[1194] Do Deeper Sections Increase the Yield of Detection of Serous Tubal Intraepithelial Carcinoma (STIC) in the "Sectioning and Extensively Examining the Fimbriated End" (SEEFIM) Protocol?

Etienne Mahe, Shangguo Tang, Pratima Deb, Alice Lytwyn, Monalisa Sur, Dean Daya. McMaster University, Hamilton, ON, Canada

Background: Several studies have demonstrated an association between STIC and pelvic (i.e. ovarian, endometrial and peritoneal) serous carcinoma. It has been suggested that the adoption of the SEEFIM protocol should enhance the detection of STIC since it allows for the histomorphological evaluation of the entire fallopian tube with added emphasis on the fimbrial mucosa. To our knowledge, however, no study has yet examined the potential effect of deeper level H&E sections of the entire fallopian tube on the yield of STIC from a sample of salpingectomies associated with ovarian, endometrial and peritoneal serous carcinomas.
Design: Two deeper level H&E sections were cut from all blocks of the entirely submitted fallopian tubes (as per the SEEFIM protocol) and were reviewed by a panel of expert gynaecological pathologists. The 55 cases from which these deeper sections were obtained were initially diagnosed as STIC-negative serous carcinomas of ovarian, endometrial and primary peritoneal origin. These cases were part of a larger study of the frequency of STIC in 300 consecutive bilateral salpingectomies of which 67 were associated with serous carcinoma of the ovary, endometrium or peritoneum. Of these 67 cases, 12 had shown STIC and 55 were negative.
Results: Four additional cases of STIC were identified. All four STICs were intratubal without involvement of the fimbriae. No additional cases of STIC were identified in those cases associated with an endometrial serous carcinoma.

Frequency of STIC in serous gynaecologic malignancies before and after deeper sections
Cases of Serous CarcinomaAssociated Salpingectomy Specimens
Primary SiteNumberNumber of cases with STIC by single H&E (%)Number of additional cases in which STIC was found on deeper sectionsTotal Number of cases with STIC (%)
Ovary326 (19)39 (28)
Endometrium284 (14)04 (14)
Peritoneum72 (29)13 (43)

Conclusions: The single H&E section SEEFIM approach detected only 75% (95%CI: 51-90%) of the cases of STIC in our sample. We conclude that the yield of the SEEFIM protocol is indeed increased with deeper sections. Furthermore, none of the extra cases of STIC would have been detected had deeper level H&E sections been performed only on the fimbrial blocks.
Category: Gynecologic & Obstetrics

Tuesday, March 20, 2012 1:00 PM

Poster Session IV # 136, Tuesday Afternoon


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