Mehmet BEKTAŞ, Berna SAVAŞ, Hülya ÇETİNKAYA, Murat TÖRÜNER, Arzu ENSARİ, BEYZA DOĞANAY ERDOĞAN, İrfan SOYKAN, Ali TÜZÜN, Çağdaş KALKAN, Ali ÖZDEN, Murat PALABIYIKOĞLU

Ülseratif kolitli hastalarda displazi varlığı ve displastik mukozada p53 ve Ki-67 ekspresyonu

Giriş ve Amaç: Ülseratif kolitin başlangıcından 8-10 yıl sonra kolorektal kanser gelişim riski artar. Ülseratif kolit hastalarının kansere bağlı mortalite ve morbiditesi kolonoskopik tarama yöntemleriyle azaltılabilir. Bu çalışmanın amacı; ülseratif kolit hastalarında histopatolojik olarak displazi varlığını araştırmak ve immünohistokimyasal tekniklerle displastik mukozada p53 ve Kİ-67 ekspresyon oranlarını belirlemektir. Gereç ve Yöntem: Çalışmaya klinik olarak remisyonda olan 52 ülseratif kolit hastası alındı. Tüm hastalara total kolonoskopi uygulandı ve çekuma kadar girildi. Kolondan rektuma kadar 10 cm’de bir dört kadran biyopsiler alındı. Displazi varlığı biyopsi örneklerinde histopatolojik olarak tespit edildi ve displazi saptanan hastalarda immünohistokimyasal olarak p53 ve Ki-67 ekspresyonu varlığı araştırıldı. Bulgular: Hastaların 32’sinde hastalık süresi 8 yıldan az, 20’sinde ise 8 yıl ve üzerindeydi. Hastaların hepsi klinik olarak remisyonda olmasına rağmen endoskopik olarak sadece %59,6’ı remisyondaydı. Hastalık %44,2 sol kolon ve %55,8 pankolit yerleşimliydi. Displazi 52 ülseratif kolit hastasının 9’unda (%17,5) saptandı. Hastalık lokalizasyonu 6 hastada pankolit, 3 hastada ise sol kolon yerleşimliydi. Displazi, hastalık süresi 8 yıldan fazla olan hastalarda yüksek saptandı. İmmünohistokimyasal inceleme ile p53 için pozitif boyanma 6 hastada, Ki-67 boyanması 3 hastada görüldü. Sonuç: Displazi hastalık süresi 8 yıl ve üzeri olanlarda ve pankolitli olgularda daha fazla saptanmıştır. Çalışmamızda hastalık süresi 8 yıldan daha az olanlarda da displazi saptanması, tarama programına erken başlanmalı mı sorusunu akla getirmektedir.

Anahtar Kelimeler:

Ülseratif kolit, displazi

The presence of dysplasia in patients with ulcerative colitis and p53 and Ki-67 expression in dysplastic mucosa

Background and Aims:The risk of developing colorectal cancer increases distinctly for more than 8-10 years from the onset of ulcerative colitis. Mortality and morbidity in patients with ulcerative colitis can be decreased with colonoscopic screening methods. The aim of this study was to investigate the presence of dysplasia histopathologically in patients with ulcerative colitis and to determine p53 and Ki-67 expression rates in dysplastic mucosa using immunohistochemical techniques. Materials and Methods: Fifty-two ulcerative colitis patients who were followed clinically while in remission were enrolled into the study. Total colonoscopy was applied to every patient. Biopsies were taken from the colon and rectum every 10 cm. Presence of dysplasia was detected histopathologically in the biopsy samples, and p53 and Ki-67 expression was investigated immunohistochemically in dysplastic samples. Results: The duration of disease was 8 years. On immunohistochemical examination, positive staining for p53 was detected in 6 patients and positive Ki-67 staining in 3 patients. Conclusions: Dysplasia was found at a higher rate in patients with disease duration >8 years and pancolitis. In our study, the presence of dysplasia in patients with disease duration of

Keywords:

Ulcerative colitis, dysplasia,

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