Introduction/Background Ovarian cancer is the most lethal gynecological malignancy.The high mortality rate is a consequence of delayed diagnosis due to the lack of screening and early diagnostic methods. Based on the recent theory that the majority of the gynecological extrauterine high grade serous carcinomas originate from the fallopian tube, we aimed to evaluate the correlation between epithelial carcinoma of the ovary and the immunocytochemistry of the ipsilateral fallopian tube cells.
Methodology Our research protocol is ongoing and is designed to include at least 115 patients undergoing salpingoophorectomy or total hysterectomy and salpingoophorectomy for any ovarian pathology. Ex vivo fallopian tube cytology smears are obtained utilizing a cytology brush and are placed in both microscopic slides and ThinPrep solution. The fallopian tube cytology samples are classified as benign, atypical or malignant. The cytological samples are also evaluated with immunocytochemistry for p53 protein and PAX-8 biomarker. The pathologic evaluation of the fallopian tubes follows the SEE-Fim protocol.
Results We have collected 40 fallopian tube cytological samples. Among the cases enlisted so far, 42.5% (17/40) refer to malignant ovarian carcinomas (9 HGSC, 2 LGSC, 4 endometrioid, 1 clear cell and 1 non-Hodgkin lymphoma) out of which, 58.8% (10/17) is both p53 and PAX-8 positive, 29.4% (5/17) is negative in immunocytochemistry, whereas 11.7% (2/17) shows positivity in one biomarker only. The benign arm represents the 52.5% of our cases (21/40) and the vast majority 85.7% (18/21) demonstrates negative immunocytochemistry. However, 3 cases of cystadenomas were found positive in p53 protein. Our results in borderline tumors are inconclusive, as the one is positive in both markers and the other negative.
Conclusion The combination of cytology and immunocytochemistry of the fallopian tube smear could be used as a promising diagnostic tool for ovarian, fallopian tube and peritoneal carcinoma. Further evaluation with larger sample size is warranted.
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