Primer endometriyum kanseri olgularında immunohistokimyasal incelemenin prognoz ile ilişkisinin retrospektif incelenmesi
Küçük Resim Yok
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Namık Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmanın amacı, endometrium kanseri tanılı hastalarda MLH-1, MSH-2, MSH-6, PMS-2 ve p53 ekspresyonunun prognostik faktörlerle ilişkisinin değerlendirilmesi ve sağkalımı öngörme konusunda yardımcı olabilecek moleküler belirteçler olarak kullanımının araştırılmasıdır. Çalışmaya 2018-20 yıllarında Tekirdağ Namık Kemal Üniversitesi Kadın Hastalıkları ve Doğum Anabilim Dalı Jinekolojik Onkoloji Kliniğine başvurmuş olup endometrium kanseri tanısı alan hastalar dâhil edildi. Hastalar opere edilip klinik takip ve tedavileri sağlandı. Opere edilen hastalardan patoloji anabilim dalı tarafınca MLH-1, MSH-2, MSH-6, PMS-2 ve p53 immunohistokimyasal inceleme yapılan, daha sonra en az bir yıl boyunca ameliyat sonrası takipleri yapılan tüm hastalar dahil edildi. Cerrahi tedavi olarak histerektomi, bilateral salphingoooferektomi, pelvik/paraaortik lenfnodu diseksiyonu, omentektomi uygulandı. Veriler; çalışmadaki olguların jinekoloji servisi ve jinekolojik onkoloji polikliniği takip dosyaları kullanılarak, Olguların tıbbi patoloji bölümündeki parafin blokları ve preperatları kullanılarak ve hastalar aranıp anamnezleri alınarak elde edildi. Bu olgular patoloji ve immunohistokimyasal inceleme sonuçları, pre/postoperatif serum tümör marker düzeyleri, postoperatif süreçte takip prokolu ikincil kanser eşliği, sağ kalım, rekürrens ve ölüm açısından değerlendirildi. Verilerin analizinde NCSS kullanıldı. Tanımlayıcı istatistiksel metodlar, Bağımsız gruplar t testi, Mann-Whitney U testi, Pearson ki-kare test, Fisher's exact test, Fisher-Freeman-Halton exact test kullanıldı. İstatistiksel anlamlılık p<0.05 olarak kabul edildi. Çalışmanın sonucunda; MLH-1 ekspresyon kaybı ile ileri cerrahi evre ve lenfovasküler invazyon varlığı, PMS-2 ekspresyon kaybı ile lenfovasküler invazyon varlığı, p53 ekspresyon anomalisi ile ileri cerrahi evre, ileri grade tümör varlığı, myometriyal invazyonun >%50, lenfovasküler invazyon, tip 2 tümör saptanması, kemoterapi + radyoterapi tedavi ihtiyacı, postoperatif Ca15-3 yüksekliği ile istatistiksel olarak anlamlı bir ilişki bulunmuştur. MLH-1, PMS-2 ekspresyon kaybı ve P53 ekspresyon anomarlikleri ileri evre endometrium kanseri ile istatistiksel olarak ilişkili saptanmıştır. P53 ekspresyon anormallikleri ayrıca klinik olarak kötü prognoz ile ilişkili saptanmıştır. Sonuçlar yeni çalışmaların önünü açmakla birlikte immünohistokimyasal ölçütlerin bir parametre olarak kullanılabilmesi için randomize kontrollü prospektif çalışmalara ihtiyaç vardır.
Purpose of this study is to determine the significance of MLH-1, MSH-2, MSH-6, PMS-2 ve p53 expression on prognosis of patients diagnosed with primary endometrium cancer. The effect of these immunohistochemical markers on determining the survival and recurrance is being researched. Patients who were operated between years 2018-2020 and diagnosed as primary endometrium cancer in Tekirdağ Namık Kemal Üniversity Hospital Gynecology and Obstetrics Clinic were included in the study. Patients included also treated and evaluated for at least a year in our same clinic after the operation. Immunochemical markers MLH-1,MSH-2, MSH-6, PMS-2 ve p53 were researched on those patients. As the surgery method, Hysterectomy, bilateral oopherectomy, pelvic/paraaortic lymph node dissection, omentectomy were performed. Data got collected from Gynecology ward and policlinic records of the patients. The paraffin blocks and the data in pathology achives were also used. Cases were evaluated with following criteria; pathology report, Immunochemical markers expression value, preoperative and postoperative serum tumor marker value, secondary cancer diagnosis, postoperative treatment protocol, survival, recurrence and death. We used NCSS to analyze the data.independent T test, Mann-Whitney U, Pearson ki-square test, Fisher's exact test, Fisher-Freeman-Halton exact test were used. P<0.05 was considered as statistically relevant. Cases with MLH1 expression loss had higher incidance to have stage 3C, or have lymphovascular invasion. Cases with PMS2 expression loss have lymphovascular invasion rate. P53 expression anormalities had statistically relevant corolation with high stage tumor, myometrial invasion high than %50, higher lymphovascular invasion rate.P53 expression abnormalities also had statistically relevant coralation with postoperative treatment need and postoperative ca15-3 tumor marker level. MLH-1, PMS-2 expression loss and p53 expression anomalies are statistically relevant when predicting high grade endometrial cancer. P53 anomalies are also relevant with bad prognosis in clinical follow up on endometrial cancer.These results shows that further multicentered randomized controlled research should be done to perform these immunohistocemical markers as a parameter on prognosis of endometrial cancer.
Purpose of this study is to determine the significance of MLH-1, MSH-2, MSH-6, PMS-2 ve p53 expression on prognosis of patients diagnosed with primary endometrium cancer. The effect of these immunohistochemical markers on determining the survival and recurrance is being researched. Patients who were operated between years 2018-2020 and diagnosed as primary endometrium cancer in Tekirdağ Namık Kemal Üniversity Hospital Gynecology and Obstetrics Clinic were included in the study. Patients included also treated and evaluated for at least a year in our same clinic after the operation. Immunochemical markers MLH-1,MSH-2, MSH-6, PMS-2 ve p53 were researched on those patients. As the surgery method, Hysterectomy, bilateral oopherectomy, pelvic/paraaortic lymph node dissection, omentectomy were performed. Data got collected from Gynecology ward and policlinic records of the patients. The paraffin blocks and the data in pathology achives were also used. Cases were evaluated with following criteria; pathology report, Immunochemical markers expression value, preoperative and postoperative serum tumor marker value, secondary cancer diagnosis, postoperative treatment protocol, survival, recurrence and death. We used NCSS to analyze the data.independent T test, Mann-Whitney U, Pearson ki-square test, Fisher's exact test, Fisher-Freeman-Halton exact test were used. P<0.05 was considered as statistically relevant. Cases with MLH1 expression loss had higher incidance to have stage 3C, or have lymphovascular invasion. Cases with PMS2 expression loss have lymphovascular invasion rate. P53 expression anormalities had statistically relevant corolation with high stage tumor, myometrial invasion high than %50, higher lymphovascular invasion rate.P53 expression abnormalities also had statistically relevant coralation with postoperative treatment need and postoperative ca15-3 tumor marker level. MLH-1, PMS-2 expression loss and p53 expression anomalies are statistically relevant when predicting high grade endometrial cancer. P53 anomalies are also relevant with bad prognosis in clinical follow up on endometrial cancer.These results shows that further multicentered randomized controlled research should be done to perform these immunohistocemical markers as a parameter on prognosis of endometrial cancer.
Açıklama
Tıp Fakültesi, Kadın Hastalıkları ve Doğum Ana Bilim Dalı
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
