Christopher P.
推测盆腔浆液性癌的起源包括卵巢、输卵管、子宫内膜、子宫颈。和腹膜。BRCA+女性的预防性输卵管卵巢切除术最近发现输卵管伞是早期浆液性癌（输卵管上皮内癌或TIC）的起源部位。我们在连续的完整附件检查（SEE-TEE方案）病例中探讨TIC与盆腔浆液性癌的关系。输卵管内膜（包括伞）受累阳性（A组）或阴性（B组）的病例被细分为输卵管、卵巢或原发性腹膜起源。在A组中，当存在时记录共存TIC，并在5例病例中确定p53突变状态。在55例可评价病例中，41例（75%）属于A组;包括输卵管癌（n = 5）、腹膜癌（n = 6）和卵巢癌（n = 30）。分别在5/5、4/6和20/30例患者中确定了TIC病灶。93%的TIC涉及菌毛。5个TIC和并发卵巢癌包含相同的p53突变。B组14例中13例为原发性卵巢癌，10例具有支持卵巢起源的特征。总的来说。71%和48%的“卵巢”浆液性癌有输卵管内膜受累或TIC。TIC与所有形式的盆腔浆液性癌共存，是许多此类肿瘤的合理起源。需要进一步的研究来阐明TIC在盆腔浆液性癌中的病因学意义，重新评估输卵管、腹膜和卵巢浆液性癌的标准，并确定远端管在盆腔浆液性癌发生中的作用。
Proposed origins of pelvic serous carcinoma include the ovary, fallopian tube.. and peritoneum. Prophylactic salpingo-oophorectomies in BRCA+ women have recently identified the fimbria as a site of origin for early serous carcinoma (tubal intraepithelial carcinoma or TIC). We explored the relationship of TIC to pelvic serous carcinomas in consecutive cases with complete adnexal exam (SEE-FIM protocol). Cases positive (group A) or negative (group B) for endosalpinx (including fimbria) involvement, were subclassified as tubal, ovarian, or primary peritoneal in origin. Coexisting TIC was recorded in group A when present and p53 mutation status was determined in 5 cases. Of 55 evaluable cases, 41 (75%) were in group A; including tubal (n = 5), peritoneal (n = 6), and ovarian (n = 30) carcinomas. Foci of TIC were identified in 5 of 5, 4 of 6, and 20 of 30, respectively. Ninety-three percent of TICs involved the fimbriae. Five of 5 TICs and concurrent ovarian carcinomas contained identical p53 mutations. Thirteen of 14 cases in group B were classified as primary ovarian carcinomas, 10 with features supporting an origin in the ovary. Overall. 71% and 48% of "ovarian" serous carcinomas had endosalpinx involvement or TIC. TIC coexists with all forms of pelvic serous carcinoma and is a plausible origin for many of these tumors. Further studies are needed to elucidate the etiologic significance of TIC in pelvic serous carcinoma, reevaluate the criteria for tubal, peritoneal, and ovarian serous carcinoma, and define the role of the distal tube in pelvic serous carcinogenesis.