Highlights
- •Survey to assess processing protocols of gynecologic surgical pathology specimens
- •Majority of pathology labs perform SEE-Fim on risk-reducing specimens.
- •Most labs perform SEE-Fim on benign specimens if first sections are suspicious.
- •Results suggest detailed processing of fallopian tubes pathology specimens.
Abstract
Objective
Many high-grade serous carcinomas initiate in fallopian tubes as serous tubal intraepithelial
carcinoma (STIC), a microscopic lesion identified with specimen processing according
to the Sectioning and Extensive Examination of the Fimbria protocol (SEE-Fim). Given
that the tubal origin of these cancers was recently recognized, we conducted a survey
of pathology practices to assess processing protocols that are applied to gynecologic
surgical pathology specimens in clinical contexts in which finding STIC might have
different implications.
Methods
We distributed a survey electronically to the American Society for Clinical Pathology
list-serve to determine practice patterns and compared results between practice types
by chi-square (χ2) tests for categorical variables. Free text comments were qualitatively
reviewed.
Results
Survey responses were received from 159 laboratories (72 academic, 87 non-academic),
which reported diverse specimen volumes and percentage of gynecologic samples. Overall,
74.1% of laboratories reported performing SEE-Fim for risk-reducing surgical specimens
(82.5% academic versus 65.7% non-academic, p < 0.05). In specimens from surgery for
benign indications in which initial microscopic sections showed an unanticipated suspicious
finding, 75.9% of laboratories reported using SEE-Fim to process the remainder of
the specimen (94.8% academic versus 76.4% non-academic, p < 0.01), and 84.6% submitted
the entire fimbriae.
Conclusions
Changes in the theories of pathogenesis of high-grade serous carcinoma have led to
implementation of pathology specimen processing protocols that include detailed analysis
of the fallopian tubes. These results have implications for interpreting trends in
cancer incidence data and considering the feasibility of developing a bank of gynecologic
tissues containing STIC or early cancer precursors.
Keywords
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Article info
Publication history
Published online: February 03, 2018
Accepted:
January 15,
2018
Received in revised form:
January 12,
2018
Received:
December 20,
2017
Identification
Copyright
Published by Elsevier Inc.
