Gastroenteropankreatik nöroendokrin tümörlerde somatostatin reseptör 2 ve somatostatin reseptör 5 ekspresyonlarının immünohistokimyasal olarak belirlenmesi ve klinikopatolojik değişkenlerle karşılaştırılması
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Date
2011
Authors
Şehitoğlu, İbrahim
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmada gastroenteropankreatik nöroendokrin tümör tanısı almış olguların biyopsi ve rezeksiyon materyallerindeki tümör hücrelerinde somatostatin reseptör 2 (SSTR 2) ve somatostatin reseptör 5 (SSTR 5) ekspresyonlarının immünohistokimyasal olarak araştırılması ve klinikopatolojik değişkenlerle SSTR 2 ve SSTR 5 boyanmaları arasında istatistiksel anlamlılık bulunup bulunmadığının tespit edilmesi amaçlanmıştır.Bu çalışma için 1999-2010 yılları arasında Uludağ Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda histopatolojik olarak gastroenteropankreatik nöroendokrin tümör tanısı almış 49 olgu belirlendi. Tüm olguların materyallerine ait Hematoksilen-Eozin (H.E.) boyalı kesitler ile immünohistokimyasal boyama yapılmış kesitler arşivden çıkarıldıktan sonra tanı, histolojik grade ve tümör tipi açısından yeniden değerlendirildi. Hastalara ait cinsiyet, yaş, tümör lokalizasyonu, tümör çapı gibi bilgilere anabilim dalımıza ait arşivdeki patoloji raporlarından ulaşıldı. H.E ile boyalı kesitlerin incelenmesinden sonra parafin bloktan yapılan kesitlere somatostatin reseptör 2 ve 5 immünohistokimyasal boyamaları uygulandı. SSTR 2 ve 5 boyamalarından sonra kesitler ışık mikroskopu altında incelendi. SSTR 2 ve SSTR 5 boyanmaları ile yaş, cinsiyet, tümör çapı, vasküler veya perinöral invazyon varlığı, Ki 67 yüzdesi gibi değişkenler istatistiksel olarak karşılaştırıldı. Elde edilen veriler için yapılan istatistiksel karşılaştırmada Fisher'in Kesin ki-kare testi ve Pearson ki-kare testi kullanıldı. Anlamlılık düzeyi p< 0.05 olarak kabul edildi.Araştırmamıza aldığımız 49 olgunun 42'si (%85,71) SSTR 2 ile pozitif, 7'si (%14,29) negatif boyanırken, SSTR 5 ile 49 olgunun 30'u (%61,22) pozitif, 19'u (%38,78) negatif boyanmıştır. SSTR 2 ve SSTR 5 boyanmaları ile yaş, cinsiyet ya da histopatolojik parametreler (tümör çapı, vasküler veya perinöral invazyon varlığı gibi) arasında istatistiksel anlamlılık saptanmazken Ki 67 yüzdesi düşük olgularda SSTR 5 boyanma pozitifliği daha yüksek bulunmuştur (p=0.01).Bu çalışmada gastroenteropankreatik nöroendokrin tümör tanılı olguların doku örneklerinde, kaynaklardaki bilgilerle uyumlu şekilde, tümör hücrelerinin yüksek oranlarda SSTR2 ve SSTR 5 ekspresyonunun olduğu gösterildi. Böylece kriterleri iyi belirlenmiş ve seçilmiş gastroenteropankreatik nöroendokrin tümör tanılı olguların somatostatin analoglarından klinik yarar görebileceği düşünülmüştür.
The aim of this study is to find the expression of somatostatin receptor 2 (SSTR 2) and somatostatin receptor 5 (SSTR 5) in biopsy and resection materials of patients tumor cells who were diagnosed gastroenteropancreatic neuroendocrine tumor, by immunohistochemistry and to assess if there is statistically significance difference between clinicopathological variables and SSTR 2 and SSTR 5 staining.In this study 49 cases were determined who were diagnosed with gastroenteropancreatic neuroendocrine tumor by histopathological examination in University of Uludag Faculty of Medicine Pathology Department between 1999-2010 years. Diagnose, histological grade and tumor type were reevaluated after hematoxylin and eosin and immunhistochemically stained sections were obtained. Gender, age, tumor localization and tumor size of patients were obtained from our department archive. Subsequently, hematoxylin and eosin stained sections were examined and the sections from paraffin embedded blocks were processed for SSTR 2 and SSTR 5 staining. After SSTR 2 and SSTR 5 staining, sections were examinated by light microscopy. SSTR 2 and SSTR 5 staining were statistically compared with the variables such as age, gender, tumor size, vascular or perineural invasion, Ki 67 percentage. Fishers exact chi-square tests and Pearsons chi-square tests were used for findings to compare them statistically. A p-value 0.05 was considered as statistically significant.Forty two of the cases exhibited expression of SSTR 2 (85,71%) and 30 of the cases exhibited expression of SSTR 5 (61,22%) which include 49 cases in the investigation. 7 of tumors did not express SSTR 2 (14,29%) and 19 of tumors did not express SSTR 5 (38,78%). Otherwise no significant correlation was found between SSTR 2 and SSTR 5 staining and age, gender or histopathological parameters (like tumor size, vascular or perineural invasion). SSTR 5 positivity were higher in cases with lower Ki 67 percentage.In this study, in tissue samples of gastroenteropancreatic neuroendocrine tumor diagnosed cases, it was demonstrated that tumor cells have higher SSTR 2 and SSTR 5 expression rates which are consistent with the literature. Thus, it is thought that selected gastroenteropancreatic neuroendocrine tumor patients with well determined criteria can be treated by somatostatin analogues.
The aim of this study is to find the expression of somatostatin receptor 2 (SSTR 2) and somatostatin receptor 5 (SSTR 5) in biopsy and resection materials of patients tumor cells who were diagnosed gastroenteropancreatic neuroendocrine tumor, by immunohistochemistry and to assess if there is statistically significance difference between clinicopathological variables and SSTR 2 and SSTR 5 staining.In this study 49 cases were determined who were diagnosed with gastroenteropancreatic neuroendocrine tumor by histopathological examination in University of Uludag Faculty of Medicine Pathology Department between 1999-2010 years. Diagnose, histological grade and tumor type were reevaluated after hematoxylin and eosin and immunhistochemically stained sections were obtained. Gender, age, tumor localization and tumor size of patients were obtained from our department archive. Subsequently, hematoxylin and eosin stained sections were examined and the sections from paraffin embedded blocks were processed for SSTR 2 and SSTR 5 staining. After SSTR 2 and SSTR 5 staining, sections were examinated by light microscopy. SSTR 2 and SSTR 5 staining were statistically compared with the variables such as age, gender, tumor size, vascular or perineural invasion, Ki 67 percentage. Fishers exact chi-square tests and Pearsons chi-square tests were used for findings to compare them statistically. A p-value 0.05 was considered as statistically significant.Forty two of the cases exhibited expression of SSTR 2 (85,71%) and 30 of the cases exhibited expression of SSTR 5 (61,22%) which include 49 cases in the investigation. 7 of tumors did not express SSTR 2 (14,29%) and 19 of tumors did not express SSTR 5 (38,78%). Otherwise no significant correlation was found between SSTR 2 and SSTR 5 staining and age, gender or histopathological parameters (like tumor size, vascular or perineural invasion). SSTR 5 positivity were higher in cases with lower Ki 67 percentage.In this study, in tissue samples of gastroenteropancreatic neuroendocrine tumor diagnosed cases, it was demonstrated that tumor cells have higher SSTR 2 and SSTR 5 expression rates which are consistent with the literature. Thus, it is thought that selected gastroenteropancreatic neuroendocrine tumor patients with well determined criteria can be treated by somatostatin analogues.
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Keywords
Gastroenteropankreatik nöroendokrin tümör, SSTR 2, SSTR 5, İmmünohistokimya, Gastroenteropancreatic neuroendocrine tumor, Immunohistochemistry
Citation
Şehitoğlu, İ. (2011). Gastroenteropankreatik nöroendokrin tümörlerde somatostatin reseptör 2 ve somatostatin reseptör 5 ekspresyonlarının immünohistokimyasal olarak belirlenmesi ve klinikopatolojik değişkenlerle karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.