Serous adenocarcinoma of fallopian tubes: histological and immunohistochemical aspects

Abstract

Primary cancer of the fallopian tubes (PCFT) has the lowest incidence of tumors of the female reproductive organs, but its mortality is quite high.1 It was first described in a small number of patients as sporadic observations. The cause, frequency, diagnosis, prevention, and treatment of PCFT are insufficiently illuminated in the modern medical literature. The incidence of malignant tumors of the fallopian tubes (FT) ranges from 0.14% to 1.8% among all malignant tumors of the female reproductive system.2-5 While it is difficult to identify the initial tumor process of tubo-ovarian tumors, FT malignant tumors are often regarded as a type of ovarian cancer. Consequently, these tumors are much more frequent in gynecologic practice.6,7 This causes significant discrepancies regarding reports of PCFT morbidity, which undoubtedly depends on the quality of morphologic diagnosis. Practically, FT carcinomas are found more frequently in oncogynecology. Moreover, they serve as the primary source for serous and mucinous tumors of the ovaries and peritoneum.8-11 Increased oncologic awareness and improved diagnostic methods have led to a relative increase in the PCFT detection rate in recent years.12 The main prognostically important criteria remain tumor clinical stage and their degree of malignancy.13,14 The rarity of PCFT has made it impossible to identify significant predictive factors thus far. Identification of tumor markers in PCFT tissue may provide important diagnostic and prognostic information about the biological properties of this neoplasm. Information about tumor hormonal status (estrogen receptor [ER] and progesterone receptor [PR]), proliferative potential (Ki-67), anti-apoptotic properties (p53 and Bcl-2), and ability to stimulate angiogenesis (vascular endothelial growth factor [VEGF]) will undoubtedly serve as the basis for a pathophysiologic understanding of the molecular properties of FT cancer. Further information may allow identification of new target therapeutic methods for PCFT. Investigation of these tumor parameters is the aim of this study.