S İNAN, T ÖZGÜDER, H.S. VATANSEVER, K ÖZBİLGİN, M. SANCI, S. SAYHAN

Epitelyal Ovel Tümörlerinin CD 34 ve Vonwillebrand Faktör ile İmmunohistokimyasal Yöntemle Değerlendirilmesi

Amaç: Endotel hücrelerinin CD34 ve vonWillebrand Faktör (Faktör VIII) gibi özel işaretleyiciler ile immunohistokimyasal yöntemle boyanarak mikro damar sayılması, tümör anjiyogenezini belirlemede kullanılan bir yöntemdir. Bu çalışmada, jinekolojik kanserler içinde 3. sıklıkla görülen ve en öldürücü olan epitelyal over tümörlerinin, normal over dokusu ile anjiyogenez açısından karşılaştırmalı olarak değerlendirilmesi amaçlanmıştır. Materyal-Metod: Çalışmada SSK Ege Doğumevi ve Kadın Hastalıkları Eğitim Hastanesinde opere edilen ve patoloji laboratuvarında tanı konulan toplam 60 vaka değerlendirildi. Olgulardan folliküler ve luteal evredeki normal over dokuları kontrol grubu; borderline-seröz, borderline-müsinöz, seröz adenokarsinoma ve müsinöz adenokarsinoma tanılı olgular ise çalışma grubu olarak belirlendi (n=10). Hastalardan elde edilen biopsiler formalin ile tespit edilerek rutin parafin takip protokolü uygulandı. Kesitler histolojik değerlendirme için hematoksileneosin ile, anjiyogenezi belirlemek için endotel işaretleyiciler CD34 ve vonWillebrand Faktör primer antikorları ile indirek immunoperoksidaz tekniği kullanılarak değerlendirildi. Damar yüzey dansiteleri ölçümü için, çalışma ve kontrol gruplarında mikro damar sayımları intersept gridi kullanılarak yapıldı. Elde edilen veriler istatistiksel olarak ANOVA testi ile değerlendirildi. Bulgular: Folliküler ve luteal evrede alınan normal over dokularında damar yüzey dansite ölçümleri arasında istatistiksel olarak farklılık gözlenmedi. Borderline ve adenokarsinom olgularında istatistiksel olarak kontrol grubuna göre artış saptandı. Buna ilaveten, damar yüzey dansitesinin müsinöz kanserlerde en fazla olduğu görüldü. Sonuç: Anjiyogenez, normal siklusda over ile endometriumda gözlenen follikülerluteal evre değişikliklerinde ve kadın üreme sistemi hastalıklarının birçoğunda etiyopatogenezde ön plandadır. Bu çalışmada da malign over tümörlerinde damar yüzey dansitesinin istatistiksel olarak arttığı ve bu artışın müsinöz over karsinomlarında daha belirgin olduğu görülmüştür. Anjiyogenezin yoğun olduğu olgularda tedaviye antianjiyogenik kemoterapinin eklenmesinin yararlı olabileceği düşünülmüştür.

Anahtar Kelimeler:

Epitelyal over tümörü, anjiyogenez, immunohistokimya

Purpose: The staining of endothelial cells with specific markers such as CD34 and Factor VIII-Related Factor (vonWillebrand Factor) is a method used to detect angiogenesis of tumour. In this study, we aimed to evaluate the 3rd common type of gynecological cancer and fatal epithelial ovarian tumours, by using immunohistochemistry to investigate vascular surface density. Materials and methods: In this study, sixty patients who were operated at the SSK Aegean Maternity Hospital were evaluated. Ovarian specimens from women in follicular or luteal phases without ovarian pathology were investigated as a control group; specimens with borderline serous, borderline musinous, musinous adenocarsinoma, who had gone undergone laporoscopy were investigated as the study group (n= 10). Ovarian tissues were fixed in formaline and embedded in paraffin. Histological sections were immunostained with CD34 and vonWillebrand factor primary antibodies using indirect immunoperoxidase technique. Vascular surface densities in both study and control groups were evaluated with using intercept grid. Data were evaluated statistically with using ANOVA test. Results: The mean vascular surface density was not statistically different between the ovarium in follicular and in luteal phases. The mean vascular surface density was significantly higher in both borderline and malign ovarian carcinoma than control group. In addition, the mean vascular surface density was highest in the in musinous carcinoma. Conclusion: Angiogenesis plays a key role during follicular and luteal phases in normal menstrual cycle and etiopathogenesis of female reproductive system diseases. In this study, the vascular surface density was increased statistically in malign ovarian carcinoma, and it was higher in musinous ovarian carcinoma. Our results suggested that anti-angiogenic chemotherapy might be added to the treatment of ovarian carcinoma with increased angiogenesis. Key Words: angiogenesis, Epithelial ovarian tumour, hemistry immunohistoc

Keywords:

Epithelial ovarian tumour, angiogenesis, immunohistochemistry,

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