“Primary peritoneal” high-grade serous carcinoma is very likely metastatic from serous tubal intraepithelial carcinoma: Assessing the new paradigm of ovarian and pelvic serous carcinogenesis and its implications for screening for ovarian cancer

摘要: Abstract Objective Primary peritoneal high-grade serous carcinoma is thought to arise from the peritoneum, but recent data suggest that fallopian tube may be an occult source of many these tumors. This study was performed evaluate this hypothesis in unselected series cases. Methods Fallopian tubes 51 consecutive cases meeting GOG criteria for primary carcinoma, FIGO stages II–IV, were analyzed. Results Serous tubal intraepithelial (STIC) identified 19 patients (37%). When fimbriae examined, STIC 46%, and when all tissue 56%. confined 53%, involved nonfimbrial mucosa 20%, 20%. Patients with significantly older than those without (75years vs. 67years, respectively; p =0.007). more likely have stage IV disease as compared (42% 12.5%, =0.037). Conclusions At least half are associated tube, usually involving fimbriae. These findings support view that, like "primary ovarian carcinoma," what has been traditionally classified carcinoma" probably derived tube. important implications ultrasound screening trials cancer which based on assumption enlarged ovary a very early manifestation disease.