A comparison between cytology and histology to detect tubal intraepithelial lesion.
Alexandra Asaturova (RU), Leyla Adamyan (RU), Nikolay Kondrikov (RU), Larisa Ezhova (RU), Maya Sannikova (RU), Grigory Khabas (RU), Nafisa Fayzullina (RU)
[Asaturova] "Research Center for Obstetrics, Gynecology and Perinatology", [Adamyan] "Research Center for Obstetrics, Gynecology and Perinatology", [Kondrikov] "Research Center for Obstetrics, Gynecology and Perinatology", [Ezhova] "Research Center for Obstetrics, Gynecology and Perinatology", [Sannikova] "Research Center for Obstetrics, Gynecology and Perinatology", [Khabas] "Research Center for Obstetrics, Gynecology and Perinatology", [Fayzullina] "Research Center for Obstetrics, Gynecology and Perinatology"
Context: A lot of molecular and genetics evidence suggests the fallopian tube as the origin for ovarian high grade serous carcinoma (HGSC). Objective: We attempted to identify special cytological features for tubal intraepithelial lesions and compare them with histological pictures. Methods: cytological, hystological, immunocytochemical (bcl-2 expression) and immunohistochemical (p16 and Ki-67 expression) and statistical (χ2- test) methods were used. Patients: 14 patients were recruited, 23 smears from fallopian tube were investigated (HGSC, n=6, serous borderline ovarian tumors (SBOT), n=7, benign ovarian tumors, n=10) (mean age 47,3 ± 13,3) Results. Few-celled smear was revealed in 48% of cases, middle-celled – in 32%, hyper-celled – in 20%. Severe nuclear membrane irregularity was shown in 8% (moderate – in 16%, mild – in 40%, absence – in 28%). Different nuclear shape was detected in 83% of smears in HGSC patients and in 30% of smears in benign ovarian tumors patients. Nuclear polymorphism and nuclear membrane irregularity was more impressive in HGSC patients (p<0.05). Histologically all fallopian tubes from patients with HGSC demonstrated serous tubal intraepithelial carcinoma (STIC) (in 43% with invasive tubal carcinoma), in all cases of HGSC more than 10 secretory cells outgrowth (SCOUT) was revealed. Papillary tubal hyperplasia was diagnosed in 72% of fallopian tubes from patients with SBOT, more than 10 SCOUT was detected in 60% of these patients. In fallopian tubes from benign ovarian tumors more than 10 SCOUT was diagnosed in 20% of cases. STIC and more than 10 SCOUT was detected more frequently in patients with HGSC (p<0.01). Conclusion: Our results showed that we could differ benign and malignant cells and detect STIC cytologically. Thus, tubal cytology may be useful for precancerous tubal lesion and ovarian cancer screening and early detection.