Biyopsi Değerlendirilmesinde Gleason (3+3) Tanılı Hastaların Prostatlarında Kribriform Alan Şüphesi. Kısıtlı Morfolojik Görünüm Hastaları Takip Grubuna Almak için Yeterli Olmayabilir

Amaç: Histolojik derece, prostat kanseri prognozunun en yararlı öngörücüsüdür. Gleason skorlaması, Dünya Sağlık Örgütü tarafından önerilen prostat karsinomu için tek derecelendirme yöntemidir. Gleason (3+3) 6 şu anda tanımlanan en düşük skordur. Radikal materyallerde tüm prostat bölgelerini görebilir ve temel skorlamaya kolayca karar verebiliriz. Ancak biyopside tümörün sadece bir kısmını görebiliriz ve tümörün tümünün histolojik derecesinden kesin emin olamayız. Tümörün kribriform yapılanma potansiyeli varsa biz bunu mevcut yöntemler ile tespit edemiyoruz. Bu çalışmada amacımız iyi diferansiye prostat kanserlerinde moleküler heterojenite saptayabilmektir. Gereç ve Yöntem: Prostat karsinomu Gleason (3+3) tanılı hastalara ait 26 adet prostat iğne biyopsisi Betakatenin, Siklin D1, Pax2 ve Pax8 immünohistokimyasal belirteçleri ile boyanıp incelenmiştir. Bulgular: Tümör yapılarında Betakatenin ile yoğun boyanma izlenmişken, Siklin D1, Pax2 ve Pax8 ile anlamlı bulgu tespit edilememiştir. Sonuç: Betakatenin, Siklin D1, Pax2 ve Pax8 günlük patoloji pratiğinde sıkça kullandığımız belirteçler olup ayrıca ürogenital sistem kanserogenezinde literatürde çalışmalara konu olmuştur. Ancak iyi diferansiye tümöral asiner yapılarda Betakatenin ile yoğun boyanma izlenmişken, Siklin D1, Pax2 ve Pax8 ile anlamlı bulgu tespit edilememiştir.

Cribriform Area Suspicion in the Prostates of Patients with Gleason (3+3) Diagnosis in Biopsy Evaluation. Restricted Morphological Appearance may not be Sufficient to Include Patients in the Follow-up Group

Objectives: Histologic grade is the most useful predictor of prognosis of prostate cancer. The Gleason scoring is the only grading method for prostatic carcinoma, which is recommended by World Health Organization. The Gleason grading (3+3) 6 is the lowest score currently assigned. In radical materials, we can see all prostate areas and decide certain grading easily. However, in the biopsy, we can see only a part of the tumor and we cannot be sure of the histologic grade of the total tumor. If the tumor has a potential for cribriform formation, we cannot detect it with current methods. Our aim in this study was to detect molecular heterogeneity in well-differentiated prostate cancers. Materials and Methods: Twenty-six prostate needle biopsies from patients with prostate carcinoma Gleason (3+3) were stained and analyzed with immunohistochemical markers of Betacatenin, Cyclin D1, Pax2 and Pax8. Results: While intense staining was observed with Betacatenin in tumor, no significant findings were detected with Cyclin D1, Pax2 and Pax8. Conclusion: Betacatenin, Cyclin D1, Pax2 and Pax8 are the markers that we use frequently in daily pathology practice and have also been the subject of studies in the literature on urogenital system carcinogenesis. However, while intense staining was observed with Betacatenin in well- differentiated tumoral acinar structures, no significant findings were detected with Cyclin D1, Pax2 and Pax8.

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