Böbrek hücreli karsinomalarda Ki-67 ve CD-44 ekspresyonunun prognostik önemi

Bu amaçla Dicle Üniversitesi Tıp Fakültesi Hastanesi Patoloji Anabilim Dalı’nda 1980-1999 yılları arasında tanısı konulan ve radikal nefrektomiyle tedavi edilmiş toplam 57 yetişkin böbrek hücreli Karsinoma olgusunda immünohistokimyasal yöntem kullanarak Ki-67 ve CD-44’ün prognostik önemini araştırdık. Olgular TNM (1997) sistemine göre patolojik evrelendi ve Furhman’a göre nükleer derecelendirildi. Tümör hücre paterni berrak, granular, iğsi ve karışık hücreli tip olarak dörde ayrıldı. Tüm olgular patolojik evre, derece, tümör hücre paterni ve tümör çapı değişkenleri göz önüne alınarak prognoz yönünden değerlendirildi. Ayrıca tümör patolojik evre, derece, hücresel patern ve tümör çapı değişkenlerinin Ki-67 ve sürvey ile olan ilişkisi Kaplan-Meier testiyle beraber değerlendirildi. Ayrıca CD-44 ile sürvey arasındaki ilişki araştırıldı. Sonuç olarak; ileri patolojik evre ve derece tümörlerde düşük evre ve derecedeki tümörlere göre prognoz daha kötü seyretmiştir. Ayrıca Ki-67 pozitif ileri patolojik evre ve derece tümörlerde de prognoz kötü seyretmiştir. Hücre paterni iğsi ve karışık olanlarda diğer tiplere göre prognoz daha kötü olup, Ki-67 ve hücre paterni beraber değerlendirildiğinde istatistiksel olarak anlamlı bir fark bulunamamıştır. CD-44 pozitif olgularda negatif olanlara göre prognoz daha kötüdür.

Anahtar Kelimeler:

Ki-67 antijeni, Karsinom, renal hücreli, Antijenler, CD44, İmmünohistokimya, Neoplazm evrelendirilmesi, Geriyedönük çalışma

The prognostic significance of the Ki-67 and CD-44 in renal cell carcinomas

The prognostic significance of the Ki-67 and CD-44 were studied by using the immuno histochemical methods in 57 adult cases dignosed as Renal Cell Carcinoma and treated by radical nephrectomy at Dicle University, Medical Faculty between 1980 to 1999 We evaluated both the stage, nuclear grade, tumor diameter and cellular pattern, and these parameters with Ki-67 by Kaplan-Meier test in point of prognosis in all cases. Also, the prognostic significance of CD-44 was investigated alone in renal cell carcinoma. As results, the prognosis of the advance stage and grade tumors was more worse .Also, the prognosis was worse in Ki-67 positive cases with advance stage and grade tumors. The spindle and mixed cell tumors had more worse prognosis than the other patherns. When the Ki-67 positive cases and cellular pattern were evaluated statistically together, there was not any statistical meaning between them. C-44 positive cases had more worse progosis than negative ones.

Keywords:

Ki-67 Antigen, Carcinoma, Renal Cell, Antigens, CD44, Immunohistochemistry, Neoplasm Staging, Retrospective Studies,

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