İsmail HARMANKAYA, Pınar KARABAĞLI, Güler YAVAŞ, Zeliha Esin ÇELİK, Özlem ATA

Rektal adenokarsinomlarda aldehid dehidrogenaz 1 (ALDH1) ve gamma synuclein ekspresyonunun prognostik değeri

Amaç: Kolorektal kanserler arasında her evrede sağkalımın en olumsuz olduğu tümörler rektum kanserleridir. Bununla birlikte cerrahi tekniğin optimizasyonu ve neo-adjuvan tedavi yaklaşımı, son yıllarda rektum kanserlerinde 5 yıllık sağ kalım sürelerinin kolon kanserinden daha iyi olmasına neden olmuştur. Erken evre rektum tümörlü hastaların tedavisinde küratif tedavinin köşe taşı cerrahidir. Ancak transmural invazyon ve/veya pozitif perirektal lenf nodu olan hastalarda, hastalığın lokal kontrolü ve kürü açısından olumlu sonuçlar elde edebilmek için cerrahi tedaviye radyoterapi ve kemoterapinin eklenmesi gerekir. Kanser kök hücre belirteci olan ALDH1 ekspresyonunun kemoterapiye rezistansta, tümör progresyonunda ve metastazında anlamlı olduğu yapılan çalışmalarda gösterilmiştir. Ayrıca metastatik ve ileri evre meme over, karaciğer, prostat ve kolon kanserlerinde normal dokudan farklı olarak anormal gamma synuclein ekspresyonu varlığı da gösterilmiştir. Gamma synuclein ekspresyonu meme kanser hücrelerinin proliferasyonu, invazyonu ve metastazıyla ilişkili bulunmuştur.Gereç ve Yöntem: Çalışmamızda rektum rezeksiyon materyallerinden rektal adenokarsinom tanısı alan 55 olguya ait tümöral ve normal mukoza örnekleri incelendi. Prognostik parametreler ile ALDH 1 ve Gamma synuclein antikorlarının ekspresyonları arasındaki ilişki araştırıldı. Bu şekilde çalışmamızda rektum kanserinde gamma- synuclein ve ALDH1 ekspresyonu ile tümör agresivitesi ve prognozu üzerine etkilerini belirlemeyi amaçladık.Bulgular: İmmunohistokimyasal olarak Gamma synucleinin rektum kanseri ve normal mukozasında boyanmadığı görüldü. ALDH 1 ile farklı boyanma paternleri saptanarak bulgular literatür eşliğinde yorumlandı. Sonuç: Çalışmamızda rektum kanseri ve normal mukozal dokuda derece, evre, lenf nodu metastazı, Lenfovasküler invazyon ve Perinöral invazyon ile ALDH1 ekspresyonu arasında istatiksel olarak anlamlı olmayan, boyanma kuvveti açısından ters orantılı bir ilişki saptandı. Gamma synucleinin ise rektum kanserlerinde eksprese olmadığı görülmüştür.

Expression and prognostic value of aldehyde dehydrogenase 1 (ALDH1) and synuclein gamma in rectal adenocarcinoma

Objective: Rectum cancers are the most negative survival in all stages of colorectal cancer. However, optimization of the surgical technique and neo-adjuvant treatment approach have led to 5-year survival times in rectal cancers better than colon cancer in recent years. The corner stone of curative treatment in the treatment of patients with early-stage rectum tumors is surgery. However, in patients with transmural invasion and / or positive perirectal lymph node, radiotherapy and chemotherapy should be added to surgical treatment to achieve positive results in terms of local control and cure of the disease. Cancer stem cell marker ALDH1 expression has been shown to be significant in chemotherapy resistance, tumor progression and metastasis. In addition, the presence of abnormal gamma synuclein expression in metastatic and advanced breast, ovarian, liver, prostate and colon cancers, as opposed to normal tissue, has also been demonstrated. Gamma synuclein expression has been associated with proliferation, invasion and metastasis of breast cancer cells. Material and Methods: In our study, tumoral and normal mucosa samples of 55 cases diagnosed with rectal adenocarcinoma from rectum resection materials were examined. The relationship between prognostic parameters and the expression of ALDH 1 and Gamma synuclein antibodies was investigated. In this study, we aimed to determine the effects of gamma-synuclein and ALDH1 expression on tumor aggressivity and prognosis in rectal cancer. Results: Immunohistochemically, it was observed that Gamma synuclein was not stained in rectum cancer and normal mucosa. With ALDH 1, different staining patterns were detected and the findings were interpreted in the light of the literature. Conclusion: In our study, a statistically insignificant, inversely proportional relationship was found between rectum cancer and grade, stage, lymph node metastasis, lymphovascular invasion, and expression of ALDH1 in normal mucosal tissue. Gamma synuclein was not found to be expressed in rectum cancers.

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