CYTOHISTOLOGICAL CORRELATION IN THE DIAGNOSIS OF INTRAEPITHELIAL FALLOPIAN TUBE LESIONS
Objective of the study is to identify the possibility of the diagnosis of benign and precancerous lesions of fallopian tube epithelium using cytological technique by comparing the specific features of liquid-based cytology smears and histological preparations. Materials and Methods: 23 fallopian tubes of 14 patients with high-grade serous ovarian carcinoma (n=6), serous borderline ovarian tumors (n = 7), benign ovarian tumors (n=10) (the mean age of patients was 47,3 ± 13,3 years) were examined using liquid-based cytology, histological, immunocytochemical (bcl-2 expression) and immunohistochemical (p16 and Ki-67 expression) techniques. Criterion x2 for random number tables was used for statistical processing of the results obtained. Results. Scanty cellular smears were identified in 48% of cases, moderately cellular smears - in 32%, hypercellular - in 20%. Anisonucleosis was severe in 16% of cases, moderately expressed - в 24%, mildly expressed - in 40%. The distinct roughness of nuclear membrane is observed in 8% of cases, moderate roughness - in 16%, weak - in 40%, roughness was not observed - in 28%. Nuclear chromatin was hyperchromic in 32% of cases, mixed type - in 44%, hypochromic - in 24%. Different types of nuclei was observed in all groups, however, they were more often seen in the group with high-grade serous ovarian carcinoma (in 83%), less often - in the group with benign tumors (in 30%). Nuclei were multiple in 48% of cases, single - in 24%, were not visualized - in 28% of cases. Statistically significant differences were determined in respect of two examined parameters - nuclear polymorphism and the roughness of nuclear membrane which were identified significantly more often in the group with high-grade serous ovarian carcinoma (p < 0,05). Serous tubal intraepithelial carcinoma was detected in all cases in the histological examination of the removed fallopian tubes in the group of patients with high-grade serous ovarian carcinoma (in 43% of cases - in combination with invasive fallopian tube carcinoma), in all cases more than 10 secretory cell outgrowths (SCOUTs) (linear arrays of more than 30 consecutive cells) were detected. In the group of patients with borderline tumors the presence of papillary tubal hyperplasia was revealed in 72% of cases, in 28% of cases - tubal epithelium was unchanged, more than 10 secretory cell outgrowths (SCOUT) were identified in 60% of cases. In the group of patients with benign ovarian tumors the presence of more than 10 SCOUT (secretory cell outgrowths) was found in 20% of cases, in all other cases unchanged tubal epithelium was identified. Therefore, serous tubal intraepithelial carcinomas (STIC) and more than 10 SCOUT (secretory cell outgrowths) were discovered significantly more often in cases of high grade serous ovarian carcinoma, and papillary tubal hyperplasia - in cases of borderline ovarian tumors (p < 0,01). Conclusion: Thus, our research demonstrated that malignant and benign cells of fallopian tube epithelium can be verified using cytological method, and such precancerous lesions as serous tubal intraepithelial carcinoma (STIC) can be diagnosed as well. This suggests that liquid-based cytology technique can be used for the screening examination of intraepithelial lesions of fallopian tube.