Hayriye TATLI DOĞAN, Nuran SÜNGÜ, Aydan KILIÇARSLAN

TENDON KILIFININ DEV HÜCRELİ TÜMÖRÜNDE Kİ-67, CD68 VE KANİBALİZM ANALİZİ

Amaç: Tendon kılıfının dev hücreli tümörü(TKDHT) nispeten yavaş büyüyen, tendon kılıfı ve sinovial hücrelerden orijin alan bir tümördür. TKDHT lezyonlarının çoğu el ve ayak parmaklarının tendon kılıflarından gelişir. Bu çalışmada amaç retrospektif olarak 45 olguyu klinikopatolojik olarak incelemek, proliferasyon aktivitesinin ve kanibalizm varlığının lokal rekürrens oranına etkisini araştırmaktır.Gereç ve Yöntemler: Hastanemizde 2005-2014 yılları arasında TKDHT tanısı alan 45 olgu retrospektif olarak değerlendirildi. Hastaların yaşı, cinsiyeti, tümör lokalizasyonu, lokal rekürrens varlığı, Ki-67 proliferasyon indeksi, CD68 ile boyanan dev hücre oranı ve kanibalistik hücre varlığı değerlendirildi. Bulgular: Hastaların 21'i kadın, 24'ü erkek ve yaş ortalaması 41.3 idi. Tümör en sık el parmaklarında (36 hasta, %80) yerleşim göstermekteydi. 3 hastada lokal rekürrens gözlendi. Serimizdeki TKDHT'inde Ki-67proliferasyon indeks ortalaması % 12,9'du. CD68 ile 33 hastada (%73) boyanma görüldü. Kanibalistik hücre varlığı 22 hastada (%48,8) mevcuttu. Lokal rekürrens gösteren hastaların hepsinde Ki-67 proliferasyon indeksi (%20) olarak saptandı. Ayrıca lokal rekürrens gösteren hastaların hepsinde CD68 ile pozitif boyanma (yaygın paternde) ve kanibalistik hücre (%10'un üzerinde) varlığının olduğu dikkati çekmiştir. Kanibalistik hücre varlığı açısından lokal rekürrens gösteren ve lokal rekürrens göstermeyen hastalar arasında istatistiksel olarak anlamlı fark bulundu (p=0,045). Tartışma ve Sonuç: Ki-67 proliferasyon indeksinin yüksek olması ve kanibalistik hücrelerin varlığı TKDHT'de lokal rekürrens olasılığını tahmin etmede önemli bir prediktif belirleyici olabilir. Ancak hasta sayımız yeterince fazla olmadığından daha geniş serilerde yeni araştırmalarla desteklenmesi önerilir.

Analysis of Cannibalism, Ki-67 And CD68 in Giant Cell Tumor of Tendon Sheath

Objectives and Introduction: Giant cell Tumor of Tendon Sheath(GCTTS) is a slow growing tumor and it origins from tendon sheath and synovial cells. GCTTS lesions generally occur on fingers' and toes' sheaths. In this study our aim is to clinopathologically review 45 retrospective cases and find the effect of proliferation activity and cannibalism on local recurrence. Material and Methods: 45 cases diagnosed with GCTTS between the years 2005 and 2014 in our hospital evaluated retrospectively. Patients' age, gender, tumor localization, local recurrence occurance, Kİ-67 proliferation index, CD68 stained giant cell ratio and cannibalistic cell existence is evaluated.Results: 21 of the patients are female, 24 of the patients are male and the average age is 41.3 (1268). Tumor localization is mostly seen on fingers(36 patients, 80%). Local recurrence is observed in 3 patients. In our series of patients,average Ki-67 proliferation index in GCTTS is 12,9% and in 33 patients CD68 staining is observed (73%). In 22 patients(48,8%) cannibalistic cell existence is detected. For all patients who showed local recurrence, Ki-67 proliferaton index (20%), CD68 staining ratio was common and cannibalistic cell ratio was above 10%. The presence of cannibalistic cell was statistically significant in the cases with local recurrence (p=0,045) Discussion and Conclusion: High levels of Ki-67 proliferation index and existence of cannibalism could be a predictive discovery in prediction of GCTTS local recurrence. However our patient range was not wide enough. We suggest further research on wider series to enlighten this subject.

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