Postoperatif adjuvan kemoradyoterapi uygulanan mide adenokarsinomu tanılı hastalarda Her-2 gen polimorfizmi ve p21 gen mutasyonunun sağkalım, lokalbölgeselve uzak kontrole etkilerinin değerlendirilmesi
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Dosyalar
Tarih
2010
Yazarlar
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma ile postoperatif adjuvan kemoradyoterapi uygulanan mide adenokarsinomu tanılı hastalarda Her-2 gen polimorfizmi ve p21 gen mutasyonunun sağkalım, lokal-bölgesel ve uzak kontrole etkilerinin değerlendirilmesi amaçlandı. Kırk dört olgunun patoloji preapartları incelenerek immünohistokimyasal boyama yöntemi ile Her-2 ve p21 protein ekspresyonu pozitifliği ve polimeraz zincir reaksiyon yöntemi ile p21 gen mutasyonu ve Her-2 gen polimorfizmi varlığı araştırılmıştır. p21 ve Her-2 ekspresyon pozitifliği sırası ile %61,4 ve %9,1 olarak saptanmıştır. p21 mutasyonu her beş olgudan birinde mevcut iken Her-2 gen polimorfizmi %2,3 oranında II fenotipinde idi. p21 ekspresyonunun negatif olduğu olgularda diffüz tip adenokarsinom, vasküler/nöral invazyon varlığı ve indiferansiye histoloji p21 ekspresyonu pozitif olgulara göre anlamlı olarak daha yüksek oranlarda gözlenmiştir. p21 mutasyon varlığında ise diffüz tip ve indiferansiye histoloji anlamlı olarak yüksek bulunmuştur. p21 ekspresyonunun negatif olduğu olgularda genel sağkalım p21 ekspresyonu pozitif olgulara göre anlamlı olarak daha kısa bulunmuştur (Cox regresyon, p=0.014). Hastalıksız sağkalım ile p21 ekspresyonu arasında ilişki saptanamamıştır. Her-2 gen ekspresyon pozitifliği ve polimorfizmi ile histopatolojik parametreler ve genel ve hastalıksız sağkalım arasında anlamlı bir ilişki bulunamamıştır. Sonuç olarak; p21 ekspresyonu negatifliği kötü prognostik faktörler olduğu bilinen vasküler/nöral invazyon, indiferansiye ve diffüz tip histoloji ile ilişkili olup mide adenokarsinom tanılı hastalarda genel sağkalımı olumsuz etkilemektedir. Anahtar kelimerler: Mide kanseri, p21, Her-2
Abstract
In this study it was aimed to evaluate the effects of Her-2 gene polymorphism and p21 gene mutation on overall survival, locoregional and distant control in patients treated with postoperatively adjuvant chemoradiotherapy. Immunohistochemical staining (IHC) and polymerase chain reaction (PCR) was performed in 44 patients who were treated with adjuvant chemoradiotherapy in 1999-2008. The expression of p21 and Her-2 was found in 61.4% and 9.1% patients respectively. p21 gene mutation was positive in one of every five patients and Her-2 polymorphism was II phenotype in 2.3% patient. In the patients with the negative expression of p21, diffuse type histology, whole gastric involvement and positive vascular and neural invasion, undifferential histology rate was significantly higher than in the patients with positive expression of p21. p21 mutation was significantly higher in diffuse and undifferential type histology. In the patients with the negative expression of p21, overall survival was significantly shorter than in the patients with positive expression of p21 (Cox regression, p=0.014). There was no association between any parameters with disease free survival. There was no significant association between histopathological parameters with Her-2 expression and Her-2 gene polymorphism. Consequently, negative p21 staining with IHC is associated with undifferantial and diffuse type histology which are known as a worse prognostic factors and it effects negatively overall survival in patients with gastric adenocarcinoma who were treated with postoperatively adjuvant chemoradiotherapy. Key words: Gastric cancer, p21, Her-2.
Abstract
In this study it was aimed to evaluate the effects of Her-2 gene polymorphism and p21 gene mutation on overall survival, locoregional and distant control in patients treated with postoperatively adjuvant chemoradiotherapy. Immunohistochemical staining (IHC) and polymerase chain reaction (PCR) was performed in 44 patients who were treated with adjuvant chemoradiotherapy in 1999-2008. The expression of p21 and Her-2 was found in 61.4% and 9.1% patients respectively. p21 gene mutation was positive in one of every five patients and Her-2 polymorphism was II phenotype in 2.3% patient. In the patients with the negative expression of p21, diffuse type histology, whole gastric involvement and positive vascular and neural invasion, undifferential histology rate was significantly higher than in the patients with positive expression of p21. p21 mutation was significantly higher in diffuse and undifferential type histology. In the patients with the negative expression of p21, overall survival was significantly shorter than in the patients with positive expression of p21 (Cox regression, p=0.014). There was no association between any parameters with disease free survival. There was no significant association between histopathological parameters with Her-2 expression and Her-2 gene polymorphism. Consequently, negative p21 staining with IHC is associated with undifferantial and diffuse type histology which are known as a worse prognostic factors and it effects negatively overall survival in patients with gastric adenocarcinoma who were treated with postoperatively adjuvant chemoradiotherapy. Key words: Gastric cancer, p21, Her-2.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Onkoloji, Oncology, Radyoloji, Nükleer Tıp, Radiology, Nuclear Medicine, Mide Kanseri, Gastric
