Anaplastik büyük hücreli lenfomada CD99 immünekspresyonunun klinikopatolojik parametreler ile ilişkisi
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Date
2011
Authors
Aşık, Naile
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Publisher
Uludağ Üniversitesi
Abstract
Anaplastik büyük hücreli lenfomalar nadir görülen neoplazilerdir. Klinik olarak sistemik ve kutanöz hastalık şeklinde görülürler. Sistemik hastalık; Dünya Sağlık Örgütü'ne göre T/null-cell immünfenotipinde ALK pozitif ve ALK negatif Lenfoma olarak kategorize edilmiştir.Primer kutanöz hastalık ise kutanöz CD30 pozitif lenfoproliferatif hastalık grubunun subtipi olarak sınıflandırılmıştır. Sistemik hastalığın ALK pozitif ve negatif tipleri, görülme yaşı, prognoz ve genetik özellikler açısından birbirinden farklılıklar gösterir.Klasik incelemelerde ALK pozitif tiplerin küçük hücreli paterni; periferik T hücreli lenfoma, başka şekilde sınıflandırılamayan lenfomalar ve diğer küçük hücreli neoplazilerle karışabilmektedir.ALK negatif tipin özellikle CD30 pozitifliği olan periferik T hücreli lenfoma ve başka şekilde sınıflandırılamayan lenfomalardan ayrımı oldukça zor olup bu ayrım bazen mümkün olamamaktadır.CD99; Apoptozis, homotipik adhezyon ve protein transportu gibi hücresel olaylarda rol oynayan transmembran glikoproteinidir. Az sayıda çalışmada anaplastik büyük hücreli lenfomalarda sık CD99 pozitifliği dikkati çekmiştir.Bu çalışmada da anaplastik büyük hücreli lenfomalardaki CD99 pozitifliği ile bunun diğer parametrelerle ilişkisi araştırıldı.1996-2008 yıllarında Uludağ Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda tanı alan 21 sistemik ve 3 kutanöz anaplastik büyük hücreli lenfoma çalışmaya alındı. Olgu bloklarından yapılan kesitlere immünohistokimyasal CD99 antikoru uygulandı. CD99 immunreaktivitesi, ALK pozitif ve negatif olguların immünfenotipik ve klinik (yaş, cinsiyet, evre, performans durumu, uluslararası prognostik indeks, laktat dehidrogenaz, B semptomları, ekstranodal tutulum) prognostik özellikleriyle karşılaştırıldı.İstatistiksel olarak, CD99 ile ALK ekspresyonu arasında ve olguların yaşı ile CD99 ve ALK ekspresyonları arasında anlamlı ilişki saptandı (sırasıyla p=0.016 p=0.034, p=0.020). CD99 ve ALK ekspresyonu ile klinik prognostik özellikler ve sağkalım arasında anlamlı bir ilişki saptanmadı.
Anaplastic large cell lymphomas are rarely diagnosed neoplasia. Clinically, they are seen as systemic or cutaneous disease. According to World Health Organization, systemic anaplastic large cell lymphomas are categorized as ALK positive Anaplastic Large Cell Lymphoma and ALK negative Anaplastic Large Cell Lymphoma in T/null-cell immunophenotype. Primary cutaneous disease is classified as a subtype of the cutaneous CD30 positive lymphoproliferative disease group. ALK positive and negative types show distinct features that depend on age, prognosis, and genetics. In classical studies it can be confused with small cell pattern of ALK positive Anaplastic Large Cell Lymphomas, Periferical T cell Lymphoma, other unclassified lymphomas, or small cell neoplasia.However, it may be impossible to distinguish ALK negative types from Periferic T cell Lymphoma or from other types of unclassified lymphoma, which have a common CD30 positivity.CD99 is a transmembrane glycoprotein that plays a role in cellular events such as apoptosis, homotypical adhesion, and protein transport Frequent seen CD99 positivity was noted in a few studies which makes the biological role of CD99 worth conducting a research for.21 systemic and 3 cutaneous Anaplastic Large Cell Lymphoma cases were studied in Uludag University Medicine Faculty Pathology Department between the years 1999- 2008. CD99 immunohistochemical stain was applied to the sections obtained from the blocks that belonged to the cases. The CD99 immunoreactivity in the cases was compared with the immunophenotypical and clinical prognostic features of ALK positive and negative cases.Statistically, CD99 and ALK expression showed a significant relevance with patients' ages (p=0.016). There was also a relevance diagnosed between the ages of the cases and CD99 and ALK expressions (p=0.034, p=0.020 respectively). Other immunophenotypical, clinical prognostic features, and survival time length did not show relevance with one another.
Anaplastic large cell lymphomas are rarely diagnosed neoplasia. Clinically, they are seen as systemic or cutaneous disease. According to World Health Organization, systemic anaplastic large cell lymphomas are categorized as ALK positive Anaplastic Large Cell Lymphoma and ALK negative Anaplastic Large Cell Lymphoma in T/null-cell immunophenotype. Primary cutaneous disease is classified as a subtype of the cutaneous CD30 positive lymphoproliferative disease group. ALK positive and negative types show distinct features that depend on age, prognosis, and genetics. In classical studies it can be confused with small cell pattern of ALK positive Anaplastic Large Cell Lymphomas, Periferical T cell Lymphoma, other unclassified lymphomas, or small cell neoplasia.However, it may be impossible to distinguish ALK negative types from Periferic T cell Lymphoma or from other types of unclassified lymphoma, which have a common CD30 positivity.CD99 is a transmembrane glycoprotein that plays a role in cellular events such as apoptosis, homotypical adhesion, and protein transport Frequent seen CD99 positivity was noted in a few studies which makes the biological role of CD99 worth conducting a research for.21 systemic and 3 cutaneous Anaplastic Large Cell Lymphoma cases were studied in Uludag University Medicine Faculty Pathology Department between the years 1999- 2008. CD99 immunohistochemical stain was applied to the sections obtained from the blocks that belonged to the cases. The CD99 immunoreactivity in the cases was compared with the immunophenotypical and clinical prognostic features of ALK positive and negative cases.Statistically, CD99 and ALK expression showed a significant relevance with patients' ages (p=0.016). There was also a relevance diagnosed between the ages of the cases and CD99 and ALK expressions (p=0.034, p=0.020 respectively). Other immunophenotypical, clinical prognostic features, and survival time length did not show relevance with one another.
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Keywords
Anaplastik büyük hücreli lenfoma, CD99, ALK, Prognostik faktörler, Anaplastic large cell lymphoma, Prognostic factors
Citation
Aşık, N. (2011). Anaplastik büyük hücreli lenfomada CD99 immünekspresyonunun klinikopatolojik parametreler ile ilişkisi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.