Kemoradyoterapi ile tedavi edilen lokal ileri evre baş boyun kanserli olgularda CK19, CK20, EGFR, survivin pozitifliğinin lokal kontrol ve sağkalıma etkisinin değerlendirilmesi
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Date
2013
Authors
Kekilli, Esra
Journal Title
Journal ISSN
Volume Title
Publisher
Uludağ Üniversitesi
Abstract
Bu çalışmanın amacı lokal ileri baş boyun kanseri (LİBBK) tanısıyla radyoterapi (RT) uygulanan olgularda, Epidermal Growth Faktör Reseptörü (EGFR), Sitokeratin19 (CK19), Sitokeratin20 (CK20) ve Survivin gen ekspresyonlarının, lokal kontrol (LK) ve genel sağkalıma (GS) etkisini değerlendirmektir. Uludağ Üniversitesi Tıp Fakültesi Radyasyon Onkolojisi Anabilim Dalına LİBBK (EIII-EIV) tanısı ile başvuran, periferik kanında ve tümör dokusunda EGFR, CK19, CK20, Survivin gen ekspresyonları incelenen 26 olgu, sözü edilen genlerin LK ve sağkalımdaki rolünü belirlemek üzere irdelendi. Olguların 1'i tükrük bezi, 1'i hipofarenks, 2'si maksiler sinüs, 2'si orofarenks, 5'i nazofarenks, 5'i oral kavite ve 10'u larenks yerleşimliydi. RT başlamadan önce periferik kan örneklerinden ve parafinize edilmiş tümör dokularından total RNA izolasyonu gerçekleştirildi. Total RNA'lardan cDNA elde edilerek, Syber green boyama yöntemi ile EGFR, CK19, CK20 ve survivin genlerine ait ekspresyon düzeyleri belirlendi. Aynı işlem RT sonrası alınan periferik kanlarda tekrarlandı. EGFR, CK19, CK20 ve Survivin genlerinin birbirleriyle ilişkisi ve RT sonrası sağkalım üzerindeki etkisi pearson korelasyon yöntemiyle değerlendirildi. RT öncesi ve sonrası EGFR, CK19 ve CK20 ekspresyonları birlikte ele alınarak değerlendirildiğinde RT öncesi CK19, CK20 veya EGFR pozitif olan olgularda, RT sonrasında da CK19 ya da CK20 pozitifliğinin devam ettiği gözlenirken, pearson korelasyon analizine göre survivininin RT öncesi ve sonrası ekspresyonunda da pozitif korelasyon saptandı. Çalışmamızda LİBBK'li olgularda EGFR, CK19, CK20 ve Survivin ekspresyonu'nun LK ve GS üzerine anlamlı bir etkisi gösterilemezken bu genlerin herhangi birinde RT öncesi ekspresyon saptanan LİBBK olgularının diğer olgulara göre RT'den daha az yarar sağladığını öngörmekteyiz. Çalışmamızın güvenilirliğini arttırmak için daha fazla olgu sayısı ile bulgularımızın ileri protein analizleri ile desteklenmesi gerekmektedir.
In this study we aimed to investigate the effects of Epidermal Growth Factor Receptor (EGFR), Cytokeratin 19 (CK19), Cytokeratin 20 (CK20) and Survivin gene expressions on local control (LC) and overall survival (OS) in patients with local advanced head and neck cancer (LAHNC) who administered radiotherapy (RT). 26 patients who applied to Uludağ Universty Medical Faculty Department of Radiation Oncology with the diagnosis of LAHNC (SIII-SIV) were included in this study in order to determine the effects of EGFR, CK19, CK20 and survinin gene expressions on LC and OS by evaluating the mentioned gene expressions in tumor tissues and peripheral blood. Tumor were localized in salivary gland in 1 case, in hypopharynx in 1 case, in maxillary sinus in 2 cases, in oropharynx in 2 cases, in nasopharynx in 5 cases, in oral cavity in 5 cases and in larynx in 10 cases. RNA isolation was performed for paraffinized tumor tissues and peripheral blood samples prior to RT. cDNAs were obtained from total RNAs. EGFR, CK19, CK20 and survivin gene expression levels were determined via Syber green staining technique. The same procedures were performed to peripheral blood samples taken after RT. Pearson correlation test was used to determine the effects of EGFR, CK19, CK20, and survivin gene on survival after RT and to investigate their relationship within each other. EGFR, CK19 and CK20 expression levels were evaluated both before and after RT. It was observed that CK19 and CK20 gene expressions still remained positive after RT in patients who were positive for CK19, CK20 and EGFR before the RT. A positive correlation was found with Pearson correlation test between survinin levels evaluated both before and after RT. v In our study, it was observed that EGFR, CK19, CK20 and survivin gene levels do not have a significant effect on LC and OS in patients with LAHNC. However we can assert that patients resulted as positive for any of gene expressions mentioned above before RT may have less benefits from RT compared to those who are negative. It is necessary to investigate our hypothesis on a larger patient population and confirm our findings with advanced protein analysis tests in order to increase the study confidence.
In this study we aimed to investigate the effects of Epidermal Growth Factor Receptor (EGFR), Cytokeratin 19 (CK19), Cytokeratin 20 (CK20) and Survivin gene expressions on local control (LC) and overall survival (OS) in patients with local advanced head and neck cancer (LAHNC) who administered radiotherapy (RT). 26 patients who applied to Uludağ Universty Medical Faculty Department of Radiation Oncology with the diagnosis of LAHNC (SIII-SIV) were included in this study in order to determine the effects of EGFR, CK19, CK20 and survinin gene expressions on LC and OS by evaluating the mentioned gene expressions in tumor tissues and peripheral blood. Tumor were localized in salivary gland in 1 case, in hypopharynx in 1 case, in maxillary sinus in 2 cases, in oropharynx in 2 cases, in nasopharynx in 5 cases, in oral cavity in 5 cases and in larynx in 10 cases. RNA isolation was performed for paraffinized tumor tissues and peripheral blood samples prior to RT. cDNAs were obtained from total RNAs. EGFR, CK19, CK20 and survivin gene expression levels were determined via Syber green staining technique. The same procedures were performed to peripheral blood samples taken after RT. Pearson correlation test was used to determine the effects of EGFR, CK19, CK20, and survivin gene on survival after RT and to investigate their relationship within each other. EGFR, CK19 and CK20 expression levels were evaluated both before and after RT. It was observed that CK19 and CK20 gene expressions still remained positive after RT in patients who were positive for CK19, CK20 and EGFR before the RT. A positive correlation was found with Pearson correlation test between survinin levels evaluated both before and after RT. v In our study, it was observed that EGFR, CK19, CK20 and survivin gene levels do not have a significant effect on LC and OS in patients with LAHNC. However we can assert that patients resulted as positive for any of gene expressions mentioned above before RT may have less benefits from RT compared to those who are negative. It is necessary to investigate our hypothesis on a larger patient population and confirm our findings with advanced protein analysis tests in order to increase the study confidence.
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Keywords
Lokal ileri evre baş boyun kanseri, EGFR, CK19, CK20, Survivin, Radyoterapi, Local advanced head and neck cancer, Radiotherapy
Citation
Kekilli, E. (2013). Kemoradyoterapi ile tedavi edilen lokal ileri evre baş boyun kanserli olgularda CK19, CK20, EGFR, survivin pozitifliğinin lokal kontrol ve sağkalıma etkisinin değerlendirilmesi. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.