Kolorektal adenomlarda revize viyana sınıflandırılmasına göre patologlar arasındaki uyum ile Kİ-67 ve P53 immunhistokimyasal boyamalarının histopatolojik tanıdaki rolü
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Date
2014
Authors
Moray, Melike Nalbant
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Publisher
Uludağ Üniversitesi
Abstract
Çalışmamızın amacı; kolorektal bölgeden kaynaklanan mukozal neoplazilerde revize Viyana sınıflandırılmasına göre patologlar arası uyum ve Kİ-67 ile p53 immunohistokimyasal boyamalarının histopatolojik tanıdaki rolünü değerlendirmektir. Kolorektal bölgedeki malignite şüphesi olan veya adenom ön tanısıyla eksize edilen 159 hastaya ait 224 neoplazi içeren kesitler çalışmaya dahil edildi. Bu olguların patoloji raporları retrospektif olarak incelendi ve raporlardan elde edilen yaş, cinsiyet, biyopsi ve materyalinin alındığı lokalizasyon ile histolojik tanı parametreleri belirlendi. Olguların Hematoksilen&Eosin boyalı preparatları birbirinden bağımsız 3 patolog tarafından 1 aylık bir süre içerisinde değerlendirildi. Gözlemciler; Uludağ Üniversitesi Tıp Fakültesi bünyesinde çalışan gastrointestinal sistemde deneyimli bir patolog, Uzman patolog ve Araştırma görevlisinden oluşmaktaydı. Tüm olgular immunohistokimyasal olarak p53, Ki-67 belirteçleri ile boyanarak p53 ekspresyonu semikantitatif olarak değerlendirildi, Ki-67 proliferasyon indeksi hesaplandı. Olgular; 1.gözlemci tarafından Kİ-67 ve P53 immünhistokimyasal sonuçlarıyla birlikte revize Viyana sınıflamasına göre değerlendirildiğinde 1 ( %0,4) olgu 'kategori 2- kesin olmayan displazi', 85 (%37,9) olgu 'kategori 3- düşük dereceli mukozal neoplazi', 129 (%57,6) olgu 'kategori 4.1- yüksek dereceli mukozal neoplazi/adenoma', 1 (%0,4) olgu 'kategori 4.2- noninvaziv karsinoma (karsinoma in situ-CIS)', 5 (%2,2) olgu 'kategori 4.3- şüpheli invaziv karsinoma', 3 (%1,3) olgu 'kategori- 4.4 intramukozal karsinoma' tanısı aldı. Gastrointestinal sistemde deneyimli olan 1.gözlemcinin sadece H&E boyalı kesitleri ve p53 ile Kİ-67 immunhistokimyasal boya bulguları ile birlikte değerlendirmesi arasında ve her 3 gözlemcinin H&E boyalı preparatlarla verdikleri tanılar arasında istatistiksel anlamlı fark bulundu. Sonuç olarak kolorektal neplazi öntanılı olguların; gastrointestinal sistemde deneyimli bir patolog tarafından değerlendirilmesinin ve rutin olarak p53 ile Kİ-67 immunhistokimyasal boyamaları ile birlikte değerlendirmenin daha faydalı olacağı sonucuna varıldı.
The aim of our study is to evalutate the accordance among pathologists according to revised Vien classification on mucosal neoplasm which arose from colorectal region and the role of Kİ-67 and p53 immunohistochemical staining on histopathologic diagnosis. Hematoksilen&Eosin stained 224 sections of 159 cases diagnosed as neoplasia, which have suspicious for malignacy or precancerous lesions in collorectal region are included in the study. The records of these cases are examined retrospectively and age, gender, regions of gastrointestinal system, which the material and biopsy are taken from, and histologic diagnosis parameters are identified. The H&E stained sections are evaluated by 3 irrelative pathologists during the period of a month. Observers consist of an experienced pathologist who works in the Faculty of Medicine, an expert pathologist and a research assistant. All of the facts are stained via p53; Ki-67 reagents, p53 manifestations are evaluated semiquantitatively, Ki-67 proliferation indicator is calculated. When the cases were evaluated according to revised Vienna classification with Ki-i67 and p53 immunohistochemical results, one case (0,4 %) is diagnosed with ''category 2-indefinite for neoplasia'',85 (%37.9) cases diagnosed with "category 3-low grade mucosal neoplasia"; 129 (57,6 %) cases are diagnosed with "category 4.1 – high grade mucosal neoplasia/adenoma"; one case (0,4 %) is diagnosed with "category 4.3 – non-invasive carcinoma (carcinoma in situ –CIS)"; five cases (2,2 %) are diagnosed with "category 4.3 – suspicion of invasive carcinoma"; three cases (1,3 %) are diagnosed with "category 4.4 – intramucosal carcinoma" . The facts of the first observers experienced in the gastrointestinal tract and p53 and Ki-67 immunohistochemical only HE stained with paint and all three observers of the evaluation of the HE stained preparations, significant differences were found between their diagnosis. In conclusion; the incidence of colorectal adenoma by an experienced pathologist in the gastrointestinal tract and p53 and Ki-67 immunohistochemical staining as a routine evaluation would be more useful along with concluded.
The aim of our study is to evalutate the accordance among pathologists according to revised Vien classification on mucosal neoplasm which arose from colorectal region and the role of Kİ-67 and p53 immunohistochemical staining on histopathologic diagnosis. Hematoksilen&Eosin stained 224 sections of 159 cases diagnosed as neoplasia, which have suspicious for malignacy or precancerous lesions in collorectal region are included in the study. The records of these cases are examined retrospectively and age, gender, regions of gastrointestinal system, which the material and biopsy are taken from, and histologic diagnosis parameters are identified. The H&E stained sections are evaluated by 3 irrelative pathologists during the period of a month. Observers consist of an experienced pathologist who works in the Faculty of Medicine, an expert pathologist and a research assistant. All of the facts are stained via p53; Ki-67 reagents, p53 manifestations are evaluated semiquantitatively, Ki-67 proliferation indicator is calculated. When the cases were evaluated according to revised Vienna classification with Ki-i67 and p53 immunohistochemical results, one case (0,4 %) is diagnosed with ''category 2-indefinite for neoplasia'',85 (%37.9) cases diagnosed with "category 3-low grade mucosal neoplasia"; 129 (57,6 %) cases are diagnosed with "category 4.1 – high grade mucosal neoplasia/adenoma"; one case (0,4 %) is diagnosed with "category 4.3 – non-invasive carcinoma (carcinoma in situ –CIS)"; five cases (2,2 %) are diagnosed with "category 4.3 – suspicion of invasive carcinoma"; three cases (1,3 %) are diagnosed with "category 4.4 – intramucosal carcinoma" . The facts of the first observers experienced in the gastrointestinal tract and p53 and Ki-67 immunohistochemical only HE stained with paint and all three observers of the evaluation of the HE stained preparations, significant differences were found between their diagnosis. In conclusion; the incidence of colorectal adenoma by an experienced pathologist in the gastrointestinal tract and p53 and Ki-67 immunohistochemical staining as a routine evaluation would be more useful along with concluded.
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Keywords
Kolorektal neoplazi, P53, Kİ-67 proliferasyon indeksi, Revize Viyana sınıflaması, Colorectal neoplasm, Kİ-67-antigen proliferative indeks, Revised Vienna classification
Citation
Moray, M. N. (2014). Kolorektal adenomlarda revize Viyana sınıflandırılmasına göre patologlar arasındaki uyum ile Kİ-67 ve P53 immunhistokimyasal boyamalarının histopatolojik tanıdaki rolü. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.