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PubMed1986

Demonstration of pregnancy-associated plasma protein-A (PAPP-A)-like material in the fallopian tube.

The distribution and concentration of pregnancy-associated plasma protein-A (PAPP-A) in the human fallopian tube were examined by the immunoperoxidase staining technique and radioimmunoassay as part of a detailed study of PAPP-A in the nonpregnant state. PAPP-A-like material was identified in the epithelial cells of the mucosa in all fallopian tube specimens examined (n = 21). The intensity of the staining for PAPP-A was unrelated to the phase of the menstrual cycle. PAPP-A-like material was detected in saline extracts from all tubal tissues (n = 14) but not in any of the sera obtained from the same patients. The tissue concentration (mean +/- standard error of the mean) of immunoreactive PAPP-A varied from 15.2 +/- 1.1 to 30.1 +/- 4.2 micrograms/g protein in different parts of the tubes. No difference in the PAPP-A concentration was found between isthmic, ampullar, and fimbrial part of the tube, but proliferative phase tube seems to contain more PAPP-A than secretory phase tube. The PAPP-A measured in the fallopian tube appears to be similar in molecular size and antigenicity to that of pregnancy.

Adult↗
PubMed2006

Human fallopian tube neutrophils--a distinct phenotype from blood neutrophils.

PROBLEM: The role of neutrophils in the human Fallopian tube (FT) is unknown. In order to provide insights into their functions in the FT, we systematically compared neutrophils from normal FT and peripheral blood (PB). METHOD OF STUDY: Flow cytometric analysis of surface receptors, granule proteins, and intracellular cytokines expressed by neutrophils from enzymatically dispersed FT and PB was performed. RESULTS: Fallopian tube neutrophils expressed significantly higher levels of CD64, human class II histocompatibility antigen DR (HLA-DR), gamma-interferon, and vascular endothelial growth factor than those from PB. Fewer FT neutrophils expressed IL-8 receptors compared to PB, while more expressed the receptor for the bacterial-derived chemoattractant formyl-Met-Leu-Phe (fMLP). The number of FT neutrophils containing the granule proteins matrix metalloproteinase-9, lactoferrin, and myeloperoxidase was decreased versus PB. CONCLUSION: Fallopian tube neutrophils exhibit a phenotype distinct from PB neutrophils, suggesting functional activation of innate immune defense in the female reproductive tract as well as a potential role in maintaining normal FT physiology.

Cell Separation↗
PubMed2006

Prostaglandin E2 and F2alpha receptors in the human Fallopian tube before and after mifepristone treatment.

Prostaglandins are associated with several reproductive processes in addition to their effects on the vascular system and muscular contractility. The aim of this study was to gain information about the localization of the receptors for PGE(2) (EP1-EP4) and PGF(2alpha) (FP) in the human Fallopian tube and their regulation following treatment with mifepristone. Sixteen healthy fertile women received a single dose of 200 mg mifepristone or placebo immediately after ovulation (LH+2). Laparoscopic sterilization was performed on days LH+4 to LH+6. Biopsies were taken from the Fallopian tubes bilaterally. The expression of EP1, EP2, EP3, EP4 and FP was analysed using immunohistochemistry and RT-PCR. The co-localization of prostaglandin receptors and c-kit or e-nos was analysed using confocal microscopy. The effect of progesterone, mifepristone and prostaglandin on tubal contractility was studied. The presence of EP1-EP4 and FP in the Fallopian tube was detected using immunostaining. The receptors were expressed in serosal cells, luminal epithelial cells, and the muscular wall and vessels of the Fallopian tube. Co-localization studies showed that the endothelial cells stained positive for EP1-EP4 and FP and that co-localization was seen for EP4 and c-kit. Decreased contractility was seen after progesterone treatment, whereas increased contractility was seen after PGF(2alpha) and PGE(2) treatment. These data suggest that both the transport of the embryo and the communication between the embryo and the Fallopian tube involve the action of prostaglandins through EP and FP receptors in addition to the effect of prostaglandins on the vascular system and muscular contractility.

Adult↗
PubMed1975

Contractility of the fallopian tube.

Recordings of intratubal pressure in women reveal a complex pattern of tubal contractions. Overall activity of the fallopian tube is increased during ovulation. During the luteal phase of the menstrual cycle, activity is depressed but never suppressed. The fallopian tube remains active during gestation in contrast with the uterus which is quiescent. The early puerperal tube displays a pattern of activity similar to that recorded during the late luteal phase of the menstrual cycle. Activation occurs during suckling and in response to exogenous oxytocin, prostaglandins, nor-adrenergic compounds, and ergot derivatives. It is concluded that contractility of the fallopian tube is less influenced by ovarian steroids than that of the uterus.

Animals↗
PubMed2006

Salpingo-oophorectomy and the risk of ovarian, fallopian tube, and peritoneal cancers in women with a BRCA1 or BRCA2 Mutation.

CONTEXT: Women with BRCA1 or BRCA2 mutation are often advised to undergo preventive oophorectomy. The effectiveness of this intervention has not been prospectively evaluated in a large cohort. OBJECTIVES: To estimate the incidence of ovarian, fallopian tube, and primary peritoneal cancer in women who carry a deleterious mutation in BRCA1 or BRCA2. To estimate the reduction in risk of these cancers associated with a bilateral prophylactic salpingo-oophorectomy. DESIGN, SETTING, AND PARTICIPANTS: Women known to carry a BRCA1 or BRCA2 mutation were identified from an international registry between 1992 and 2003. A total of 1828 carriers at 1 of 32 centers in Canada, the United States, Europe, and Israel completed questionnaires at baseline and follow-up. Participants were observed from the date of study entry until: diagnosis of ovarian, fallopian tube, or peritoneal cancer; death; or the date of the most recent follow-up. INTERVENTION: Participants were divided into women who had undergone bilateral prophylactic oophorectomy and those who had not. MAIN OUTCOME MEASURE: The incidence of ovarian, peritoneal, and fallopian tube cancer was determined by survival analysis. The risk reduction associated with prophylactic salpingo-oophorectomy was evaluated by a time-dependent survival analysis, adjusting for covariates. RESULTS: After a mean follow-up of 3.5 years, 50 incident ovarian, fallopian tube, and peritoneal cancer cases were reported in the cohort. Of the 1828 women, 555 (30%) underwent a bilateral prophylactic salpingo-oophorectomy prior to study entry, 490 (27%) underwent the procedure after entering the study, and 783 (43%) did not undergo the procedure. There were 32 incident cancers diagnosed in women with intact ovaries (1015/100,000 per year). Eleven cancer cases were identified at the time of prophylactic oophorectomy and 7 were diagnosed following prophylactic oophorectomy (217/100,000 per year). The estimated cumulative incidence of peritoneal cancer is 4.3% at 20 years after oophorectomy. The overall (adjusted) reduction in cancer risk associated with bilateral oophorectomy is 80% (multivariate hazard ratio = 0.20; 95% confidence interval, 0.07-0.58; P = .003). CONCLUSION: Oophorectomy is associated with reduced risk of ovarian and fallopian tube cancer in high-risk women, although there is a substantial residual risk for peritoneal cancer in BRCA1 and BRCA2 mutation carriers following prophylactic salpingo-oophorectomy.

Adult↗
PubMed1999

Lymphadenectomy in primary carcinoma of the Fallopian tube.

OBJECTIVE: The bad prognosis of primary carcinoma of the Fallopian tube is ascribed to early lymphogenous metastasis. Due to the rarity of cases, there exist only few and divergent results on the importance of lymph node metastasis in the relevant literature. Thus, our study aimed at detecting the incidence of lymph node metastases and their influence on overall survival, as well as at evaluating the therapeutic effect of radical lymphadenectomy. METHODS: We studied 158 cases of primary carcinoma of the Fallopian tube in a retrospective multicenter analysis. Group I (n = 38) consisted of patients who were subjected to radical pelvic and para-aortic lymphadenectomy in addition to total abdominal hysterectomy, bilateral adenectomy and omentectomy. The control group II (n = 71) underwent the same surgical procedures but without radical lymphadenectomy. Patients who received post-operative irradiation (n = 49) were excluded from the study. RESULTS: On average, 38 lymph nodes (range 12-68) were extirpated. In group I 42.1% of the cases showed lymph node metastases. Lymphatic dissemination was observed only after the carcinoma had spread beyond the organ (intraabdominal stage II); the incidence of lymph node metastases rose significantly (P = 0.02) with growing intraperitoneal tumour masses. Pelvic and para-aortic metastases occur simultaneously. Overall survival with tumour of equal size is markedly, but not significantly reduced (P = 0.18) if the lymph nodes are involved. If, however, radical lymphadenectomy is performed (group I) the median survival time increases to 43 months (95% confidence-interval 20-66), compared with 21 months (95% confidence-interval 10-32) in group II (P = 0.095). CONCLUSION: Correct staging is obtained only on the basis of pelvic and para-aortic lymphadenectomy. Radical lymphadenectomy in tumours of equal size may markedly prolong survival.

Carcinoma↗
PubMed1993

Sperm numbers and distribution within the human fallopian tube around ovulation.

This study aimed to determine the number and distribution of spermatozoa within the human Fallopian tubes around ovulation. Parous women, undergoing total abdominal hysterectomy for menorrhagia, were inseminated with either partner's semen (3/10) or donor semen (7/10). Approximately 18 h later both Fallopian tubes were ligatured into ampullary, isthmic and intramural regions. These were removed and assessed for sperm content by flushing, scanning electron microscopy (SEM) or homogenization. A median of 251 spermatozoa were recovered (range, 79-1386). The number of spermatozoa within each tube was not significantly different. The ovulatory ampulla contained a significantly (P < or = 0.01) larger percentage of spermatozoa than the non-ovulatory ampulla. The number of motile spermatozoa inseminated was not significantly correlated to the number of spermatozoa recovered, but a trend was identified. The time between the onset of the luteinizing hormone surge and hysterectomy was significantly correlated (P < or = 0.01) to the number of spermatozoa within the intramural regions, but not to the tubal sperm distribution. Spermatozoa were not observed, by SEM, bound to the tubal epithelium. These data suggest that, after artificial insemination at least, sperm access to the human Fallopian tube may be controlled, but that ovulation does not affect the redistribution of spermatozoa between tubal regions and that the isthmus does not appear to act specifically as a sperm reservoir.

Adult↗
PubMed1991

Fallopian tube catheterization and recanalization under ultrasonic observation: a simplified technique to evaluate tubal patency and open proximally obstructed tubes.

OBJECTIVE: To test a sonoscopic technique developed for transvaginal catheterization and recanalization of the fallopian tube. DESIGN: In a feasibility study, catheterization was performed with the use of laparoscopic control. Patients with bilateral proximal tubal obstruction underwent fallopian tube recanalization under ultrasonic observation. SETTING: This study represents patients evaluated for primary or secondary infertility at Humboldt University Hospital. PATIENTS, PARTICIPANTS: Proximal tubal obstruction had been diagnosed on previous hysterosalpingogram and with laparoscopy. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Tubal patency was assessed by hydrotubation under ultrasonic observation. RESULTS: Transvaginal catheterization was successful in 31 (91.2%) of the 34 tubes. In 19 patients with proximal tubal obstruction, patency of both or at least one tube was achieved in 16 (84.2%) women. Five (31.6%) of 16 patients successfully recanalized were found to have an intrauterine pregnancy at a 6-month follow-up interval. CONCLUSION: This catheterization technique should be investigated for possible use in diagnostic schedule early in the evaluation of the infertile patient. Also, the transvaginal recanalization of proximally obstructed tubes calls into question the application of microsurgical treatment of a selected group of patients.

Adult↗
PubMed1998

Isolated torsion of the fallopian tube. A case report.

BACKGROUND: While torsion of the adnexa is relatively common, isolated torsion of the fallopian tube alone remains a rare occurrence. Diagnosis and surgical intervention are often delayed. CASE: A 38-year-old woman presented with acute lower right abdominal pain initially managed as renal colic. She returned to the emergency department three days later. After surgical consultation, a computed tomography scan and ultrasound showed a cystic pelvic mass with normal ovarian flow studies. Ultimately, the gynecology team performed laparoscopy with the suspicion of intermittent adnexal torsion. A 6 x 8-cm, twisted, dusky purple right fallopian tube was noted. A laparoscopic salpingectomy was performed. CONCLUSION: In the differential diagnosis of acute lower abdominal pain, isolated torsion of the fallopian tube should be considered. A timely diagnosis and surgical intervention may allow preservation of the tube. Even when irreversible damage has occurred, laparoscopic management is recommended.

Abdominal Pain↗
PubMed1993

In-vitro synthesis of total protein and placental protein PP14 by the fallopian tube mucosa: variation in relation to anatomical site, the ovarian cycle and the menopause.

De-novo synthesis and secretion of protein by short term explants of mucosa from each anatomical section of the Fallopian tube and endometrium of pre-menopausal (n = 25) and tubal mucosa of post-menopausal (n = 5) women were studied by demonstration of incorporation of radiolabelled L-[35S]methionine and one-dimensional SDS-polyacrylamide gel electrophoresis. A consistent finding in 25 pre-menopausal women was the presence of a 25 kDa protein band synthesized by tissue obtained throughout the ovarian cycle. Western blotting demonstrated that this protein band contained placental protein 14 (PP14)-like immunoreactivity in the proliferative (n = 2) and luteal phase (n = 2) of the ovarian cycle. To determine if there is quantitative variation in total protein and PP14 synthesis and secretion during the ovarian cycle, the total quantities of protein and PP14 synthesized were determined by Coomassie Brilliant Blue staining and radioimmunoassay respectively. Analysis of the results of total protein assay revealed statistically significant differences in relation to the anatomical origin of the study tissue (P < 0.01), the stage of the ovarian cycle (P < 0.04) and the manner in which each anatomical site varied during the ovarian cycle (P < 0.01), the endometrium being significantly different from the Fallopian tube. When the data for PP14 synthesized by the Fallopian tube mucosa were analysed, these effects were not seen. PP14 was not detected in the culture media of Fallopian tube mucosa obtained from post-menopausal women.

Adult↗
PubMed2001

Paclitaxel-based chemotherapy in carcinoma of the fallopian tube.

OBJECTIVE: The objective of this study was to determine the clinical outcomes of patients with fallopian tube carcinoma treated with paclitaxel-based combination chemotherapy following primary cytoreductive surgery. METHODS: Twenty-four patients with the diagnosis of primary tubal adenocarcinoma treated between 1993 and 1998 were identified through the gynecology service database and the Memorial Sloan-Kettering Cancer Center tumor registry. Medical records were reviewed for information on age, stage, chemotherapy regimen, surgical intervention, relapse, and survival. All patients had their histologic material initially read or reviewed at Memorial Sloan-Kettering Cancer Center prior to treatment. The original slides were reviewed again by one of the authors (P.E.S.) to confirm the diagnosis of primary fallopian tube cancer. RESULTS: The mean age of the patients was 63 years (range, 44-76). Distribution by stage was as follows: four patients (17%) were Stage I, three patients (12%) were Stage II, 16 patients (67%) were Stage III, one patient (4%) was Stage IV. Four patients had grade 2 tumors, 20 had grade 3. Sixteen patients (67%) had optimal cytoreduction at the time of initial surgery with residual disease less than 1 cm. Eight patients (33%) had suboptimal cytoreduction. Following initial surgery, all patients were treated with paclitaxel-based chemotherapy for a median of five cycles. Twenty-three patients received paclitaxel at the dose of 135-175 mg/m(2) in combination with carboplatin or cisplatin; the majority, 17 of 23 (74%), received carboplatin. One patient received paclitaxel alone. Median follow-up from time of initial surgery was 24 months (range, 1-73 months). Two patients are dead of disease. Overall survival for the entire group was 96% at 12 months by Kaplan-Meier analysis, and 90% at 3 years. The overall median progression-free survival was 27 months (range, 5-57 months) for the entire group. The median disease progression-free survival at 3 years was 67% (95% CI, 45-100) in the optimally debulked group as compared with 45% in the suboptimally debulked group (95% CI, 27-57). Twelve patients (50%) had evidence of recurrence or persistent disease. There were fewer recurrences in the optimally debulked group: 5 of the 16 patients (31%) versus 7 of the 8 patients (88%) with suboptimal cytoreduction. CONCLUSION: Optimally cytoreduced patients with primary fallopian tube carcinoma treated with a paclitaxel-based chemotherapy regimen have an excellent possibility of survival.

Adenocarcinoma↗
PubMed1978

Endometrioid carcinoma of the fallopian tube.

A case of endometrioid carcinoma arising in endometriosis of the fallopian tube is described. One case of tubal endometrioid carcinoma has been reported previously, but the entity has not hitherto been recognized among primary fallopian tube tumors. The clinical presentations, histopathology, and pathogenesis of this rare tumor are discussed.

Adenocarcinoma↗
PubMed1993

Primary malignant tumor of the fallopian tube: appearance at CT and MR imaging.

Primary malignancy of the fallopian tube is a rare entity. To determine the radiologic characteristics of the tumor, 10 patients with pathologically confirmed fallopian tube malignancy (nine with adenocarcinoma and one with mixed müllerian tumor) underwent magnetic resonance (MR) imaging and computed tomography (CT). With both CT and MR imaging, the lesion appeared relatively small, solid, and lobulated when not associated with hydrosalpinx. At CT, the lesion had an attenuation equal to that of other nonspecific soft-tissue masses and enhanced less than myometrium. On T1-weighted MR images the tumor was usually hypointense, and on T2-weighted images the tumor was most often homogeneously hyperintense. Associated CT and MR imaging findings were peritumoral ascites (four cases), intrauterine fluid collection (two cases), and hydrosalpinx (one case). MR findings allowed the lesion to be distinguished from uterine leiomyoma in three cases in which pelvic examination, ultrasound, and CT findings were equivocal.

Adenocarcinoma↗
PubMed2025

Mutant p53 disrupts antioxidant defense in fallopian tube epithelium via GSTAs suppression: A pathway to serous tubal carcinogenesis.

High grade serous ovarian cancer (HGSOC) is the most common and aggressive type of epithelial ovarian cancer. The fimbria of the fallopian tube is the likely site of origin based on the presence of distinct precancerous lesions with TP53 signatures known clinically as serous tubal intraepithelial carcinoma (STICs) detected in this region in individuals at genetically high risk or with HGSOC. Previously we identified that matched fallopian tube epithelia (FTE) from fimbria and ampulla of normal fallopian tubes from premenopausal women exhibit differential expression of genes associated with antioxidant and inflammatory pathways. One gene, glutathione S-transferase 2 (GSTA2), showed both higher expression in the fimbria and in the follicular phase (pre-ovulation) compared to the ampulla, suggesting that GSTA2 expression may regulate reactive oxygen homeostasis in these cells in response to ovulation-related stress. Here, to understand how preneoplastic genomic alterations influence regulation of oxidative stress, FTE cells were isolated from healthy tissue and introduced with p53 mutations, from which expression and function of GSTA2 and other antioxidant enzymes were investigated. Mutant p53 downregulated the expression of GSTA2 and subsequently increased DNA damage. The combination of p53 mutation and dysregulated oxidative response likely promotes the genomic instability that initially drives the transformation to high grade serous ovarian carcinoma.

Female↗
PubMed2006

Microplicae-like structures of the fallopian tube in postmenopausal women as shown by electron microscopy.

Female reproductive aging is associated with several morphological changes of the genital tract with a subsequent decline in fertility; however, ultrastructural changes occurring after menopause have still not been well illustrated. Our aim was to characterize the three-dimensional microanatomy of the luminal surface of the human fallopian tube in perimenopause and postmenopause. Twenty bioptic samples of fallopian tubes were obtained after surgery under the informed consent of the patients. Samples were processed for transmission electron microscopy (TEM) and field-emission scanning electron microscopy (FE-SEM). As age increases the surface epithelium of the fallopian tube appeared somewhat flattened. Correlated TEM/FE-SEM observations showed gradual shortening of microvilli and deciliation. The most interesting finding was the gradual formation of microplicae-like structures on the surface epithelium, particularly from late perimenopause to postmenopause. Microplicae-like structures, associated with other regressive changes, represent an important adaptation of the epithelium of the fallopian tube; these are likely induced by the physiological process of aging, thus better withstanding hormonal changes associated with the advent of the menopause.

Aged↗
PubMed1998

Prognosis of primary fallopian tube adenocarcinoma: report of 25 patients.

PURPOSE OF INVESTIGATION: Because of the rarity of primary fallopian tube adenocarcinoma (PFTA), the optimal management has not been well-defined, especially in early-stage disease. Furthermore, prognosis of primary fallopian tube carcinoma has not been fully understood. METHODS: We retrospectively studied patients with proven surgico-pathological stage PFTA and excluded patients without a standard surgicopathological staging procedure. Twenty-five patients from 1970 to 1995 were identified. Eleven were in Stage I, four in Stage II and ten in Stage III and IV. Twenty patients received adjuvant chemotherapy with four to eight courses of CAP or CEP (cyclophosphamide 500 mg/m2, adriamycin 50 mg/m2 or epirubicin 50 mg/m2, and cisplatin 50 mg/m2 intravenously, every three weeks) regimen. One patient received two courses of chemotherapy and another received one course of chemotherapy; both followed with radiotherapy due to refusal of further chemotherapy. The remaining three patients did not receive any adjuvant therapy. RESULTS: Accumulative disease-free survival rate in spite of different st ages was 36%. Univariate analysis showed postoperative adjuvant chemotherapy, optimal debulking surgery, nulliparity, extent of the disease, and tumor differentiation as significant factors for disease-free survival of patients with PFTA. However, multivariate analysis did not show significance due to the small number of cases. CONCLUSION: Nearly half of the patients (44%) were diagnosed in early stage of PFTA, but patient survival was still disappointing. Understanding possibile risk factors for therapeutic failure and more aggressive and effective multi-modality treatments should be further defined.

Adenocarcinoma↗
PubMed1994

In situ characterization of leukocytes in the fallopian tube in women with or without an intrauterine contraceptive device.

Histological evaluation of sections from the human fallopian tube revealed an inflammatory reaction in 21 of 31 women using an intrauterine contraceptive device (IUCD) and in four of 29 controls (non-IUCD users). The inflammatory cells were mainly localized at the epithelium-lamina propria interface and at the center of the mucosal folds. The immunohistochemical study revealed leukocytes (CD45+), T lymphocytes (CD3+), T helper cells (CD4+), T suppressor/cytotoxic cells (CD8+), B lymphocytes (CD22+, CD19+), granulocytes, monocytes and null cells (CD11b+) mainly localized at the lamina propria in both groups. T lymphocytes were the predominant cell type, and the ratio between T helper and T suppressor/cytotoxic cells was fairly close to one both in IUCD-users and controls. B lymphocytes were the least frequent cell type identified. In IUCD users, the numbers of the different leukocytes were increased. In both groups, IgA-, IgG- and IgM-positive cells were demonstrated and were predominantly located at the lamina propria of the mucosal folds. The IgA-positive cells dominated in both groups, whereas IgG- and IgM-positive cells were less frequent. Cell positive for IgA, IgG or IgM were significantly increased in number in the IUCD users. The data confirm the presence of an immune system in the normal human fallopian tube and indicate that the IUCD can induce a prominent recruitment of inflammatory cells, with a tubal inflammation as the result. The IUCD may disturb the immunological function of the fallopian tube and its rôle in fertilization.

Adult↗