Endometrium kanserli olgularda tümör anjiogenezinin HIF 1 Alfa ve mikrodamar dansitesi ile 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 çalışmanın amacı endometrium kanserli olgularda tümör anjiogenezini immünohistokimyasal belirteçler ile incelemek ve evre, grad, sağkalım gibi klinik ve histopatolojik prognostik faktörlerle olan bağlantısını aydınlatmaya çalışmaktı. Ocak 2001 ile Ağustos 2010 tarihleri arasında Trakya Üniversitesi Tıp Fakültesi Sağlık Araştırma ve Uygulama Hastanesi Kadın Hastalıkları ve Doğum Bölümü'nde endometrium kanseri nedeniyle ameliyat edilen olgular çalışmaya dahil edildi. Olguların tümörü en iyi gösterdiğine inanılan kesitlerinin parafin blokları tekrar oluşturulup, hipoksi ile indüklenen faktör 1 alfa ve CD34 antikorları kullanılarak anjiogenez ve mikrodamar dansitesi değerlendirildi. Çalışmamızda ileri dereceli (grad) ve mikrodamar dansitesi yüksek olgularda hipoksi ile indüklenen faktör 1 alfa pozitifliği istatistiksel olarak anlamlı şekilde yüksek tespit edildi. Bu antikor ile yaş, kilo, menopozal durum, evre, toplam sağkalım, histolojik tip arasında anlamlı ilişki saptanmadı. Hipoksi ile indüklenen faktör 1 alfa pozitif ve negatif olguların, evrenin önemli belirleyicilerinden olan servikal, adneksiyal, lenfovasküler ve myometrial invazyon özellikleri kıyaslandığında iki grup arasında fark gözlenmedi. CD34 ile değerlendirilen mikrodamar dansitesinin derece (grad) ve histolojik tip ile yapılan analizinde ise ileri grad tümörlerde ve tip II histolojik tip endometrium kanserlerinde mikrodamar dansitesi yüksek olarak belirlendi. Mikrodamar dansitesi ile evre ve sağkalım üzerinde ise anlamlı bir ilişki görülmedi. Sonuç olarak endometrium kanserlerinde hipoksi ile indüklenen faktör 1 alfa ile yapılan immünohistokimyasal değerlendirmede, derece ve mikrodamar dansitesi gibi histopatolojik parametre ve angiogenetik özelliklerin literatür ile uyumlu olarak anlamlı bir ilişkiye sahip olduğu görüldü. Çalışmamızda hipoksi ile indüklenen faktör 1 alfa pozitifliğinin diğer organ tümörlerinde olan kötü prognoz ile olan ilişkisi de bulgu olarak saptanmamıştır. Ancak immünohistokimyasal verilerin moleküler araştırmalarla birleştirildiği daha geniş çalışmalar ile bu konu desteklenmelidir.
Abstract
The aim of this study was to determine tumoral angiogenesis with immunohistochemical markers in endometrium cancer and its relation with stage, grade, survival rates and other clinical and histopathological prognostic factors. Ninety-four hysterectomy specimen operated as endometrium cancer were evaluated in Trakya University, Faculty of Medicine, Department of Obstetrics and Gynecology between January 2001 and August 2010. The paraffin blocks believed to demonstrate the optimum part of the tumor were reprepared. Angiogenesis and microvessel density were investigated with the aid of hypoxia inducible factor 1alpha and CD34 antibodies. Statistically significant difference between the hypoxia inducible factor 1alpha positivity and advanced grade and high microvessel density were observed. However lacks of relation among age, weight, menopausal status, stage, overall survival rates and histological types were analyzed with hypoxia inducible factor 1 alpha. When we compare hypoxia inducible factor 1alpha positive and negative cases with cervical, adnexial, lenfovascular and myometrial invasion, being the most important factors determining stage, there was no difference between these groups. High microvessel density was evaluated with CD34 and it was remarkable and significantly different on advanced grade tumors and type II histology. However there was no relationship between the microvessel density and stage or survival rates. In conclusion, consistent with the literature, the difference was statistically significant among grade and microvessel density, which were one of the most important factors of histopathological parameters and angiogenetic features, with hypoxia inducible factor 1 alpha in endometrial cancers. Our results also showed that there was no correlation between the hypoxia inducible factor 1 alpha positivity and poor prognosis as oppositely reported in other cancers. However more detailed studies supporting the immunohistochemical findings based on molecular investigations are needed in the future.
Abstract
The aim of this study was to determine tumoral angiogenesis with immunohistochemical markers in endometrium cancer and its relation with stage, grade, survival rates and other clinical and histopathological prognostic factors. Ninety-four hysterectomy specimen operated as endometrium cancer were evaluated in Trakya University, Faculty of Medicine, Department of Obstetrics and Gynecology between January 2001 and August 2010. The paraffin blocks believed to demonstrate the optimum part of the tumor were reprepared. Angiogenesis and microvessel density were investigated with the aid of hypoxia inducible factor 1alpha and CD34 antibodies. Statistically significant difference between the hypoxia inducible factor 1alpha positivity and advanced grade and high microvessel density were observed. However lacks of relation among age, weight, menopausal status, stage, overall survival rates and histological types were analyzed with hypoxia inducible factor 1 alpha. When we compare hypoxia inducible factor 1alpha positive and negative cases with cervical, adnexial, lenfovascular and myometrial invasion, being the most important factors determining stage, there was no difference between these groups. High microvessel density was evaluated with CD34 and it was remarkable and significantly different on advanced grade tumors and type II histology. However there was no relationship between the microvessel density and stage or survival rates. In conclusion, consistent with the literature, the difference was statistically significant among grade and microvessel density, which were one of the most important factors of histopathological parameters and angiogenetic features, with hypoxia inducible factor 1 alpha in endometrial cancers. Our results also showed that there was no correlation between the hypoxia inducible factor 1 alpha positivity and poor prognosis as oppositely reported in other cancers. However more detailed studies supporting the immunohistochemical findings based on molecular investigations are needed in the future.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology, Endometrium Kanseri, Hipoksi, Anjiogenez, Endometrium Cancer, Hypoxia, Angiogenesis
