Osteosarkomda MDR/P-gp fenotipinin diferansiyasyon ile ilişkisi

Bazı deneysel çalışmaların sonucunda, diğer malignitelerde savunulduğu gibi, osteosarkom da (OS) da, p-glikoprotein (P-gp) pozitifliğinin diferansiyasyonla doğru orantılı olarak arttığı iddia edilmektedir. Bu nedenle P-gp'nin kötü prognostik belirleyici olamayacağı öne sürülmektedir. Bu çalışmada OS'larda farklı diferansiyasyon gösteren alanlardaki P-gp pozitifliğinin dağılımı saptanarak diferansiyasyonla ilişkisi sorgulanmıştır. 1984-2000 yılları arasında, Anabilim Dalımızda osteosarkom tanısı almış, 81 primer ameliyat, 82 biyopsi, 13 akciğer, bir aksiller lenf nodülü, bir kosta metastazı, üç lokal rekürrens ameliyat materyalinden hazırlanan 337 kesite immunohistokimyasal yöntemle P-gp boyası uygulanmıştır. Kesitlerde saptanan toplam 544 değişik diferansiyasyon alanında P-gp boyanma özellikleri 0-6 arası skorlanmıştır. Çalışmamızda OS'larda P-gp varlığının matriks içeriği ve diferansiyasyon ile bir ilişkisi olmadığı saptanmıştır. OS'ların histolojik alt tipleri göz önüne alınarak yapılan analizlerde de boyanma oranının farklılık göstermediği bulunmuştur. Bu proteinin diferansiyasyon ile ilişkisi olabileceğini ön gören kaynaklarla uyuşmayan bir sonuç elde edilmiştir. P-gp boyanması diferansiyasyondan bağımsız bir belirleyici gibi görünmektedir.

Anahtar Kelimeler:

İlaç direnci, çoklu, İmmünohistokimya, Osteosarkom, P-glikoprotein

The correlation of MDR/P-gp phenotype and differentiation of osteosarcoma

Recent experimental studies on osteosarcomas (OS) have postulated that similar to other malignancies, p-glycoprotein (P-gp) positivity is directly correlated with differentiation. Therefore, it has been hypothesized that P-gp cannot be a marker of poor prognosis. In this study, the distribution of P-gp positivity in different areas of OSs with variable differentiation pathways is assessed and its relationship with differentiation is questioned. The cases, which have received the diagnosis of OS in our department between 1984-2000, were included in the study. A total of 337 sections were immunohistochemically stained for P-gp, which consisted of 81 primary surgical materials, 82 biopsies, 13 lung specimens, one axillary lymph node and one rib metastasis, and three local recurrence materials. The P-gp staining patterns were scored between 0 and 6 on a total of 544 areas with different differentiation pathways. Our results have shown that P-gp expression of OSs has no correlation with the matrix content and differentiation. Furthermore, the analysis of the histological subtypes did not present any differences in the staining patterns. In conclusion, despite the previous reports demonstrating correlation of this protein with differentiation, It appears that P-gp staining of OSs is an independent factor.

Keywords:

Drug Resistance, Multiple, Immunohistochemistry, Osteosarcoma, P-Glycoprotein,

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