Serdar ALTINAY, Aydın SAV, Özlem YAPICIER, İlhan ELMACI

Ependimomalarda Antiapoptik BCL-2 Protein ve Tümör Supressör P53 Protein İfadesi ve Proliperatif İndeks Kİ-67 ile Histolojik Tipler ve Derecelerin İlişkisi

Amaç: Bu çalışmanın amacı ependimomaların MIB-1 aynı zamanda Ki-67 olarak bilinen işaretleyicisi ile hem proliferatif aktivitesini belirlemek hem de p53 ve bcl-2 proteinlerinin immünohistokimyasal analizi ile ependimoma subtipleri ve tümör derecesi arasında ilişki olup olmadığını değerlendirmektir. Metod: Marmara Üniversitesi Nörolojik Bilimler Enstitüsü Nöropatoloji Bölümünde ependimal tümör olarak kayıtlı 33 hastanın spinal kord ve beyin biyopsi örneklerine ait formalinle fikse parafin blokları tekrar incelendi. Çalışmaya histopatolojik özelliklerini gösteren 2 subependimoma, 3 miksopapiller ependimoma Grade I , 13 ependimoma Grade II , ve 15 anaplastik ependimoma Grade III alındı. Bulgular: Grade I ve Grade II ependimomalar düşük proliferatif aktivite gösterdi. Tüm p değerleri atipide p=0.00034, nekrozda p=0.0011, mitozda p=0.00447 ve dansitede p=0.0000 anlamlı idi. MIB-1 proliferatif indeksi anaplastik ependimomalarda %78 oranında görüldü. Bcl-2 protein ekspresyonu özellikle miksopapiller ependimomalarda belirgin olmak üzere bütün ependimoma subtiplerinde ve gradelerinde tespit edildi. 7 tümör %21.2 farklı boyanma yüzdelerinde nükleer p53 pozitivitesi gösterdi. Pozitivite anaplastik ependimomalarda anlamlı idi %33.4 . Supratentorial ve infratentorial ependimomaların LI değerleri arasında anlamlı ilişki bulundu Mann-Whitney-U testi, p=0.0012 18 yaş altı ve üstü hastaların Ki-67 LI değerleri arasında da aynı testle korelasyon tespit edildi p=0,0018 . Sonuç: Bu veriler yüksek MIB-1 ve p53 değerlerinin yüksek dereceli ependimomalarda belirleyici olabileceğini düşündürdü. Ependimomalarda komplet, uzun süreli klinik takipli çok sayıda hastayı ve bcl-2, p53 ekspresyonu, MIB-1 hücre kinetik çalışmalarını içeren ilave araştırmalara ihtiyaç vardır

Ependymal Tumors: Correlation of Proliferative Mib-1 , Tumor Supressor P53 and Anti-Apoptotic Bcl-2 Indices With Histologic Types and Grading

Background: The objectives of this study are to investigate both proliferative activity of ependymomas as determined by MIB-1 also known as Ki67 labeling index LI and p53 and bcl-2 proteins by immunohistochemical analysis to assess their expressivity and to correlate findings with ependymoma subtypes and tumor grades. Methods: We investigated routinely formalin-fixed, paraffin-embedded brain and spinal cord biopsy tissues from 33 patients with ependymal neoplasms retrieved from the files of the Neuropathology division, Institute of Neurological Sciences, Marmara University. This study covers 33 tumors with the histological features of 2 subependymomas, 3 myxopapillary ependymomas Grade I , 13 ependymomas Grade II , and 15 anaplastic ependymomas Grade III . Results: Grade I and Grade II ependymomas showed low proliferative activity. P values were significant for atypia p=0.00034, for necrosis p=0.0011, for mitosis p=0.00447, for density p=0.0000. MIB-1 immunexpressivities were seen in 78% of anaplastic ependymomas. Protein expression of bcl-2 was detected in all of ependymoma subtypes and grade, specifically prominent in myxopapillary ependymomas. Seven tumors %21.2 showed nuclear p53 positivity with different percentages with staining of nuclei. Positivity was significant in anaplastic ependymomas %33.4 . We found LI values with significant correlation between supratentorial and infratentorial ependymomas Mann-Whitney-U test, p=0.012 Ki-67 LI values and patients with >18 years old and

Keywords:

ependymoma, p53 gene, MIB-1, bcl-2,

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