Pankreas kanserinde MDR (P-glycoprotein), Ki-67 ve survivin ekspresyonu ile apoptotik aktivitenin prognoz üzerine etkilerinin değerlendirilmesi
The effect of survivin, MDR (P-glycoprotein), Ki-67 and, apoptotic activity on prognosis
- Tez No: 124434
- Danışmanlar: Y.DOÇ.DR. İLHAN ÖZTOP
- Tez Türü: Tıpta Uzmanlık
- Konular: Onkoloji, Oncology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2003
- Dil: Türkçe
- Üniversite: Dokuz Eylül Üniversitesi
- Enstitü: Tıp Fakültesi
- Ana Bilim Dalı: İç Hastalıkları Ana Bilim Dalı
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: 57
Özet
ÖZET Pankreas kanserinde prognozun kötü olması ve tedavi seçeneklerinin başarısının düşük olması, bu tümörün biyolojisini anlamaya ve aydınlatmaya yönelik çalışmalar ihtiyaç olduğunu göstrmektedir. Bu amaçla 45 pankreas kanserli hastanın patoloji preperatlarında apoptozis aktivitesi, survivin, ki-67 ve MDR proteinlerinin ekspresyonlarını incelemeyi ve elde edilen veriler ile hastaların klinik ve patolojik özellikleri, sağkalım oranları ve kemoterapiye verdikleri yanıt arasındaki ilişkiyi araştırmayı planladık. Çalışmaya Patoloji Ana Bilim Dalı' nda pankreas kanseri tanısı almış 45 hasta alındı. Bu hastaların 30'una adjuvan kemoterapi uygulandı. Hastaların klinik ve patolojik özellikleri retrospektif olarak kaydedildi. Patoloji preperatlarında immunhistokimyasal olarak apoptozis aktivitesi, survivin, ki-67 ve MDR proteinlerinin ekspresyonları incelendi. Hastaların tümünde histolojik tip adenokarsinom idi. Yaş ortalaması 60.06 ve cinsiyet dağılımı eşit bir oran gösterdi. Evrelerine göre %55.6'sı metastatik, %44.4'ü lokal ve lokal ileri evre hastalıktı. Survivin, %15.6 oranında pozitif saptandı. Survivin ekspresyonu ile klinik ve patolojik veriler arasında bir ilişki saptanmadı. Survivinin ile Al ve Pl arasında istatistiksel olarak anlamlı bir ilişki bulunmadı (p
Özet (Çeviri)
SUMMARY The fact that the prognosis is bad in the pancreas cancer and the success of the treatment choises are low indicates that there is a need for studies aiming at understanding the biology of the tumour and enlightening it. We aimed to examine the expression proteins of survivin, ki-67, MDR and apoptosis activity at pathology specimens of 45 pancreatic cancer patients and with the date obtained. We studied the relation amount clinical and pathological variables and overall survival response to the chemotherapy. In this study, 45 patients with pancreatic cancer who diagnosed by pathology department were taken, and the twenty-nine of these patients were applied chemotherapy. Clinicopathological variables of the patients were enrolled retrospectively. The expression of survivin, ki-67, MDR and apoptosis activity were examined in the pathology specimens immunohistochemistrly. Histologic type was adenocarcinoma in all of the patients. Mean age was 60.06 and dispersion of gender indicated in equal rate. According to the stage 55.6% of patients were metastatic and 44.4% were locally and locally advanced disease. In 15.6% of the patients survivin positive was detected. There was no correlation between survivin expression and any clinical pathologic characteristic of pancreatic carcinoma. There was no correlation between survivin expression and Al and PI, however it was unremarkable statistically. Al evaluated with TUNEL method was 37.12 ± 34.55 %. PI evaluated with ki-67 expression method was 43.75 ± 25.30 %. In the correlation analysis made between Al and PI even if there was no statistically difference, a negative correlation was seen (p = 0.09). In 80 % of our patients MDR expression was positive. In our study, there was significant statistical difference between MDR and survivin expression not only in the Pearson ki-kare test but also in the Spearman's corelations analysis (p = 0.036 and p = 0.04). MDR expression was also detected in all patients with survivin expression. No significant difference was found between Al and MDR, PI and MDR (p = 0.66 and p = 0.85 ). 42The mean survival of our patients was 23.3 months (15.0-31.58 95% CI). Mean follow up period was 15 months. Actuarial survival rate of 1 or 2 years was 57% and 20% retrospectively. In correlation analysis there was no significant correlation between survival and Al (p = 0.24), but there was found negative corelation with PI (p -= 0.04). The effect of survivin expression on survival was found unremarkable statistically (p = 0.389 Kaplan Meier Log Rank). And while the effect of MDR expression on survival was unmeaningful statistically, rate of survival in the patients with MDR expression was lower than the other group (p = 0.748 Kaplan Meier Log Rank). In conclusion, though the existence of MDR expression on the patients with pancreatic cancer has an prognostic importance, there is no prognostic significance of apoptotic index, expression of survivin and ki-67. The fact that these proteins have different expressions in the various cancer types examined could be caused by many factors affecting the carcinogenesis in the developing period. 43
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