Tubal Cytology of the Fallopian Tube as a Promising Tool for Ovarian Cancer Early Detection

Summary

We explored a tubal cytologic method by sampling the fallopian tube directly post-surgical excision as a tool of ovarian cancer early detection. Here, we present a protocol to collect fallopian tube cells from freshly received surgical specimens.

Abstract

Currently, it is widely accepted that the vast majority of ovarian high-grade serous carcinoma (HGSC) originate from the fallopian tube. However, due to the lack of markers or tools for the ovarian cancer identification, the early detection of HGSC remains challenging. Direct sampling of the fallopian tube can enhance sensitivity for detection of neoplastic cells when the tumor is not grossly visible. We developed a procedure to collect fallopian tube cells directly from freshly received surgical specimens, which has shown excellent correlation with histological findings. This approach lays a foundation for the future utility of minimally invasive laparoscopic screening in high-risk patient populations.

Introduction

Ovarian high-grade serous carcinoma (HGSC) is the most common and lethal type of ovarian cancer, and remains a major threat to the public health. In the past decade, researchers have suggested that the vast majority of HGSC cases arise from the fallopian tube instead of the ovary itself ^1,2,3,4,5,6. Serous tubal intraepithelial carcinoma (STIC) is widely accepted as the precursor of HGSC ^1,7,

Protocol

An Institutional Review Board approval was received from University of Arizona for conducting this study. Informed patient consent forms were obtained.

1. Patient Selection

NOTE: An Institutional Review Board approval was obtained from University of Arizona. A total of 38 patients were recruited. The patients' ages ranged from 32 to 86 years old with a mean of 55 years, of whom 26 patients were post-menopausal and 12 patients were pre-menopausal.

1. Obtain informed consent from each patient.

2. Fallopian Tube Cells Collection Procedure

NOTE....

Results

Our previous study showed that sampling directly from the excised fallopian tube using a gentle touch brush could yield quantitatively and qualitatively adequate specimen for further cytological evaluation. In addition, the combination of automated slide preparation and modified Papanicolaou staining enable the pathologist to better visualize the cytological details to make an accurate diagnosis. An example of a manual quick pap stain of a specimen from a benign fallopian tube is illustra.......

Discussion

Prophylactic bilateral salpingectomy or salpingo-oophorectomy has been shown to decrease the risk of developing HGSC in high risk populations, such as women with BRCA gene mutations and strong familial cancer history. However, the sterility and surgical menopause caused by the surgery are serious consequences and make for a difficult decision, especially for women of childbearing age. The previous study has shown excellent correlation between tubal cytology and histology¹⁷. We believe that tubal c.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Cytobrush plus GT gentle touch of Medscand sample collection kit	CooperSurgical	C0112
ThinPrep preservCyt solution	HOLOGIC	234005
ThinPrep 2000 Processor	HOLOGIC	70031-001
Papanicolaou Stain, EA 65	sigma aldrich	HT40432
95% Ethanol	sigma aldrich	652261
100% Ethanol	sigma aldrich	493538
Xylene	sigma aldrich	214736
Hematoxylin	sigma aldrich	H9627
Sakura Tissue Tek 2000 tissue processor	SAKURA	TISSUE-TEK VIP 2000
Mayo Dissecting Scissors,5.5 straight	Pilgrim medical equiment	FA710-45
Chemware Forceps	United state plastic corp	76122
Tissue-Tek Accu-Edge Trimming blades,short	SAKURA	4785
Tissue-Tek Accu-Edge Trimming blades handle,short	SAKURA	4786