Clinical Analysis On44Cases Of Primary Fallopian Tube Carcinoma

Objective: The clinical data of primary fallopian tube carcinoma（PFTC） werestudied retrospectively.we analyze its clinical features, diagnostic methods, themisdiagnosis causes and differential diagnosis. To improve the recognition of clinicaldoctors for primary fallopian tube carcinoma. Sum up experience, in order to enhancethe rate of diagnosis for PFTC.Methods: Clinical data of44patients with PFTC admitted from Jan.1998to Jan.2013in the second and the first affiliated hospital of dalian medical university werecollected and analyzed retrospectively.we analyze its medical history,clinicalmanifestation,imaging examination which is mainly composed of ultrasound,serumCA125level,cytological examination,endoscopic examination,pathologic examination,the diagnosis rate before surgery and the misdiagnosis rate.Result: The Incidence of PFTC is higher after2008. Its median age is54.31casesof44patients with PFTC are postmenopausal,13cases are premenopausal. Only3cases present triad,31cases show Dual character.Ultrasound diagnoses4cases primaryfallopian tube carcinoma, with the diagnosis coincidence rate9.09%. CT diagnoses6cases correctly, with the diagnosis coincidence rate19.35%. MRI has no cases withpreoperative correct diagnosis.23cases of30patients with preoperative CA125inspection are higher (>35.00U/ml), accounting for76.67%.Cytological examinationhas no cases with preoperative correct diagnosis.1case of3patients with laparoscopygets the tissue make pathological examination and diagnoses primary fallopian tubecarcinoma correctly. there are10patients with tubal appearance normal;34cases areadded thick in affected side.3cases with intraoperative section view all presentabnormal. Location of lesions in unilateral are41cases, bilateral are3cases.Among allcases,31cases are ampulla and16cases are fimbria.Among13cases with frozenpathology,6cases are diagnosed as primary fallopian tube carcinoma, with accuracy of 46.15%.Postoperative paraffin pathology report that there is1case of clear cellcarcinoma,1case of endometrioid carcinoma, the rest of the42cases were tubaladenocarcinoma. Only6cases with preoperative correct diagnosis of primary fallopiantube carcinoma, the diagnosis rate is13.64%. Preoperative misdiagnosis rate is as highas86.36%.Conclusion:1. The primary fallopian tube carcinoma is rare, but its incidence has a rising trend.2. Women aged50to60, especially in postmenopausal,is a high incidence ofPFTC. Most of fallopian tube carcinoma patients are lack of characteristic clinicalmanifestation. Patients show a typical "triad" less, and are commonly seen withbigeminal signs.3. Serum CA125level can not be the diagnosis index of PFTC,because it is notspecific. But it can be as an important reference index of diagnosis, can also be used formonitoring the progression of primary fallopian tube carcinoma.4. That both clinicians and specialists in laboratory medicine shall improve thealert and consciousness of PFTC,broaden the clinical thoughts, is an important way to toimprove the diagnostic rate of fallopian tube carcinoma and to reduce the misdiagnosis.5. Due to the rarity of the disease, it is often overlooked. coupled with the lack ofspecific manifestations and diagnostic measures, the misdiagnosis rate is high. How toimprove the diagnosis rate of PFTC before surgery should be investigated further.6. Pay attention to the differential diagnosis of fallopian tube carcinoma,withovarian cancer, endometrial carcinoma,adnexitis, secondary fallopian tube carcinoma.The postmenopausal women in the event of a pelvic mass, irregular vaginal bleeding ordrainage, with increased CA125or positive dilatation curettage reports,should alert thepossibility of PFTC, before making the diagnosis of ovarian cancer or endometrialcarcinoma. For such patients,we can do colour duplex ultrasound and laparoscopicexamination, those can help the diagnosis of PFTC.