Pankreas adenokanserli olgularda pankreas aşikar diffüzyon kasay ısı değerleri ile XRCC1 ve XRCC2 gen polimorfizmlerinin karşılaştırılması
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Tarih
2021
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Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Çalışmamızın amacı pankreatik adenokanserlerin diffüzyon ağırlıklı MR görüntülemelerinde aşikar diffüzyon katsayısı değerleri, lezyonların özellikleri ve XRCC1 polimorfizminin prognoza etkilerini değerlendirmektedir. Ocak 2019-2021 arasında Trakya Üniversitesi Tıp Fakültesi Radyoloji biriminde batın manyetik rezonans görüntüleme ile tetkik edilen ve histopatolojik olarak pankreas adenokanseri tanısı alan 48 hasta çalışmaya dahil edildi. Hastaların 1.5 Tesla manyetik rezonans görüntülerinden iş istasyonunda kantitatif aşikar diffüzyon katsayı değerleri hesaplandı. Labaratuvar için ayrılan kanlardan Trakya Üniversitesi Biyofizik biriminde XRCC1 gen polimorfizmi çalışıldı. XRCC2 polimorfizmi restriksiyon enziminin yeterli DNA kesimi sağlayamaması nedeniyle çalışılamadı. Pankreas adenokanserli olgularda tümoral boyut, nekroz, lokalizasyon, görsel difüzyon kısıtlanması, vasküler invazyon, bölgesel lenfadenopati, metastaz özellikleri değerlendirildi. Olguların CA19-9 değerleri, tedavi öyküleri (cerrahi, kemoterapi) ve tanıdan itibaren hayatta kalma süreleri hastane otomasyon sisteminden kayıt altına alındı. Pankreas adenokanserli olgularda tanı anından itibaren 4,6 aydan az yaşayan olgularda aşikar diffüzyon katsayı değerleri anlamlı derecede düşük bulunmuştur. CA19-9 düzeyi yüksek olgularda daha fazla nekroz ve metastaz saptanmıştır. Cerrahi tedavi uygulanan olgularda en yüksek sağkalım süresi izlenmiştir. XRCC1 Arg399Gln GG genotipi izlenen olgularda tanı yaşı daha yüksek tespit edilmiştir. XRCC1 Arg399Gln polimorfizminin surviye etkisi saptanamamıştır. Aşikar diffüzyon katsayısı maksimum ve mean değerlerinin prognozu öngörmede etkisi gösterilememiştir, ADC değerleri ile XRCC1 Arg399Gln polimorfizmleri arası ilişki saptanmamıştır. Çalışmamız pankreas duktal adenokanserli olgularda diffüzyon ağırlıklı görüntüleme verileri ile XRCC1 Arg399Gln polimorfizm ilişkisini araştıran literatürdeki bildiğimiz ilk çalışma olup, çalışmamızın ileride yapılacak çalışmalara öncü olacağı düşüncesindeyiz. Pankreas adenokanser tanısında aşikar diffüzyon katsayı minimum değerlerinin lezyonların tanısı ve prognozu öngörmede faydalıdır. CA19-9 değerleri pankreas adenokanseri tanısında önemini korumaktadır. Büyük hasta gruplarında yapılacak çalışmalara ihtiyaç vardır.
The aim of our study is to evaluate the effects of apparent diffusion coefficient values, characteristics of lesions and XRCC1 polymorphism on prognosis in diffusion-weighted MR images of pancreatic ductal adenocarcinoma. Between January 2019-2021, 48 patients who were examined with abdominal magnetic resonance imaging in the Department of Radiology of Trakya University Faculty of Medicine and histopathologically diagnosed with pancreatic adenocarcinoma were included in the study. Quantitative apparent diffusion coefficient values were calculated from 1.5 Tesla magnetic resonance images of the patients at the workstation. XRCC1 gene polymorphism was studied in Trakya University Biophysics Department from blood allocated for the laboratory. XRCC2 polymorphism could not be studied because the restriction enzyme could not provide sufficient DNA cutting. Tumoral size, necrosis, localization, visual diffusion restriction, vascular invasion, regional lymphadenopathy, metastasis were evaluated in cases with pancreatic adenocarcinoma. The CA19-9 values, treatment histories (surgery, chemotherapy) and survival times from diagnosis were recorded from the hospital automation system. The apparent diffusion coefficient values were found to be significantly lower in cases with pancreatic adenocarcinoma who lived less than 4.6 months from the time of diagnosis. More necrosis and metastasis were detected in patients with high CA19-9 levels. The highest survival time was observed in patients who underwent surgical treatment. The age of diagnosis was higher in cases with XRCC1 Arg399Gln GG genotype. The effect of XRCC1 Arg399Gln polymorphism on survival has not been determined. The effect of apparent diffusion coefficient maximum and mean values in predicting prognosis was not demonstrated, and no relationship was found between the ADC values and the XRCC1 Arg399Gln polymorphisms. Our study is the first study we know in the literature investigating the relationship between diffusion-weighted imaging data and XRCC1 Arg399Gln polymorphism in cases with pancreatic ductal adenocarcinoma, and we believe that our study will lead to future studies. In the diagnosis of pancreatic adenocarcinoma, apparent diffusion coefficient values are useful in the diagnosis of lesions and in predicting prognosis. CA19-9 values maintain their importance in the diagnosis of pancreatic adenocarcinoma. Further studies are needed in large patient groups.
The aim of our study is to evaluate the effects of apparent diffusion coefficient values, characteristics of lesions and XRCC1 polymorphism on prognosis in diffusion-weighted MR images of pancreatic ductal adenocarcinoma. Between January 2019-2021, 48 patients who were examined with abdominal magnetic resonance imaging in the Department of Radiology of Trakya University Faculty of Medicine and histopathologically diagnosed with pancreatic adenocarcinoma were included in the study. Quantitative apparent diffusion coefficient values were calculated from 1.5 Tesla magnetic resonance images of the patients at the workstation. XRCC1 gene polymorphism was studied in Trakya University Biophysics Department from blood allocated for the laboratory. XRCC2 polymorphism could not be studied because the restriction enzyme could not provide sufficient DNA cutting. Tumoral size, necrosis, localization, visual diffusion restriction, vascular invasion, regional lymphadenopathy, metastasis were evaluated in cases with pancreatic adenocarcinoma. The CA19-9 values, treatment histories (surgery, chemotherapy) and survival times from diagnosis were recorded from the hospital automation system. The apparent diffusion coefficient values were found to be significantly lower in cases with pancreatic adenocarcinoma who lived less than 4.6 months from the time of diagnosis. More necrosis and metastasis were detected in patients with high CA19-9 levels. The highest survival time was observed in patients who underwent surgical treatment. The age of diagnosis was higher in cases with XRCC1 Arg399Gln GG genotype. The effect of XRCC1 Arg399Gln polymorphism on survival has not been determined. The effect of apparent diffusion coefficient maximum and mean values in predicting prognosis was not demonstrated, and no relationship was found between the ADC values and the XRCC1 Arg399Gln polymorphisms. Our study is the first study we know in the literature investigating the relationship between diffusion-weighted imaging data and XRCC1 Arg399Gln polymorphism in cases with pancreatic ductal adenocarcinoma, and we believe that our study will lead to future studies. In the diagnosis of pancreatic adenocarcinoma, apparent diffusion coefficient values are useful in the diagnosis of lesions and in predicting prognosis. CA19-9 values maintain their importance in the diagnosis of pancreatic adenocarcinoma. Further studies are needed in large patient groups.
Açıklama
Anahtar Kelimeler
Pankreatik duktal adenokarsinom, Manyetik rezonans görüntüleme, Difüzyon ağırlıklı görüntüleme, XRCC1 polimorfizm, Pancreatic ductal adenocarcinoma, Magnetic resonance imaging, Diffusion weighted imaging, XRCC1 polymorphism
