Meme kanserli hastaların primer tümör ve metastatik aksiller lenf nodlarındaki Ki67 proliferatif indeksi ile yaşam süresinin karşılaştırılması
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Date
2008
Authors
Şenol, Ela Paksoy
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Publisher
Uludağ Üniversitesi
Abstract
Bu çalışma ile Kİ67 immunohistokimyasal boyasını kullanılarak meme ve metastatik lenf nodülünün histopatolojik özellikleri ile hastaların sürvey, ve prognozunun önceden tahmin edilebilirliği ve tedavi için prediktif faktör olabilirliğinin araştırılması amaçlandı. Mayıs 1997 - Aralık 2002 tarihleri arasında Uludağ Üniversitesi Tıp Fakültesi Genel Cerrahi Anabilim Dalına evre II - III meme kanseri tanısıyla başvuran 95 hasta meme kanseri ile ilişkili risk faktörleri (yaş, menopozal durum, hormon ilaç kullanım), prognostik faktörler (histolojik tipi, aşaması, grade, östrojen ve progesteron reseptör pozitifliği, lenfovasküler invazyon varlığı, tümör çapı, metastatik lenf nodu sayısı ve yerleşimi, uzak metastaz varlığı), tedavileri ve son kontrol tarihlerine ait veriler retrospektif olarak değerlendirildi. Uygun örneklere Strepteavidin-Biotin tekniği kullanılarak Kİ67 immunohistokimyasal boya uygulandı. Kİ67 proliferasyon indeksi, boyanan nukleus sayısı / 1000 olarak belirtildi. Emzirme süresi 5 aydan fazla olan, meme koruyucu cerrahi ± aksiler disseksiyon uygulanan, tümör evresi II, tümör çapının 2,8 cm altında, cerrahi sınır negatifliği, histolojik grade'in I, nükleer grade'in II olan, lenfatik ve venöz invazyon, ekstrakapüler yayılım olmayan, metastatik lenf nodu sayısının 4 den az olan, tümör Kİ67 proliferatif indeksinin 141 altında yer alan ve uzak metastazı olmayan hastaların yaşam süresinin daha iyi olduğu saptandı. Lenf nodundaki Kİ67 proliferatif indeksinin histolojik ve nükleer grade yükseldikçe, östrojen ve progesteron reseptör negatifliğinde ve evre III de daha fazla arttığını tespit edildi. Meme kanserine pek çok faktörün etkili olması nedeniyle her hasta ve tümör farklı davranmaktadır. Tedavi seçeneği belirlenirken birçok prognostik faktör göz önünde bulundurulmalıdır.
The aim of this study was to estimate histopathologic characteristics of the breast and metastatic lymph node, patients' survey and prediction of prognosis and possibility of being a predicting factor by performing Ki67 immunohistochemical marker. Stage ll-lll breast cancer diagnosed patients admitted to the Uludag University Faculty of Medicine General Surgery Department between May 1997 and December 2002, were considered for the study, 95 patients with breast cancer associated risk factors (age, menopausal stage, hormonal and medical treatment), prognostic factors (histological subtype, stage, grade, estrogen and progesterone receptor positivity, vascular and lymphatic invasion, tumor diameter, metastatic nodal involvement and distribution, development of distant metastases), treatments and data of last controls were retrospectively evaluated. The specimens of the patients who had been evaluated at the department of pathology of the same institution were retrieved from the archives and reevaluated for the purposes of this study. Ki67 immunohistochemical marker was performed by using Strepteavidin-Biotin method in suitable specimens. Ki67 proliferating index was determined as nuclear staining/total nuclear rate 1000. Breast feeding period more 5 months, breast protecting surgery ± axillary dissection performed, tumoral stage II, tumoral diameter less than 2,8 cm, surgical margins negativity, histological grade I, nuclear grade II, vascular and lymphatic invasion, those without extracapsular invasion, metastatic lymph node number less than 4, tumoral proliferating index less than 141 and patients surveys without distant metastases was detected to be better. Lymph nodes Ki67 proliferating index was detected to increase with increase of histolological and nuclear grade, also in estrogen and progesterone negativity and in stage III was estimated to increase. There are many factors which effect on breast cancer, whereas every patient and tumor interprets different behavior. When medical treatment approaches are planned many prognostic factors must be evaluated.
The aim of this study was to estimate histopathologic characteristics of the breast and metastatic lymph node, patients' survey and prediction of prognosis and possibility of being a predicting factor by performing Ki67 immunohistochemical marker. Stage ll-lll breast cancer diagnosed patients admitted to the Uludag University Faculty of Medicine General Surgery Department between May 1997 and December 2002, were considered for the study, 95 patients with breast cancer associated risk factors (age, menopausal stage, hormonal and medical treatment), prognostic factors (histological subtype, stage, grade, estrogen and progesterone receptor positivity, vascular and lymphatic invasion, tumor diameter, metastatic nodal involvement and distribution, development of distant metastases), treatments and data of last controls were retrospectively evaluated. The specimens of the patients who had been evaluated at the department of pathology of the same institution were retrieved from the archives and reevaluated for the purposes of this study. Ki67 immunohistochemical marker was performed by using Strepteavidin-Biotin method in suitable specimens. Ki67 proliferating index was determined as nuclear staining/total nuclear rate 1000. Breast feeding period more 5 months, breast protecting surgery ± axillary dissection performed, tumoral stage II, tumoral diameter less than 2,8 cm, surgical margins negativity, histological grade I, nuclear grade II, vascular and lymphatic invasion, those without extracapsular invasion, metastatic lymph node number less than 4, tumoral proliferating index less than 141 and patients surveys without distant metastases was detected to be better. Lymph nodes Ki67 proliferating index was detected to increase with increase of histolological and nuclear grade, also in estrogen and progesterone negativity and in stage III was estimated to increase. There are many factors which effect on breast cancer, whereas every patient and tumor interprets different behavior. When medical treatment approaches are planned many prognostic factors must be evaluated.
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Keywords
Meme kanseri, Prognostik faktör, Ki67, Breast cancer, Prognostic factor
Citation
Şenol, E. P. (2008). Meme kanserli hastaların primer tümör ve metastatik aksiller lenf nodlarındaki Ki67 proliferatif indeksi ile yaşam süresinin karşılaştırılması. Yayınlanmamış uzmanlık tezi. Uludağ Üniversitesi Tıp Fakültesi.