Endometriumun benign, premalign ve malign lezyonlarında Glut-1 ile Ki-67'nin ayırıcı tanıdaki yeri

Amaç: Endometrium karsinomu, kadınlarda görülen karsinomlar arasında dördüncü sırada yer almaktadır. Bu nedenle endometriumun premalign lezyonlarının erken tanısı üzerinde önemle durulmakta ve risk faktörleri ile prognozu etkileyen faktörler belirlenmeye çalışılmaktadır. Çalışmamızda GLUT-1 ve Ki-67 immünohistokimyasal belirleyicilerin, endometriumun benign, premalign ve malign lezyonlarını ayırmadaki önemini belirlemeyi amaçladık. Gereç ve Yöntem: Fırat Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı Laboratuarında tanı almış 20 proliferasyon fazı, 20 sekresyon fazı, 20 basit hiperplazi, 20 kompleks hiperplazi ve 20 endometrioid karsinom olmak üzere toplam 100 olguya immünohistokimyasal yöntemle GLUT-1 ve Ki-67 uygulandı. GLUT-1 için plasenta ve Ki-67 için tonsil dokusuna ait örnekler pozitif kontrol olarak kullanıldı. GLUT-1 ile membranöz boyanma ve Ki- 67 ile nükleer boyanma gösteren hücreler pozitif olarak değerlendirildi. Bulgular: GLUT-1 boyanmasında şiddet ve yaygınlığın, proliferasyon fazı, sekresyon fazı ve hiperplazilere göre endometrioid karsinomda belirgin artış gösterdiği belirlendi. Ayrıca Ki-67 proliferasyon indeksinin (PI) de aynı şekilde, proliferasyon fazı (32.90±7.16), sekresyon fazı (16.64±9.01), basit hiperplazi (32.28±5.60) ve kompleks hiperplaziye (35.65±4.33) göre endometrioid karsinomda (47.96±5.84) belirgin artış gösterdiği saptandı. Aynı olgularda GLUT-1 pozitifliği ve Ki-67 PI arasındaki ilişki de anlamlı bulundu. Sonuç: Sonuç olarak endometriumun benign lezyonları ile premalign ve malign lezyonlarının ayırımında GLUT-1 pozitifliğinin ve Ki-67 PI’nin yardımcı olacağı kanısına varıldı.©2006, Fırat Üniversitesi, Tıp Fakültesi

Anahtar Kelimeler:

Ki-67 antijeni, Tanı, ayırıcı, Endometriyum, Endometriyum neoplazmları, Glukoz taşıyıcı tip 1

Value of GLUT-1 and Ki-67 in differential diagnosis in benign, premalign and malign lesions of endometrium

Objectives: Endometrial carcinoma is the fourth most frequently diagnosed cancer in women. For this reason, the early diagnosis of premalignant lesion of endometrium is very important and it is tried to determine the risk and prognostic factors. The objective of this study was to determine relationship between immunohistochemical markers such as GLUT-1, Ki-67 and benign, premalign, malign lesions of endometrium. Materials and Methods: A total of 100 specimens were retrieved from the archives of the Pathology Department, Firat Medical Center of Firat University. These specimens were containing: 20 proliferative endometrium, 20 secretory endometrium, 20 simple hyperplasia, 20 complex hyperplasia, 20 endometrioid carcinoma. All specimens were stained immunohistochemically with GLUT-1 and Ki-67. Placenta and tonsile tissue was used as positive control specimen for GLUT-1 and Ki-67 respectively. Cells were considered positive only when cytoplasmic staining by GLUT- 1 and nuclear staining by Ki-67 was observed. Results: Intensity of GLUT-1 staining shows progresively more staining in endometrioid carcinoma as compared to proliferative endometrium, secretory endometrium and hyperplasia. Mean Ki-67 values were also higher in cases with endometrioid carcinoma (47.96±5.84) compared with those cases with proliferative endometrium (32.90±7.16), secretory endometrium (16.64±9.01), simple hyperplasia (32.28±5.60), complex hyperplasia (35.65±4.33). The relationships between GLUT-1 positivity and Ki-67 PI were found meaningful in similar cases. Conclusion: As in a conclusion, GLUT-1 immunstaining and Ki-67 PI may be useful in distinguishing benign lesions from premalign and malign lesion.

Keywords:

Ki-67 Antigen, Diagnosis, Differential, Endometrium, Endometrial Neoplasms, Glucose Transporter Type 1,

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