[1272] Pelvic High Grade Serous Carcinoma and Association with Serous Tubal Intraepithelial Carcinoma

Huaitao Yang, Rohit Bhargava, Xiangbai Chen, Faye Gao, Zaibo Li, Chengquan Zhao. Magee-Womens Hospital of UPMC, Pittsburgh, PA; Conemaugh Memorial Hospital, Johnstown, PA

Background: Serous tubal intraepithelial carcinoma (STIC) is considered a precursor of pelvic high-grade serous carcinomas (PHGSC). However, data regarding true prevalence of STIC and specific association of STIC with PHGSC are limited. The aim of the study was to determine the frequency of STIC in women with HGSC at various sites from a large women's hospital and determine associated clinical-pathologic features.
Design: We searched our institutional pathology database from 2005 to 2010 to retrieve cases diagnosed as HGSC of tubal, ovarian, peritoneal and endometrial origins. The prevalence of STICs and their association with HGSCs in every specific group were analyzed. The data obtained before and after institution of SEE-FIM protocol (sectioning and extensively examining the fimbriated end of the fallopian tube) were also compared. The SEE-FIM protocol was instituted at our hospital in 2008. Tumors were classified as ovarian, peritoneal, tubal or endometrial primary based on the conventional criteria.
Results: During the study period 472 cases of PHGSC were identified and classified as ovarian in origin in 225 cases (48%), tubal in 130 (27%), peritoneal in 17 (4%), and endometrial in 100 (21%) cases. There were only 11 (4%) cases of STIC reported in the 3-year period of 2005-2007 (i.e. prior to SEE-FIM protocol). In contrast, in the period of 2008-2010, the number of STIC cases was significantly increased to 43% (table 1). The frequency of STIC at each site ranged from 6% (endometrial) to 88% (ovarian) in the cases from 2008-2010. STIC was identified in 29% cases of ovarian HGSC.

Table 1 Frequency of STIC in HGSCs for each primary site
YearsFallopian tubeOvaryPeritoneumEndometriumTotal
2005-20077/73 (10%)1/121 (1%)2/7 (29%)1/52 (2%)11/252 (4.0%)
2008-201050/57 (88%)30/104 (29%)5/10 (50%)3/48 (6%)93/219 (43%)

Conclusions: 1) Standard SEE-FIM protocol is necessary for accurate detection of STICs; 2) STIC is the precursor lesion of tubal HGSC; 3) The association of STIC with ovarian HGSC in the current study is lower (29% in the current study versus 40-60% in prior studies), suggesting that a significant proportion of ovarian HGSC lack a tubal precursor lesion. This could also be due to fused tubes and ovaries where it is impossible to do the SEE-FIM protocol and obviously STIC will not be determined 4) STIC is unrelated to endometrial HGSC.
Category: Gynecologic & Obstetrics

Tuesday, March 20, 2012 1:00 PM

Poster Session IV # 141, Tuesday Afternoon


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