| Objective:To investigate the clinical value and significance of prophylactic bilateral salpingectomy by analyzing the pathological data of patients who underwent total hysterectomy or subtotal hysterectomy with prophylactic tubal resection for benign uterine lesions and the expression of Ki67 and p53 proteins in the tubal tissues.Methods:1.We collected and retrospectively analyzed total or subtotal hysterectomy for benign uterine lesions(uterine smooth muscle tumor,adenomyosis,endometrial complex hyperplasia,CINIII and other lesions)admitted to the First Affiliated Hospital of Kunming Medical University at the Department of Gynecology,and simultaneously performed the clinicopathological data of 1187 patients who underwent tubectomy at the same time and analyzed the pathological characteristics of the postoperative tubal tissue.2.The fallopian tubes of 210 patients who underwent total or subtotal hysterectomy with tubal resection for benign uterine lesions from January 2022 to December 2022 in the Department of Gynecology of the First Affiliated Hospital of Kunming Medical University were examined by immunohistochemical SP staining for the expression of Ki67 and p53,the nucleus-associated antigens in the fallopian tubes,and the expression levels of p53 and Ki67 in the fallopian tubes after surgery were analyzed.The expression levels of Ki67 and p53 in the fallopian tubes were analyzed to investigate the clinical significance of prophylactic bilateral salpingectomy during hysterectomy for benign uterine lesions.Results:1.1187 patients with prophylactic bilateral salpingectomy had a mean age of(47.53±3.85)years and were all non-menopausal.Among them,1139 cases(95.96%)underwent bilateral salpingo-oophorectomy and 48 cases(4.04%)underwent unilateral salpingo-oophorectomy(the other side had been removed due to tubal ectopic pregnancy,sterilization,etc.).A total of 2326 tubes were removed,and the postoperative pathological findings were 2183(93.85%)tubes with chronic tubal inflammation,822(35.34%)tubes with mesenteric paramedian cysts,100(4.30%)tubes with interstitial hemorrhage or edema,48(2.06%)tubes with no obvious abnormalities or atrophic changes,26(1.12%)tubes with atrophic changes,and1.12% tubes with atrophic changes.1.12%)had Walthard’s nest seen in the fallopian tubes,15(0.64%)had fallopian tubes with effusion(13 with hydrocele and 2 with tubal pus),12(0.52%)had endometriotic foci observed on the fallopian tubes,10(0.43%)had low-grade intraepithelial neoplasia in the fallopian tubes,9(0.39%)had acute tubal inflammation,and 6(0.26%)had epithelial or lymphoid tissue hyperplasia in the fallopian tubes,6(0.26%)had granulomatous inflammation,2(0.08%)had epithelial metaplasia in the fallopian tubes,and 1(0.04%)had Brenner’s nest in the fallopian tubes.No tubal malignancy was seen.It was also found that in 10 patients with low-grade intraepithelial neoplasia in the fallopian tubes,there was a prevalence of significant chronic or acute inflammatory lesions in both fallopian tubes.2.The expression of Ki67 and p53 in the prophylactic bilateral salpingectomy was detected by immunohistochemical SP staining in 210 patients,of whom 205 underwent bilateral oophorectomy and 5 unilateral oophorectomy.A total of 415 fallopian tubes were removed.The immunohistochemical results were negative for P53 in 300 fallopian tubes,positive for P53 in 115 fallopian tubes and all were wild type,no mutant expression of p53 was observed.14 fallopian tubes were negative for Ki67 and the remaining 401 had expression of Ki67,and the staining area was not greater than 20%.Conclusions:1.The majority of the prophylactic bilateral salpingectomy were combined with different degrees of tubal inflammation,and prophylactic bilateral salpingectomy can remove tubal inflammatory lesions,thus eliminating tumor-inducing factors.2.Prophylactic bilateral salpingectomy eliminates the occurrence of residual tubal complications and reduces the rate of secondary surgery to some extent. |
PDF Full Text Request