Renal hücreli karsinomalarda intratümöral ve ekstratümöral lenfosit infiltrasyonu sağ kalımı etkilemekte midir?
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Date
2011-01-19
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Uludağ Üniversitesi
Abstract
İntratümöral ve ekstra tümöral lenfositik infiltrasyon, organizmanın yeni ortaya çıkan neoplazik oluşuma karşı gösterdiği tepkidir ve Renal cell carcinoma (RCC) larda oldukça belirgin şekilde saptanır. Yapılan araştırmalarda bu infiltrasyon birçok tümör tipinde sağ kalımı olumlu etkilerken RCC’de tam tersi sonuçlar bulunmuştur. Çalışmamızın amacı RCC tanısı almış olgularda intra ve ekstra tümöral lenfositik infiltrasyonun sağ kalıma etkisini araştırarak literatüre katkıda bulunmaktır. Çalışmamıza 2000-2004 yılları arasında RCC tanısı almış 136 hasta dahil edildi. Hastaların klinik ve takip bilgileri dosyalarından, kişilerin kendisinden veya ailelerinden elde edildi. Patolojik kesitler histolojik tip, tümör lokalizasyonu, evresi, tümör grade’i, perirenal invazyon, kapsüler invazyon ve intra / ekstratümöral lenfosit infiltrasyonu yoğunluğu açısından tekrar bakıldı. İntratümöral lenfositik infiltrasyon değerlendirilirken nekrozdan uzak alanlardan en az 3, büyük tümörlerde ise en az 4 tümörlü kesit seçildi. Ekstratümöral lenfositik infiltrasyon için tümör çevresi böbrek dokusundan uzak, 1 kesite bakıldı. Ortaya çıkan intratümöral inflamasyon skoru (IIS) ve ekstratümöral inflamasyon skoru (EIS) ile histolojik tip, tümör lokalizasyonu, evresi, tümör grade’i, perirenal invazyon, kapsüler invazyon ve sağ kalım arasındaki ilişkiye bakıldı. IIS ile tümör grade’i arasında ilişki bulundu (p=0.01) ancak EIS ile grade arasında anlamlılık yoktu (p >0.05). IIS ve EIS ile tümör evresi arasında ilişki görülmedi (p>0.05). Aynı şekilde histolojik tip, perirenal invazyon, kapsüler invazyon, sağ kalım ile IIS ve EIS arasında anlamlılık saptanmadı. RCC’lerde inflamasyon yoğunluğunun bilinmesi, tedavi açısından karar vermede zorlanılan olgularda yönlendirici bir rol oynayabilir.
Intratumoral and extratumoral lymphocytic infiltration are the reactions of the organism against new developing neoplastic formation and are detected quite prominently in renal cell carcinomas (RCC). While this infiltration affects survival positively in many tumor types, contradictive results were obtained in RCC. The aim of our study is to make a contribution to the literature by investigating the effect of intra and extratumoral lymphocytic infiltration on survival in cases diagnosed as renal cell carcinoma. A total of 136 patients who were diagnosed as RCC between 2000-2004 were included in our study. Clinical and follow up informations of the patients were obtained from the files, themselves or families. Pathological cross-sections were examined again in terms of histological type, tumor location, stage, grade, perirenal invasion, capsular invasion and the intensity of intra/extratumoral lymphocyte infiltration. When intratumoral lymphocytic infiltration was being evaluated, at least 3 sections were selected from the areas far from necrosis and at least 4 sections including tumor were selected in large tumors. One section that tumor border was far from renal tissue was examined for evaluation of extratumoral lymphocytic infiltration. Relationship between obtained intratumoral inflammation score (IIS) / extratumoral inflamemation score (EIS) and histologic type, tumor location, stage, grade, perirenal invasion, capsular invasion and survival was assessed. A relationship was found between IIS and tumor grade (p=0,01) however there was not a significant relationship between EIS and grade (p>0,05). A relationship was not detected between IIS/ EIS and pathological stage (p>0,05). Similarly, a significant relationship was not found between histological type, perirenal invasion, capsular invasion, survival and IIS/ EIS. Knowing the inflammation intensity can play a guiding role in cases that therapeutic decision is hardly made in RCC
Intratumoral and extratumoral lymphocytic infiltration are the reactions of the organism against new developing neoplastic formation and are detected quite prominently in renal cell carcinomas (RCC). While this infiltration affects survival positively in many tumor types, contradictive results were obtained in RCC. The aim of our study is to make a contribution to the literature by investigating the effect of intra and extratumoral lymphocytic infiltration on survival in cases diagnosed as renal cell carcinoma. A total of 136 patients who were diagnosed as RCC between 2000-2004 were included in our study. Clinical and follow up informations of the patients were obtained from the files, themselves or families. Pathological cross-sections were examined again in terms of histological type, tumor location, stage, grade, perirenal invasion, capsular invasion and the intensity of intra/extratumoral lymphocyte infiltration. When intratumoral lymphocytic infiltration was being evaluated, at least 3 sections were selected from the areas far from necrosis and at least 4 sections including tumor were selected in large tumors. One section that tumor border was far from renal tissue was examined for evaluation of extratumoral lymphocytic infiltration. Relationship between obtained intratumoral inflammation score (IIS) / extratumoral inflamemation score (EIS) and histologic type, tumor location, stage, grade, perirenal invasion, capsular invasion and survival was assessed. A relationship was found between IIS and tumor grade (p=0,01) however there was not a significant relationship between EIS and grade (p>0,05). A relationship was not detected between IIS/ EIS and pathological stage (p>0,05). Similarly, a significant relationship was not found between histological type, perirenal invasion, capsular invasion, survival and IIS/ EIS. Knowing the inflammation intensity can play a guiding role in cases that therapeutic decision is hardly made in RCC
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Keywords
Renal hücreli karsinoma, Renal cell carcinoma, İnflamasyon, Sağ kalım, Inflammation, Survey
Citation
Aytaç, B. ve Vuruşkan, H. (2010). "Renal hücreli karsinomalarda intratümöral ve ekstratümöral lenfosit infiltrasyonu sağ kalımı etkilemekte midir?" Uludağ Üniversitesi Tıp Fakültesi Dergisi, 36(3),99-102.