Paratiroid adenomu tanısında ki67 ve p53 ekspresyonunun rolü
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Date
2016-12-15
Authors
Ünal, Nermin
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Primer hiperparatiroidizmin en sık nedeni paratiroid adenomudur. Paratiroid adenomunun histopatolojik ayırıcı tanısında karsinom ve henüz küçük boyutta olanlarında normal veya hiperplastik paratiroid dokusu yer almaktadır. Morfolojik olarak tanı zorluğu olan durumlarda ek yardımcı yöntemlere ihtiyaç duyulmaktadır. Ki67 proliferasyon indeksi, çeşitli tümörlerdeki ve birçok lezyondaki hücre proliferasyonunu değerlendirmede kullanılmaktadır. Yüksek ki67 değerleri özellikle agresif tümörlerde saptanır. P53 ise tümör supresör gen olarak görev alır. Neoplazilerde en sık mutasyona uğrayan gendir. Biz çalışmamızda ki67 ve p53 ekspresyonunun paratiroid adenomunu tanısındaki yardımcı rolünü araştırdık. 86 paratiroid adenomu olgusunda ki67 ve p53 immunoekspresyonunu çevre normal paratiroid dokusu ile karşılaştırdık. Ayrıca tümörün çapı, mitotik aktivitesi, pleomorfizm varlığı ile olan ilişkilerini değerlendirdik. Adenomlardaki p53 ekspresyonunun çevre paratiroid dokusuna göre daha fazla olduğunu fakat istatistiksel olarak anlamlı olmadığını tespit ettik. Adenom ve çevre paratiroid dokusundaki ki67 ekspresyonu ise istatistiksel olarak anlamlı derecede farklılık gösterdi. Sonuç olarak ki67 ve p53 immünekspresyonlarının paratiroid adenomlarının ayırıcı tanısında ve tümörlerdeki agresif davranış ile nüks potansiyelini belirlemede etkin olacağını düşünmekteyiz.
Parathyroid adenoma is the most common cause of primary hyperparathyroidism. Histopathological differential diagnosis of parathyroid adenoma includes carcinoma, and normal or hyperplastic parathyroid, particularly in those that have small size. In cases of having difficulty in the histopathologic diagnosis, additional auxiliary methods are needed. Ki67 proliferation index is used for the evaluation of cell proliferation in many tumors and lesions. High ki67 value is determined especially in aggressive tumors. P53 is a tumor suppressor gene, which is the most mutated gene in neoplasms. In our study, the adjunctive role of ki67 and p53 expression in the diagnosis of parathyroid adenoma was evaluated. We compared their immunoexpressions between parathyroid adenomas (86 cases) and adjacent normal parathyroid tissue. Furthermore, their correlation with tumor size, mitotic activity and presence of nuclear pleomorphism was searched. We identified that p53 expression was higher in adenomas when compared with adjacent normal tissue; however it was not statistically significant. Yet, the difference of ki67 expression between adenomas and adjacent normal tissue was statistically significant. In conclusion, we suggest that ki67 and p53 immunoexpression is effective in the differential diagnosis of parathyroid adenomas, and prediction of aggressive tumor behavior and recurrence.
Parathyroid adenoma is the most common cause of primary hyperparathyroidism. Histopathological differential diagnosis of parathyroid adenoma includes carcinoma, and normal or hyperplastic parathyroid, particularly in those that have small size. In cases of having difficulty in the histopathologic diagnosis, additional auxiliary methods are needed. Ki67 proliferation index is used for the evaluation of cell proliferation in many tumors and lesions. High ki67 value is determined especially in aggressive tumors. P53 is a tumor suppressor gene, which is the most mutated gene in neoplasms. In our study, the adjunctive role of ki67 and p53 expression in the diagnosis of parathyroid adenoma was evaluated. We compared their immunoexpressions between parathyroid adenomas (86 cases) and adjacent normal parathyroid tissue. Furthermore, their correlation with tumor size, mitotic activity and presence of nuclear pleomorphism was searched. We identified that p53 expression was higher in adenomas when compared with adjacent normal tissue; however it was not statistically significant. Yet, the difference of ki67 expression between adenomas and adjacent normal tissue was statistically significant. In conclusion, we suggest that ki67 and p53 immunoexpression is effective in the differential diagnosis of parathyroid adenomas, and prediction of aggressive tumor behavior and recurrence.
Description
Keywords
ki67, Mitoz, Paratiroid adenomu, Pleomorfizm, p53, Mitosis, Parathyroid adenoma, Pleomorphism
Citation
Ünal, N. vd. (2016). “Paratiroid adenomu tanısında ki67 ve p53 ekspresyonunun rolü”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 42(2-3), 83-87.