Akciğer kanserli hastalarda prognostik ve prediktif biyobelirteçlerin serum düzeylerinin incelenmesi
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Date
2012
Authors
Coşkun, Belkıs Nihan
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
İleri evre akciğer kanserinde ortalama sağkalım süresi oldukça kısadır. Kanser tedavisinin etkinliğini erken dönemde saptamak, sağkalım için önemlidir.Sitokeratinler, epiteliyal hücrelerde yüksek düzeylerde bulunmakta, serumda ölçülebilmektedir. Onkojenik transformasyondan sonra bu ekspresyon devam etmekte hatta artmaktadır. Hücre ölümü belirteçleri olan M30 (Apoptoz belirteci) ve M65 (Nekroz belirteci) antijenlerinin birçok kanser türünde prognozda ve kanser tedavisine cevabı değerlendirmede önemli belirteçler olduğu bilinmektedir.Bu çalışmaya, potansiyel rezektabıl akciğer kanseri tanılı 48 hasta, 38 sağlıklı kontrol grubu dahil edilmiştir. Hastaların 43'ünde kemoterapi öncesi ve kemoterapiden 48 saat sonra serum M30, M65 seviyeleri çalışılmıştır. Kanserli hastalarda, sağlıklı kontrol grubuna göre tedavi öncesi serum M30, M65 seviyelerinin istatistiksel olarak anlamlı (p<0.001 ve p<0.05) derecede yüksek olduğu görülmüştür. Kemoterapi sonrası her iki belirteç de tedavi öncesine oranla anlamlı derecede yükselmiştir (p<0.001).Tedaviye yanıt veren hastalarda (n=28) M30 değerinin %34 arttığı, M65 değerinin ise %68 arttığı görüldü. Progrese olan hastalarda (n=12) M30 değerinin % 78 arttığı, M65 değerinin ise %54 arttığı görüldü. Hastaların yüzde değişimi göz önüne alındığında tedaviye cevap veren ve vermeyenlerin M30, M65 düzeyleri karşılaştırıldığında M65 değerlerinde farklılık saptanmazken, progrese olan hastalarda M30 değerinin anlamlı olarak arttığı saptandı (p=0.694, p<0.05).Sonuç olarak, akciğer kanserli hastalar, belirgin yüksek M30, M65 seviyelerine sahiptir. Bu da M30, M65 antijenlerinin prediktif marker olarak kullanılabileceğini düşündürmektedir. Tedaviye yanıt veren hastalarda M65 seviyeleri daha çok artarken, tedaviye yanıt vermeyenlerde M30 seviyeleri daha çok artmıştır. Bu artış istatistiksel olarak anlamlı olmamakla birlikte;yalnızca apoptozun değil, total hücre ölümünün (apoptoz + nekroz) ölçülmesi, taksan-bazlı kemoterapiye yanıt hakkında daha iyi bir fikir sağlayabilir.
In advanced lung cancer, the mean survival is extremely short. It is very important to establish effectiveness of cancer therapy in early stages for survival of the patient.Cytokeratins are present at high amounts, in epithelial cells and can be detected at serum. Expressions of these markers still continuous after oncogenic transformation and moreover may be increased. It is known that, among the cell death markers, M30 (marker of apoptosis) and M65 (marker of necrosis) antigens are important in prognosis and assessment of response to cancer therapy.In this study we aimed to compare M30, M65 levels in patients with local advanced lung cancer with healthy controls. Secondly we aimed to investigate the role of these markers in determining the response to therapy. Forty-eight patients, diagnosed with potentially resectable lung cancer and 38 healthy volunteers were included. M30, M65 levels before and 48 hours after chemotherapy are studied in 43 out of 48 patients. M30, M65 levels in patients with lung cancer before treatment were significantly increased when compared to healthy controls (p<0.001 and p<0.05). Both of the markers were significantly increased after chemotherapy when compared prior to the treatment (p<0.001).The mean increase in M30, M65 levels was 34% and 68% respectively among the patients who responded to therapy and the mean increase in M30, M65 levels was 78% and 54% respectively among the patients who did not responded to therapy. While the M65 levels did not vary according to response to therapy the M30 levels were significantly increased in non-responder group (p=0.694, p<0.05 respectively).In conclusion, the patients with local advanced lung cancer have significantly higher levels of M30, M65. Accordingly, M30, M65 antigens may be used as a predictive marker. While much more increase observed in serum levels of M65 in patients with respond; M30 levels were higher in non-responder group. However, this increase was not significant; not only apoptosis, also evaluation of total cell death (apoptosis and necrosis) could provide better opinion on taxan-based chemotherapy.
In advanced lung cancer, the mean survival is extremely short. It is very important to establish effectiveness of cancer therapy in early stages for survival of the patient.Cytokeratins are present at high amounts, in epithelial cells and can be detected at serum. Expressions of these markers still continuous after oncogenic transformation and moreover may be increased. It is known that, among the cell death markers, M30 (marker of apoptosis) and M65 (marker of necrosis) antigens are important in prognosis and assessment of response to cancer therapy.In this study we aimed to compare M30, M65 levels in patients with local advanced lung cancer with healthy controls. Secondly we aimed to investigate the role of these markers in determining the response to therapy. Forty-eight patients, diagnosed with potentially resectable lung cancer and 38 healthy volunteers were included. M30, M65 levels before and 48 hours after chemotherapy are studied in 43 out of 48 patients. M30, M65 levels in patients with lung cancer before treatment were significantly increased when compared to healthy controls (p<0.001 and p<0.05). Both of the markers were significantly increased after chemotherapy when compared prior to the treatment (p<0.001).The mean increase in M30, M65 levels was 34% and 68% respectively among the patients who responded to therapy and the mean increase in M30, M65 levels was 78% and 54% respectively among the patients who did not responded to therapy. While the M65 levels did not vary according to response to therapy the M30 levels were significantly increased in non-responder group (p=0.694, p<0.05 respectively).In conclusion, the patients with local advanced lung cancer have significantly higher levels of M30, M65. Accordingly, M30, M65 antigens may be used as a predictive marker. While much more increase observed in serum levels of M65 in patients with respond; M30 levels were higher in non-responder group. However, this increase was not significant; not only apoptosis, also evaluation of total cell death (apoptosis and necrosis) could provide better opinion on taxan-based chemotherapy.
Description
Keywords
Akciğer kanseri, Prognoz, M30 ve M65 antijeni, Tedaviye yanıt, Lung cancer, Prognosis, M30 and M65 antigens, Response to therapy
Citation
Coşkun, B. N. (2012). Akciğer kanserli hastalarda prognostik ve prediktif biyobelirteçlerin serum düzeylerinin incelenmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.