Larenks karsinomlu olgularda vasküler endotelyal growth faktör A ve C düzeylerinin prognoza etkisi
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Dosyalar
Tarih
2010
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Son yıllarda kanser tedavisi için yapılan araştırmalarda tümör çoğalması ve metastazının mekanizmalarının anlaşılması için uğraşılmakta ve bu mekanizmaları hedef alan tedaviler geliştirilmeye çalışılmaktadır. Bu nedenle tümörün damarlanma miktarı, damar oluşturma yeteneği ve in vivo ortamda anjiyogenik ve antianjiyogenik faktörlerin dengesinin bilinmesi gelecekte larenks kanseri gibi tümörlerde yeni bir tedavi seçeneği gündeme getirecektir. Bu çalışmanın temel amacı; erken evre ve ileri evre larenks karsinomlu hastalarda, tanı anındaki anjiyogenik moleküllerin plazma düzeylerinin ve bu anjiyogenik moleküllerin cerrahi tedavi sonrası hastaların boyun lenf nodu nüksü açısından prognostik öneminin saptanmasıdır. Değerlendirmeye değişik evrelerde larenks skuamoz hücreli karsinom tanısı almış 33 olgu ile birlikte kontrol grubu olarak 13 kişi alınmıştır. Çalışmada olguların operasyon öncesi ve operasyon sonrası 6. ayda plazma vasküler endotelyal growth faktör A ve vasküler endotelyal growth faktör C seviyelerine göre değerlendirildiğinde erken evre tümörlü olgularda plazma vasküler endotelyal growth faktör A seviyelerinin kontrol grubuna göre anlamlı derecede düşük olduğu ileri evre tümörlü olgularda ise kontrol grubuyla fark olmadığı saptandı. Tümör evresiyle vasküler endotelyal growth faktör A seviyelerinin anlamlı şekilde arttığı tespit edildi. Lenf nodu tutulumu olan olguların, plazma vasküler endotelyal growth faktör C değerleri kontrol grubuna göre anlamlı şekilde düşük bulunmuş lenf nodu tutulumu olmayan olgularla karşılaştırıldığında ise fark saptanmamıştır. Lenf nodu tutulumu olan olguların cerrahi tedavi sonrası 6. aydaki plazma vasküler endotelyal growth faktör C düzeyleri ile operasyon öncesi değerleri arasında fark saptanmamıştır. Sonuç olarak çalışmamızda larenks skuamoz hücreli karsinomlarında, vasküler endotelyal growth faktör A'nın tümör evresiyle korele olarak arttığını ancak bağımsız prognostik faktör olmadığını, vasküler endotelyal growth faktör C nin ise lenf nodu tutulumu olan olgularda prognostik değer taşımadığını göstermiştir. Anahtar kelimeler: Laringeal neoplazm, larenjektomi, vasküler endotelyal growth faktör A, vasküler endotelyal growth faktör C, lenfatik metastaz.
Abstract
In the recent researches which are done for the treatment of cancer, the proliferation and metastasis mechanism of tumor are tried to be understood and treatments which aim at these mechanisms are tried to be produced. For this reason, knowing the amount of the tumor's vessels, its ability of making vessels and the balance of the angiogenic and antiangiogenic factors under in vivo conditions will bring about new choices in the treatment of larynx cancer. The main aim of this research is to determine the prognostic importance of plasma levels of angiogenic molecules at diagnosis time and the role of relapsing neck's lymph node after the operation of the patients who have early stage or the late stage larynx carcinoma. 33 cases that have different stages of larynx squamous cell carcinoma and 13 healthy people for the control group participated in this research. In this research, cases are evaluated in terms of plasma vascular endothelial growth factor A and vascular endothelial growth factor C levels before the surgery and after six months from the surgery, the cases who have early stage tumor with respect to control group plasma vascular endothelial growth factor A levels are meaningfully low, however, in late stage tumor cases, it was detected that there was no difference with respect to the control group. It was detected that as the level of tumor increases, vascular endothelial growth factor A levels are also detected to increase meaningfully. The cases that have lymph node metastasis are low with respect to plasma vascular endothelial growth factor C control group; on the other hand, no difference was detected when compared with the cases that don't have lymph node metastasis. There was no difference between the vascular endothelial growth factor C levels in 6th month after the operation and before the surgery of cases that have lymph node metastasis. Finally, our study shows that at larynx squamous cell carcinoma plasma, vascular endothelial growth factor A levels increases synchronously with tumor's stage but it isn't an independent prognostic factor, and at the lymph node metastasis cases plasma vascular endothelial growth factor C don't have prognostic importance. Key words: Laryngeal neoplasm, laryngectomy, vasculer endothelial growth factor A, vasculer endothelial growth factor C, lymphatic metastasis.
Abstract
In the recent researches which are done for the treatment of cancer, the proliferation and metastasis mechanism of tumor are tried to be understood and treatments which aim at these mechanisms are tried to be produced. For this reason, knowing the amount of the tumor's vessels, its ability of making vessels and the balance of the angiogenic and antiangiogenic factors under in vivo conditions will bring about new choices in the treatment of larynx cancer. The main aim of this research is to determine the prognostic importance of plasma levels of angiogenic molecules at diagnosis time and the role of relapsing neck's lymph node after the operation of the patients who have early stage or the late stage larynx carcinoma. 33 cases that have different stages of larynx squamous cell carcinoma and 13 healthy people for the control group participated in this research. In this research, cases are evaluated in terms of plasma vascular endothelial growth factor A and vascular endothelial growth factor C levels before the surgery and after six months from the surgery, the cases who have early stage tumor with respect to control group plasma vascular endothelial growth factor A levels are meaningfully low, however, in late stage tumor cases, it was detected that there was no difference with respect to the control group. It was detected that as the level of tumor increases, vascular endothelial growth factor A levels are also detected to increase meaningfully. The cases that have lymph node metastasis are low with respect to plasma vascular endothelial growth factor C control group; on the other hand, no difference was detected when compared with the cases that don't have lymph node metastasis. There was no difference between the vascular endothelial growth factor C levels in 6th month after the operation and before the surgery of cases that have lymph node metastasis. Finally, our study shows that at larynx squamous cell carcinoma plasma, vascular endothelial growth factor A levels increases synchronously with tumor's stage but it isn't an independent prognostic factor, and at the lymph node metastasis cases plasma vascular endothelial growth factor C don't have prognostic importance. Key words: Laryngeal neoplasm, laryngectomy, vasculer endothelial growth factor A, vasculer endothelial growth factor C, lymphatic metastasis.
Açıklama
Tıpta Uzmanlık Tezi
Anahtar Kelimeler
Kulak Burun ve Boğaz, Otorhinolaryngology, Laringeal Neoplazm, Larenjektomi, Lenfatik Metastaz, Laryngeal Neoplasm, Cerrahi, Bölgesel Cerrahi
