Clinical Usefulness of Endometrial Aspiration Cytology and CA-125 in the Detection of Fallopian Tube Carcinoma

OBJECTIVE: To determine the clinical usefulness of endometrial aspiration cytology and CA-125 in the detection of fallopian tube carcinoma. STUDY DESIGN: Positive rates of gynecologic cytology and serum levels of CA-125 were examined in 20 consecutive patients with primary fallopian tube carcinoma before any treatment. RESULTS: The positive rates were 25% (5/20) for cervicovaginal smears and 50% (10/20) for endometrial aspiration smears in the absence of endometrial invasion. The positivity of endometrial aspiration cytology was not influenced by clinical staging or tumor differentiation. The presence of disease in all asymptomatic patients (4/4) was suspected by abnormal endometrial cytology. The features of endometrial cytology were consistent with those of extrauterine adenocarcinoma, from which ovarian carcinoma was unable to be differentiated. Serum levels of CA-125 increased with clinical staging. The positive rate for CA-125 was 20% in stage I, 75% in stage II, 88.9% in stage III, 100% in stage IV and 70% (14/20) in all cases. Eighty-five percent (17/20) of cases exhibited either positive endometrial cytology or elevated CA-125 levels. CONCLUSION: The series suggests that the use of endometrial cytology combined with determination of serum CA-125 levels covers most cases of fallopian tube carcinoma and is a potent aid in the detection of this rare disease.