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Gynecol Oncol ; 156(3): 636-640, 2020 03.
Article in English | MEDLINE | ID: mdl-31918994

ABSTRACT

OBJECTIVE: To assess the feasibility of a novel hysteroscopic catheter to collect fallopian tube cytologic samples and to correlate cytologic findings with histopathology. METHODS: This was a prospective, multicenter, single-arm pilot study. Women undergoing salpingo-oophorectomy for a pelvic mass suspicious for malignancy or for prevention of cancer for BRCA mutation carriers were recruited from 3 gynecologic oncology centers (October 2016-August 2017). Cytologic samples were collected from the fallopian tube using a novel FDA-cleared hysteroscopic catheter and evaluated by a pathologist blinded to surgical or pathologic findings. The correlation between cytologic results and final surgical pathology was assessed. RESULTS: Of the 50 patients enrolled, 42 were eligible. Hysteroscopies were completed in 40 patients with 78 fallopian tubes, of which 65 ostia (83%) were identified. Of these, 61 (72%) were successfully catheterized resulting in 44 (68%) cytology samples adequate for further evaluation: 5 were classified as positive (3 neoplastic and 2 malignant) and 39 as negative (34 benign and 5 reactive/atypical). A comparison of cytology results with fallopian tube histopathology showed a concordance rate of 95% (42/44). Of the two samples with discordant results, both had positive cytology but negative tubal pathology, and both were stage I ovarian cancers with malignant ovary histology. CONCLUSIONS: Deployment of the device yielded an evaluable cytologic sample in 68% of cases with a high rate of concordance with histopathology. Further evaluation of the device's ability to detect malignancy in high risk populations is warranted.


Subject(s)
Catheterization/instrumentation , Fallopian Tube Neoplasms/pathology , Fallopian Tubes/cytology , Hysteroscopy/instrumentation , Catheterization/methods , Cytodiagnosis/instrumentation , Cytodiagnosis/methods , Diagnosis, Differential , Fallopian Tube Neoplasms/diagnosis , Fallopian Tubes/pathology , Feasibility Studies , Female , Genes, BRCA1 , Genes, BRCA2 , Germ-Line Mutation , Humans , Hysteroscopy/methods , Middle Aged , Neoplasm Staging , Ovarian Neoplasms/genetics , Ovarian Neoplasms/pathology , Ovarian Neoplasms/prevention & control , Ovarian Neoplasms/surgery , Pilot Projects , Salpingo-oophorectomy
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