Adjuvan radyoterapi ve/veya kemoterapi gören opere larenks kanserli hastalarda mikrodamar yoğunluğu, veGF ekspresyonu ve perinöral invazyonun prognostik önemi
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Dosyalar
Tarih
2013
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Trakya Üniversitesi Tıp Fakültesi
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma, operasyon ardından RT ve/veya KT ile etkin bir şekilde tedavi edilemeyecek tümörleri belirlemek ve bu grup hastayı etkin tedavi edebilme amacı taşımaktadır. Aynı evredeki tüm hastaların, aynı tedavileri almış olmasına rağmen, benzer klinik sonuçlar elde edilmemiş olması, tümöre ait yapısal özelliklerin de dikkate alınması gerektiğini düşündürmektedir. Bu çalışmada Eylül 1999-Haziran 2011 tarihleri arasında TÜTF Radyasyon Onkolojisi Kliniği?nde operasyon sonrası adjuvan RT ve/veya KT alan 18-65 yaş arası 62 hastada tümördeki MDY, VEGF ekspresyonu ve PNİ?un genel sağkalıma etkisi değerlendirilmiştir. Hasta dosyalarından demografik, klinik özellikler, patoloji arşivinden temin edilen patoloji preperatlarından immunuhistokimyasal boyamalar yapılarak, VEGF, MDY, PNİ?u belirlenerek genel sağkalıma etkisi istatistiksel olarak belirlenmiştir. Patoloji preperatları incelendiğinde 22 hastanın %35,4 PNİ olduğu görülmüştür. Mikrodamar yoğunluğu 12-55 arasında değişmektedir. Ortalama 33?dir. Hastaların 4 tanesinde (%6,5) Level 1 VEGF ekspresyonu, 7 tanesinde (%11,3) Level 2 VEGF ekspresyonu, 24 tanesinde (%38,7) Level 3 VEGF ekspresyonu ve 27 tanesinde (%43,5) Level 4 VEGF ekspresyonu saptanmıştır. PNİ ve MDY ile sağkalım arasında istatistiksel anlamlı ilişki görülmemiştir (p>0,05). Sağkalım oranları VEGF düzeyinin artması ile istatistiksel anlamlı oranda azalmaktadır (p=0,03). Mikrodamar yoğunluğu ile VEGF ekspresyonu arasında istatistiksel anlamlı ilişki bulunmuştur (p=0,009). Sonuç olarak, çalışmamızda adjuvan RT ve/veya KT görmüş hastalarda sağkalım oranları VEGF düzeyinin artması ile istatistiksel anlamlı oranda azalmaktadır MDY ve PNİ?un ise sağ kalıma etkisi gösterilememiştir. Belirttiğimiz parametrelerin larenks kanseri tanılı hastalardaki etkisini değerlendirecek daha büyük hasta sayılı çalışmalara ve bu parametreleri belirlemeye yönelik farklı yöntemlere ihtiyaç bulunmaktadır.
Abstract
Primary objectives of this study are to determine tumors that can not be cured effectively through radiotherapy and/ chemotherapy treatments after the performed operation and to propose an effective treatment method. Different findings from the clinical results of patients that were in the same phase and being similarly treated support the idea of considering the structural characteristics of tumors. This study covers the survival rate of 62 patients that were treated in Trakya University Medical Faculty Radiation Oncology Clinic between September 1999-June 2011 by detecting the density of micro-vessels, vascular endothelial growth factor expression and perineural invasion of tumors. Age of patients in this study range from 18 to 65 and the effectiveness of the aforementioned parameters were evaluated for each patient. In order to determine the effectiveness of the stated parameters of Tumors, demographic information, clinical characteristics and pathological preparation forms of each patient in the archieve were considered statistically with the help of immunohistochemical marking (coloring). On the basis of investigations on Pathology preparations 22 patients were diagnosed as 35,4 % perineural invasion where the microvessel density of these patients vary between 12 -55 and the average value of perineural invasion value is computed as 33. Additionally, 31 patients in this study were reported with low vascular endothelial growth factor expression (47.7%) while 34 of the patients were detected with the high vascular endothelial growth factor expression (52.3%). Statistical evaluation of survival rate with perineural invasion, microvessel density, vascular endothelial growth factor does not lead to a meaningful value (p>0,05). In contrast, statistical evaluation of density of micro-vessel and vascular endothelial growth factor expression were well-correlated and resulted as a meaningful value (p=0,009). Finally we can say that research studies with larger amount of patients and different treatment procedures are strongly required to determine the effectiveness of stated parameters in the diagnosis of Laryngeal cancer.
Abstract
Primary objectives of this study are to determine tumors that can not be cured effectively through radiotherapy and/ chemotherapy treatments after the performed operation and to propose an effective treatment method. Different findings from the clinical results of patients that were in the same phase and being similarly treated support the idea of considering the structural characteristics of tumors. This study covers the survival rate of 62 patients that were treated in Trakya University Medical Faculty Radiation Oncology Clinic between September 1999-June 2011 by detecting the density of micro-vessels, vascular endothelial growth factor expression and perineural invasion of tumors. Age of patients in this study range from 18 to 65 and the effectiveness of the aforementioned parameters were evaluated for each patient. In order to determine the effectiveness of the stated parameters of Tumors, demographic information, clinical characteristics and pathological preparation forms of each patient in the archieve were considered statistically with the help of immunohistochemical marking (coloring). On the basis of investigations on Pathology preparations 22 patients were diagnosed as 35,4 % perineural invasion where the microvessel density of these patients vary between 12 -55 and the average value of perineural invasion value is computed as 33. Additionally, 31 patients in this study were reported with low vascular endothelial growth factor expression (47.7%) while 34 of the patients were detected with the high vascular endothelial growth factor expression (52.3%). Statistical evaluation of survival rate with perineural invasion, microvessel density, vascular endothelial growth factor does not lead to a meaningful value (p>0,05). In contrast, statistical evaluation of density of micro-vessel and vascular endothelial growth factor expression were well-correlated and resulted as a meaningful value (p=0,009). Finally we can say that research studies with larger amount of patients and different treatment procedures are strongly required to determine the effectiveness of stated parameters in the diagnosis of Laryngeal cancer.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Perinöral İnvazyon, Prognostik Faktör, Larenks Kanseri, Vasküler Endotelyal Growth Faktör Ekspresyonu, Mikrodamar Yoğunluğu, Perineural İnvasion, Prognostic Factor, Larynx Cancer, Vascular Endothelial Growth Factor Expression, Microvessel Density
