Mehmet Sezgin PEPELER, Berna SAVAŞ, Merve PAMUKÇUOĞLU, Murat TÖRÜNER, Hakan AKBULUT

Vitamin D reseptör ekspresyonunun kolorektal kanserlerde evre ile ilişkisi ve prognoz üzerine etkisi

Giriş ve Amaç: Kolorektal kanser hücrelerinde vitamin D reseptör eks-presyonunun tespiti ve bu reseptör ekspresyon derecesi ile kolorektal kanser prognoz ve evresinin ilişkisi olup olmadığını tespit etmektir. Gereç ve Yöntem: Çalışmaya 2003-2009 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi Genel Cerrahi Bölümünde opere olmuş, Ankara Üniversitesi Tıp Fakültesi Patoloji Bölümünde kolon ve rektum kanseri tanısı konu-lup medikal tedavisi aynı üniversitenin Tıbbi Onkoloji Bölümünce yapılan hastalar dahil edilmiştir. Vitamin D reseptörlerinin değerlendirilmesi için seçilen olguların hematoksilen ve eozin kesitleri yeniden değerlendirildi. Vitamin D reseptör tayininde 9A7 immünoglobulin G2b monoklonal anti-kor boyaması kullanıldı. Bulgular: Çalışmaya 64’ü (%55.7) erkek ve 51’i (%44.3) kadın olmak üzere toplam 115 hasta alındı. Vitamin D reseptörü pozitif olan hastalarda genel sağ kalım istatistiksel olarak anlamlı olmasa da reseptör negatif olanlara göre daha iyi bulunmuştur. Vitamin D resep-tör pozitif olanlarda medyan sağ kalıma ulaşılamamıştır. 5 yıllık sağ kalım %69.4 oranında saptanmıştır. Vitamin D reseptör negatif olanlarda med-yan sağ kalım 60 ay olarak saptanmıştır. 5 yıllık sağ kalım %32 oranında bulunmuştur. Vitamin D reseptör negatif olanlarda 5 yıllık hastalıksız sağ kalım %56.8 bulunurken, vitamin D reseptör pozitif olanlarda hastalıksız sağ kalım %43.3 bulunmuştur. Vitamin D reseptör pozitif ve negatif olanlar arasında hastalıksız sağ kalım açısından istatiksel olarak anlamlı fark saptanmamıştır (p: 0.053). Sonuç: Vitamin D reseptör ekspresyonu-nun kolorektal kanser prognozu üzerine olan etkisinin tek başına anlamlı olmadığı saptanmıştır. Reseptör ekspresyonu dışında reseptör polimor-fizminin ve reseptörün etkilediği yolaklarda rol oynayan mutasyonların da prognozu belirlemede etkili olabileceği kanısına varılmıştır.

Expression of vitamin D receptor in colorectal cancer staging and its effects on prognosis

Background and Aims: The aim of the study was to evaluate the effects of vitamin D receptor expression on the prognosis and stag-ing of colorectal cancer. Materials and Methods: Pathological speci-mens of 115 patients diagnosed with colorectal cancer were analyzed. Perinuclear vitamin D receptors were immunohistochemically analyzed with 9A7 IgG2b monoclonal antibody. Results: Vitamin D receptor positivity, serosa infiltration, metastatic lymph node involvement, re-lapse period, and staging relationship was not statistically significant. Survival was found to be better in vitamin D receptor-positive patients than in vitamin D receptor-negative patients; however, the results were not statistically significant. Vitamin D receptor-positive patients could not achieve median survival, but their 5-year survival was found to be 43.3%. Vitamin D receptor-negative patients achieved a median sur-vival of 60 months, and the 5-year survival was 56.8%. Survival with-out disease was not significant based on vitamin D receptor positivity. There was no significant difference in disease-free survival between vitamin D receptor-positive and vitamin D receptor-negative patients (p = 0.053). Conclusion: Colorectal cancer prognosis was not affected with vitamin D receptor expression alone. Besides vitamin D receptor expression, receptor polymorphisms and mutations at the routes of re-ceptor affection and investigation of other factors would be beneficial.

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