Difüz büyük B hücreli lenfomada Siklooksijenaz-2 pozitifliği ve mikrodamar yoğunluğu
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Tarih
2010
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info:eu-repo/semantics/openAccess
Özet
Bu çalışmada Trakya Üniversitesi Hematoloji Kliniğine başvuran difüz büyük B hücreli lenfoma tanısı almış 49 hastanın patoloji örnekleri geriye dönük olarak incelendi. İnceleme yapılırken doku mikrodizin aletiyle örnekler parafin bloklara gömülerek siklooksijenaz-2 ve CD34 boyaması yapıldı. Doku mikro dizin kesitlerinde 0.57 mm2 denk düşen alanlarda mikroskop eşliğinde büyük büyütme (x200) ile tarandı. CD34 ifadesi ile mikro damar yoğunluğu hesaplandı. Kesit alanına sığan yaklaşık 10 alan sayıldı. Mikrodamar yoğunluğu ?10 olanlar artmış damar yoğunluğu olarak kabul edildi. Siklooksijenaz-2 ifadesi boyanma örneğine göre 0 (negatif), 1 (zayıf), 2 (orta) ve 3 (kuvvetli) olarak skorlandı. Boyanma bulunmayan ve zayıf boyanan olgular siklooksijenaz-2 ekspresyonu negatif, orta ve kuvvetli boyanan olgular siklooksijenaz-2 ekspresyonu pozitif olarak kabul edildi. Siklooksijenaz-2 ifadesi ve mikrodamar yoğunluğu hastaların klinik başvuru, evre, tedavi yanıtı, sağ kalımla ilişkileri Sapiro-Wilk testi, Mann-Whitney U testi, Ki-kare, Ki-kare Fisher Exact testleri ile irdelendi. Kadın hastalarda siklooksijenaz-2 ifadesi erkeklere göre istatistiksel olarak anlamlı derecede daha fazla görüldü (p=0.030). Siklooksijenaz-2, 41 (% 83.7) hastada negatif, 8 (% 16.3) hastada pozitif olarak kabul edildi. CD34 ile bakılan mikro damar yoğunluğu 2-87 arasında değişmekteydi. Mikrodamar yoğunluğu ortanca değeri 12.5 (IQR=12.1) olarak hesaplandı. Siklooksijenaz-2 ifadesi negatif olan hastalarda mikrodamar yoğunluğu sonucunda artmış damarlanma görülme oranı % 61.0 (n=25) iken, siklooksijenaz-2 ifadesi pozitif olanların tamamında (% 100.0, n=8) artmış damarlanma gözlendi. Siklooksijenaz-2 ifadesinin pozitif olması damarlanmayı arttırma yönünde istatistiksel olarak da anlamlıydı (p=0.031). Siklooksijenaz-2 ifadesinin pozitif ya da negatif olması ile tedaviyle tam yanıt sağlanıp sağlanamaması arasında istatistiksel olarak anlamlı bir ilişki yoktu (p=0.477). Mikrodamar yoğunluğu sonucunda artmış damarlanma gözlenip gözlenmemesi ile tedaviyle tam yanıt sağlanıp sağlanamaması arasında istatistiksel olarak anlamlı bir ilişki yoktu (X2=0.633; p=0.426). Hastalarda ortalama sağ kalım zamanı ise 34.0 (%95 güven aralıkları 27.0? 41.0) hafta idi. Siklooksijenaz-2 ifadesi negatif ya da pozitif olması ile sağ kalım zamanı arasında istatistiksel olarak anlamlı farklılık gözlenmedi (p:0.681 ). Mikrodamar yoğunluğu sonucunda artmış damarlanma gözlenmesi ile sağ kalım zamanı arasında istatistiksel olarak anlamlı farklılık yoktu (p:0.147 ). Bu sonuçlarla siklooksijenaz-2 ifadesinin ve mikro damar yoğunluğunun difüz büyük B hücreli lenfomalarda artmadığı ve bu belirteçlerin hastaların ortalama yaşam süreleri ve tedavi başarıları üzerine etkili olmadığı görüldü.
Cyclooxygenase-2 and microvessel density are important factors in many solid tumors but there are no strong data for the diffuse large B-cell lymphoma. Some studies showed that cyclooxygenase-2 expression and micro vessel density are correlate with the poor prognosis. The role of the cyclooxygenase-2 in diffuse large B-cell lymphoma pathogenesis remains a question mark. Forty-nine formalin fixed, paraffin wax embedded diffuse large B-cell lymphoma tissue samples from the archives of the clinics of pathology and the clinic of hematology at the University of Trakya were included in our study. The study made with the tissue micro array construction and the area of 0.57 mm2 stained with the CD34 and cyclooxygenase-2 histochemistry slides were reviewed at magni cation of x200. Expressions of cyclooxygenase-2 and microvessel density were counted at the 10 binocular areas. Microvessel density which was greater than 10, defined as elevated. Cyclooxygenase-2 scored as 0 (negative), 1 (weak), 2 (medium) and 3 (strong) according to expression of the tissue. The tissues which were negative or weak and medium or strong cyclooxygenase-2 expression defined as negative and positive respectively. Microvessel density, cyclooxygenase-2 expression, stage, treatment, overall survive are tested with Sapiro-Wilk test, Mann-Whitney U test, Chi-square and Chi-square Fisher Exact tests. Cyclooxygenase-2 expression was greater in women (p=0.030). Cyclooxygenase-2 expression was negative in 41 (83.7%) and positive in 8 (16.3%) patients. Microvessel density counted at the range of 2-87. Median microvessel density reviewed as 12.5 (IQR=12.1). The patients whose cyclooxygenase-2 expression reviewed as negative and positive, microvessel density increased at 25 (61.0%) and 8 (100%) patients respectively. Cyclooxygenase-2 expression was correlated with the microvessel density (p=0.031). There were no correlation between cyclooxygenase-2 expression and treatment response (X2=0.633; p=0.426). Median survival was determined as 12 weeks (OR 95% CI 8.95 ? 15.05). There was no correlation between overall survive and the cyclooxygenase-2 expression (p:0.681). No correlation has been found between overall survive and the microvessel density (p:0.147). These data show that cyclooxygenase-2 expression and microvessel density are not correlate by the overall survive and treatment outcomes at diffuse large B cell lymphomas. In conclusion cyclooxygenase-2 expression and microvessel density are not increased in diffuse large B-cell lymphoma and not correlate with the prognosis. More confirmatory studies are needed.
Cyclooxygenase-2 and microvessel density are important factors in many solid tumors but there are no strong data for the diffuse large B-cell lymphoma. Some studies showed that cyclooxygenase-2 expression and micro vessel density are correlate with the poor prognosis. The role of the cyclooxygenase-2 in diffuse large B-cell lymphoma pathogenesis remains a question mark. Forty-nine formalin fixed, paraffin wax embedded diffuse large B-cell lymphoma tissue samples from the archives of the clinics of pathology and the clinic of hematology at the University of Trakya were included in our study. The study made with the tissue micro array construction and the area of 0.57 mm2 stained with the CD34 and cyclooxygenase-2 histochemistry slides were reviewed at magni cation of x200. Expressions of cyclooxygenase-2 and microvessel density were counted at the 10 binocular areas. Microvessel density which was greater than 10, defined as elevated. Cyclooxygenase-2 scored as 0 (negative), 1 (weak), 2 (medium) and 3 (strong) according to expression of the tissue. The tissues which were negative or weak and medium or strong cyclooxygenase-2 expression defined as negative and positive respectively. Microvessel density, cyclooxygenase-2 expression, stage, treatment, overall survive are tested with Sapiro-Wilk test, Mann-Whitney U test, Chi-square and Chi-square Fisher Exact tests. Cyclooxygenase-2 expression was greater in women (p=0.030). Cyclooxygenase-2 expression was negative in 41 (83.7%) and positive in 8 (16.3%) patients. Microvessel density counted at the range of 2-87. Median microvessel density reviewed as 12.5 (IQR=12.1). The patients whose cyclooxygenase-2 expression reviewed as negative and positive, microvessel density increased at 25 (61.0%) and 8 (100%) patients respectively. Cyclooxygenase-2 expression was correlated with the microvessel density (p=0.031). There were no correlation between cyclooxygenase-2 expression and treatment response (X2=0.633; p=0.426). Median survival was determined as 12 weeks (OR 95% CI 8.95 ? 15.05). There was no correlation between overall survive and the cyclooxygenase-2 expression (p:0.681). No correlation has been found between overall survive and the microvessel density (p:0.147). These data show that cyclooxygenase-2 expression and microvessel density are not correlate by the overall survive and treatment outcomes at diffuse large B cell lymphomas. In conclusion cyclooxygenase-2 expression and microvessel density are not increased in diffuse large B-cell lymphoma and not correlate with the prognosis. More confirmatory studies are needed.
Açıklama
Tıpta Uzmanlık
Anahtar Kelimeler
Hematoloji, Hematology, CD34, Lenfoma-B hücreli, Lymphoma-B cell, Lenfoma-diffüz, Lymphoma-diffuse
