Clinicalanalysis On 27 Cases Of Primary Fallopian Tube Carcinoma

Objective: The clinical data of primary fallopian tube carcinoma(PFTC)nearly 10 years in the Second Affiliated Hospital of Chongqing Medical University were studied retrospectively.Analized its clinical features、supporting test results、diagnostic accuracy、 surgical staging 、prognosis, and the relationship between chronic pelvic inflammatory disease and PFTC. To guide clinicians to better diagnosis and treatment of PFTC.Methods: Collected 27 cases of PFTC in the second affiliated hospital of Chongqing Medical University in the 2006.01 to 2016.01.Analysed their age, occupation, clinical symptoms, gynecological examination results,assistant examinations, preoperative diagnosis, the intraoperative findings and staging, prognosis and followed-up the Prevalence of chronic pelvic inflammatory disease before the onset of PFTC by telephone.To summarize the clinical features of PFTC and to explore whether the chronic pelvic inflammatory disease cause PFTC.Result: 4 cases in five years earlier, accounting for 14.81% of the total sample, 23 cases in five years later, accounting for 85.19% of the totalsample. Age in 28 years-74 years, with a median age of 57 years, <50years 7 cases(25.93%),> 50 years 20 cases(74.07%), 4 cases premenopausal(14.81%), 23 cases postmenopausal( 85.19%). Main clinical symptoms: vaginal fluid(22.22%), abdominal pain(22.22%),pelvic mass(25.93%), abdominal distension(25.93%), vaginal bleeding(22.22%).The typical triad "vaginal fluid + abdominal pain + pelvic mass" of PFTC only 3.70%. The sample gynecological examination positive rate of 85.19%. Tumor marker CA-125, HE4, TPA were increased to varying degrees, the positive rate was 82.61%, 69.57% of patients with CA-125 increased. Ultrasound and CT examination can found adnexal cystic – solid masses, only 1 case showed adnexal "sausage-like" mixed echo mass who was accurately diagnosed PFTC.Therefore, this sample preoperative diagnosis rate was 3.70%. Intraoperative found unilateral or bilateral tubal twisting or dilated formed cystic mass.L esions can form cauliflower-like or papillary neoplasm,like rotten meat or fish.Tubal fimbria may be closed,fulled of plot liquid. Some patients had different degrees of yellow serous ascites or bloody ascites in the abdominal cavity. The surgical staging patients were followed up, I of 9 patients, survived, survival time from 5months to 4 years; II of 2patients,survived, survival time from 3 years and4 months to 3 years and 7 months; III of 6 patients, survived 2 cases, the survival time from 7 months to 1 year and 10 months, 4 deaths,postoperative survival time from1 month to 7 years and 5 months; IV of 2patients, all were dead, postoperative survival time from 6 months to 1 year.Followed-up all patients to meet the 2006 US CDC diagnostic criteria of chronic pelvic inflammatory disease, 15 cases meet the minimum criteria,8 cases meet the additional criteria, 25 cases meet the specific criteria.Conclusion:1、The incidence of PFTC seems to have increased nearly 5 years;2、Low incidence 、atypical symptoms and signs, limited assistant examinations, special anatomical location cause a very low preoperative diagnosis rate of PFTC;3、When Seek medical advice,most patients with advanced stage,and so early diagnosis and early treatment is the key to improve survival of PFTC. For patients over 50 years of menopause, a "paroxysmal vaginal discharge" symptoms, serum CA-125, HE4 rises, while "sausage-shaped" Imaging should be considered the diagnosis of PFTC;4 、 Surgery is the first selection for PFTC.Giving platinum-based chemotherapy combine with radiotherapy, immunotherapy can significantly improve the prognosis;5 、 The risk factors of PFTC is not very clear, chronic pelvic inflammatory disease may be a risk factor.