Özden TULUNAY, M. Kürşat GÖKCAN, Alp DEMİRELLER

Do cytokeratins play a role as a prognostic biomarker in squamous cell carcinoma of larynx?

Amaç. Larenks kanserinde belirli sitokeratin (SK) subtiplerinin immünhistokimya (IHK) ile ekspresyon derecelerine bakılarak sonuçların prognostik faktörlerle korelasyonu amaçlandı. Yöntem. Bu prospektif çalışmaya, 30 larenks kanseri olgusu dahil edildi. Tümör kesitleri histopatolojik olarak incelenerek Broder sistemine göre derecelendirildi. Ardından poliklonal yüksek molekül ağırlıklı SK (YMASK), düşük molekül ağırlıklı SK (DMASK) antikorları ve monoklonal SK 18 ve SK 19 antikorları streptavidin-biotin peroksidaz yöntemi ile tümöral ve non-neoplastik dokulara tatbik edilerek ekspresyon dereceleri incelendi. Bulgular. Tümörler yassı hücreli karsinoma (YHK), adenoskuamoz hücreli, verrüköz, bazaloid ve sarkomatoid karsinomlardan oluşmaktaydı. Grade 2 YHK en sık görülen tümör idi ( % 63,3). IHK ile YMASK ve DMASK’ler herhangi bir prognostik incelemeye izin vermeyecek derecede yoğun ve yaygın boyandılar. SK-18 ekspresyon derecesi, tömörde grade artışı ile azalırken, evre artışı ile artmaktaydı. SK-19 ekspresyonunda ise hem evre, hem de grade artışı ile pozitif korelasyon izlendi. Prognostik değerlendirmede daha geniş bir seride SK-18 ekspresyonunun boyun metaztazı üzerine tahmin değeri bulunabileceği düşünüldü (p=0,064). Sonuçlar. Bu çalışma SK boyanma derecelerini patolojik prognostik faktörlerle ilişkilendirme açısından özgündür. Poliklonal SK’ler içerdikleri SK çeşitliliğinden dolayı farklılaşma derecesinin tayininde ve hiperplastik mukozaların değerlendirilmesinde uygun görülmemiştir. Ancak SK-18 ve 19, antikor paneline bazı SK antikorlar eklendiği takdirde larenks kanserinde prognostik değere sahip olabilir.

Sitokeratinler larenks yassı hücreli kanserinde prognostik belirteç olabilir mi?

Aim. In this prospective study, expressions of distinct cytokeratin (CK) subtypes in larynx cancer (LC) were examined by immunohistochemistry (IHC) and these findings were correlated with known prognostic factors. Method. Thirty LC patients were enrolled into study. Tumor sections were examined and graded according to Broder’s criteria. For examining the CK expression, polyclonal low molecular weight CK (LMWCK) and high molecular weight CK (HMWCK) antibody cocktails, and monoclonal CK18 and CK19 antibodies were applied into tumoral and non-neoplastic mucosa sections with streptavidin-biotin peroxidase technique. Result. Tumors included squamous cell (SC), adenosquamous cell, verrucous, basaloid carcinomas and sarcomatoid carcinoma. Grade 2 SC cancer was the most prevalent type (63.3 %). On IHC, LMWCK and HMWCK were found to have diffuse expression that disables any prognostic implication. CK-18 expression seemed to diminish by grade but to increase by stage. CK-19 expression had positive correlation with both grade and stage (p=0.064). Conclusion. This study is first research evaluating the correlation of CK staining findings with pathologic prognostic factors. Findings of this CK cocktail study suggest that these markers are not optimal for decision making of hyperplastic mucosa and differentiation degree in neoplasias, as they include a variety of CK classes that result in diffuse cytoplasmic staining. However with the addition of certain monoclonal CKs, CK-18 and 19 could have prognostic implications in SC carcinomas of larynx.

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