Primary Fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction
Primary Fallopian tube malignancies in BRCA-positive women undergoing surgery for ovarian cancer risk reduction
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DOI：
10.1200/jco.2007.12.2622
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发表时间：
2007-09-01
影响因子：
45.3
通讯作者：
Muto, Michael G.
中科院分区：
文献类型：
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作者：
Callahan, Michael J.;Crum, Christopher P.;Muto, Michael G.
PurposeTo审查的频率和位置的恶性肿瘤检测后，预防性输卵管卵巢切除术的妇女BRCA mutations.MethodsMedical记录和病理结果进行了审查，从BRCA阳性的妇女进行预防性手术，卵巢癌的风险降低谁进行了完整的附件检查。1999年1月和2007年1月之间进行此程序的患者进行了identified.ResultsFrom 1999年1月至2007年1月，122 BRCA阳性患者进行了预防性手术在布里格姆妇女医院妇科肿瘤科。中位年龄为46.5岁（范围：33 - 76岁）。7例（5.7%）发现有上生殖道早期恶性肿瘤，所有患者诊断时年龄>= 44岁。在1999年1月至2007年1月期间剔除的7个连续癌症中，所有（100%）起源于输卵管的伞部或壶腹区域; 6个具有早期（上皮内）成分。其中两例与卵巢表面植入有关，另外两例需要重复切片才能检测到伞部的微观癌。结论输卵管远端似乎是早期恶性肿瘤的主要起源部位，在接受卵巢癌风险降低手术的女性中，约6%的女性检测到了早期恶性肿瘤。BRCA突变阳性女性中最大比例的浆液性癌症风险应分配给伞而不是卵巢，未来的临床和研究方案应采用伞的彻底检查，包括每个组织块的多个切片，以最大限度地检测该人群的早期恶性肿瘤。
PurposeTo review the frequency and location of malignancies detected after prophylactic salpingo-oophorectomy in women with BRCA mutations.MethodsMedical records and pathology findings were reviewed from BRCA-positive women undergoing prophylactic surgery for ovarian cancer risk reduction who underwent complete examination of the adnexa. Patients undergoing this procedure between January 1999 and January 2007 were identified.ResultsFrom January 1999 to January 2007, 122 BRCA-positive patients underwent prophylactic surgery in the Division of Gynecologic Oncology at Brigham and Women's Hospital. The median age was 46.5 years (range, 33 to 76 years). Seven (5.7%) were found to have an early malignancy in the upper genital tract and all patients were age >= 44 years at diagnosis. Of seven consecutive cancers culled between January 1999 and January 2007, all (100%) originated in the fimbrial or ampullary region of the tube; six had an early (intraepithelial) component. Two were associated with surface implants on the ovary and two required repeated sectioning to detect microscopic carcinomas in the fimbria.ConclusionThe distal fallopian tube seems to be the dominant site of origin for early malignancies detected in approximately 6% of women undergoing ovarian cancer risk-reduction surgery. The greatest proportion of serous cancer risk in BRCA mutation-positive women should be assigned to the fimbria rather than the ovary, and future clinical and research protocols should employ thorough examination of the fimbria, including multiple sections from each tissue block, to maximize detection of early malignancies in this population.