SEE-FIM Protocol

A protocol for examining fallopian tubes in pathology

SEE-FIM Protocol

The SEE-FIM protocol is a specialized pathological examination technique used to thoroughly evaluate the fallopian tubes, particularly in the context of ovarian cancer research and diagnosis. The protocol is designed to enhance the detection of early-stage serous carcinomas, which are often implicated in high-grade serous ovarian cancer.

A diagram illustrating the SEE-FIM protocol steps

Background

The SEE-FIM protocol was developed in response to the growing evidence that many high-grade serous carcinomas, traditionally thought to originate in the ovary, may actually begin in the fallopian tubes. This insight has significant implications for the early detection and prevention of ovarian cancer. The protocol's name, SEE-FIM, stands for "Sectioning and Extensively Examining the FIMbriated end," which highlights its focus on the distal end of the fallopian tube where early lesions are often found.

Procedure

The SEE-FIM protocol involves a meticulous dissection and examination of the fallopian tubes. The process includes the following steps:

1. Sectioning: The fallopian tube is serially sectioned at 2-3 mm intervals. This allows for a comprehensive examination of the entire tube, with particular attention to the fimbrial end.
2. Extensive Examination: Each section is carefully examined under a microscope. Pathologists look for early signs of serous carcinoma, such as serous tubal intraepithelial carcinoma (STIC), which is considered a precursor to high-grade serous carcinoma.
3. Fimbriated End Focus: Special attention is given to the fimbriated end of the fallopian tube, as this is where early lesions are most commonly found. The fimbrial end is often the site of origin for serous carcinomas that were previously attributed to the ovary.

Significance

The SEE-FIM protocol has significantly improved the detection of early-stage serous carcinomas. By identifying precursor lesions such as STIC, the protocol aids in the early diagnosis and potential prevention of ovarian cancer. This has important implications for patient management and treatment strategies, as early detection is crucial for improving outcomes in ovarian cancer patients.

Applications

The protocol is widely used in both clinical and research settings. In clinical practice, it is employed during the examination of prophylactically removed fallopian tubes in women at high risk for ovarian cancer, such as those with BRCA1 or BRCA2 mutations. In research, the SEE-FIM protocol is used to study the pathogenesis of serous carcinomas and to develop new strategies for early detection and prevention.

Related pages

• Ovarian cancer
• Fallopian tube
• Serous carcinoma
• BRCA1
• BRCA2