Abstract
BackgroundMounting evidence suggests the fallopian tube as the origin for ovarian high grade serous carcinoma (HGSC). We attempted to identify the tubal cytological features that allow us to distinguish malignant from benign conditions.MethodsTubal specimens (n = 56) were collected from patients who underwent bilateral salpingo-oophorectomy (BSO) due to various clinical indications. A standard procedure to collect fallopian tube brushings from freshly received surgical specimens was developed. Cytological diagnoses were classified into three categories: benign, atypical, and suspicious for malignancy/malignant. Cytological variables of individual cells and epithelia were subjected to statistical analysis. The fallopian tube histology was used as diagnostic reference for confirmation of cytology diagnosis.ResultsAmong the 56 fallopian tube specimens, 2 (3.7 %) showed inadequate cellularity preventing further evaluation, 11 (20.4 %) were diagnosed as malignant or suspicious of malignancy, 7 were atypical, and 36 were benign. The presence of three dimensional clusters (p < 0.0001, Fisher’s Exact Test), or prominent nucleoli (p = 0.0252, Fisher Exact test) was highly correlated with the diagnosis of malignancy. The suspicious malignant/malignant cytological diagnosis was also highly correlated with presence of HGSC with or without serous tubal intraepithelial carcinoma (STIC).ConclusionsTubal cytology may be useful for ovarian cancer screening and early detection.
Highlights
Mounting evidence suggests the fallopian tube as the origin for ovarian high grade serous carcinoma (HGSC)
The accumulated data of the past decade indicates that the fallopian tube is likely the cellular source of ovarian high-grade serous carcinoma (HGSC), the most common and deadly type of ovarian cancer [1,2,3,4,5,6]
It is known that the majority of HGSCs arise within the fallopian tube, in the tubal fimbriated end, ovarian cancer early detection remains difficult and patients still largely present in the clinic at late stages
Summary
Mounting evidence suggests the fallopian tube as the origin for ovarian high grade serous carcinoma (HGSC). Our prior study suggests the fallopian tube as the main organ site of origin for ovarian low-grade serous carcinoma [7]. Study of the exfoliative cytology of fallopian tube epithelial cells has been previously attempted with the admission that it was complex, subject to degenerative changes and variation with menstrual cycle [16, 17]. The aim of these early studies was to recognize fallopian tube cells and to avoid misinterpretation of their presence within the cervical
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