Metastatik meme kanserli hastalarda HER3 ekspresyonu ile prognostik belirteçler ve sağkalım arasındaki ilişki
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Date
2012
Authors
Ölmez, Ömer Fatih
Journal Title
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışma ile Uludağ Üniversitesi Tıbbi Onkoloji Bilim Dalı'nda tanı almış metastatik meme kanserli hastalarda HER3 ekspresyonunun sıklığının; bu sıklığın klinik ve patolojik parametrelerle ilişkisinin ve sağkalıma olan etkilerinin ortaya konulması amaçlanmıştır.Çalışmaya 1996-2006 yılları arasında, Uludağ Üniversitesi Tıp Fakültesi Tıbbi Onkoloji bölümünde tedavi edilen 45 metastatik meme kanserli hasta dahil edildi. Hastaların dosyaları retrospektif olarak taranarak, klinik ve patolojik parametreler not edildi. 45 metastatik meme kanser hastasının formalin fikse edilmiş parafine gömülü bloklarından RTJ1 monoklonal antikoru kullanılarak c-erbB-3 protein ekspresyon analizi çalışıldı. Yapılan boyama rajkumar skorlaması ve sitoplazmik 4 puanlı skorlamayla değerlendirildi.Yapılan immünohistokimyasal boyamanın sonucunda hücrelerde daha fazla sitoplazmik boyama görülmekle birlikte membranöz ve nükleer boyanmada not edildi. Hastaların %51.2 (n=23) Rajkumar Skorlaması'na göre HER3 negatif kabul edilirken %48.8'inde (n=22) pozitif boyanma saptandı. Yapılan analizde c-erbB-3 ekspresyonu ile klinik ve patolojik parametreler arasında istatistiki anlamlılığa ulaşan sonuç saptanmadı. Değerlendirilmeye alınan metastatik meme kanserli hastaların ortalama genel sağ kalımı 22,178 ± 17,209 ay, progresyonsuz sağ kalımı 11,356 ± 10,447 ay ve hastalıksız sağkalımı 22,650 ± 15,892 ay olarak hesaplandı. Rajkumar Skorlama sistemi ile değerlendirlen hastalarda sağkalım ile HER3 ekspresyonu arasında ilişki saptanmazken, sitoplazmik 4 puanlı skorlama ile aynı vakalar değerlendirildiğinde HER3 ekspresyon yüzdesi yüksek olan vakalarda hastalıksız sağkalım anlamlı olarak düşük saptandı (Log-rank=22,596; p=0,000.1).Sonuç olarak, çalışmamızda HER3 ekspresyonu ile klinik ve patolojik parametreler arasında ilişki saptanmazken, sitoplazmik boyama dikkate alındığında hastalıksız sağ kalım ile HER3 ekspresyonu arasında negatif anlamlı ilişki saptandı. Bu belirteçin klinik pratikte kullanıma girebilmesi ve tedavi kararında etki yapabilmesi için büyük ölçekli çalışmalara ihtiyaç vardır.
This study aims to reveal the incidence of C-erbB-3 expression, its correlation with clinical and pathological parameters and its effects on the survival in the patients with metastatic breast cancer who had been diagnosed at the Uludag University, Department of Medical Oncology.The study included a total of 45 patients with metastatic breast cancer who had been treated in Uludag University, Faculty of Medicine, Department of Oncology between 1996-2006. The patient files were retrospectively reviewed and the clinical and pathological parameters were noted. HER3 protein expression was analyzed on formaline-fixed paraffin-embedded blocks obtained from 45 patients with metastatic breast cancer using RTJ1 monoclonal antibody. Staining results were evaluated using Rajkumar scoring and cytoplasmic 4-point scoring systems.Although the immunohistochemical staining mostly resulted in cytoplasmic staining in the cells, membranous staining and nuclear staining were also noted. According the Rajkumar scoring system, 51.2% (n=23) of the patients were c-erbB-3 negative and 48.8% (n=22) showed positive staining. In the analysis performed, no statistically significant correlation was found between HER3 expression and clinical and pathological parameters. Of the patients with metastatic breast cancer who have been enrolled to the study, mean overall survival was 22,178 ± 17,209 months, mean progression-free survival was 11,356 ± 10,447 months and mean disease-free survival was 22,650 ± 15,892 months. While no correlation was detected between survival and HER3 expression in the patients evaluated using Rajkumar scoring system, the subjects with a higher percentage of HER3 expression were found to have a significantly lower disease-free survival when cytoplasmic 4-point scoring system was used (Log-rank=22,596; p=0,000<0,01).Consequently, while our study did not reveal a correlation between HER3 expression and clinical and pathological parameters, cytoplasmic staining resulted in a significant negative correlation between disease-free survival and HER3 expression. Large scale studies are warranted to establish this marker in the clinical practice and to involve it in the therapeutic decision making.
This study aims to reveal the incidence of C-erbB-3 expression, its correlation with clinical and pathological parameters and its effects on the survival in the patients with metastatic breast cancer who had been diagnosed at the Uludag University, Department of Medical Oncology.The study included a total of 45 patients with metastatic breast cancer who had been treated in Uludag University, Faculty of Medicine, Department of Oncology between 1996-2006. The patient files were retrospectively reviewed and the clinical and pathological parameters were noted. HER3 protein expression was analyzed on formaline-fixed paraffin-embedded blocks obtained from 45 patients with metastatic breast cancer using RTJ1 monoclonal antibody. Staining results were evaluated using Rajkumar scoring and cytoplasmic 4-point scoring systems.Although the immunohistochemical staining mostly resulted in cytoplasmic staining in the cells, membranous staining and nuclear staining were also noted. According the Rajkumar scoring system, 51.2% (n=23) of the patients were c-erbB-3 negative and 48.8% (n=22) showed positive staining. In the analysis performed, no statistically significant correlation was found between HER3 expression and clinical and pathological parameters. Of the patients with metastatic breast cancer who have been enrolled to the study, mean overall survival was 22,178 ± 17,209 months, mean progression-free survival was 11,356 ± 10,447 months and mean disease-free survival was 22,650 ± 15,892 months. While no correlation was detected between survival and HER3 expression in the patients evaluated using Rajkumar scoring system, the subjects with a higher percentage of HER3 expression were found to have a significantly lower disease-free survival when cytoplasmic 4-point scoring system was used (Log-rank=22,596; p=0,000<0,01).Consequently, while our study did not reveal a correlation between HER3 expression and clinical and pathological parameters, cytoplasmic staining resulted in a significant negative correlation between disease-free survival and HER3 expression. Large scale studies are warranted to establish this marker in the clinical practice and to involve it in the therapeutic decision making.
Description
Keywords
Meme kanseri, Sağ kalım, HER3, Prognostik faktör, Breast cancer, Survival, Prognostic factor, c-erbB-3
Citation
Ölmez, Ö. F. (2012). Metastatik meme kanserli hastalarda HER3 ekspresyonu ile prognostik belirteçler ve sağkalım arasındaki ilişki. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.