Yusuf Aytaç TOHMA, Fulya KAYIKÇIOĞLU, Ali HABERAL, Yıldırım KARSLIOĞLU, Özlem EVLİYAOĞLU, Ömer GÜNHAN, Ahmet ÖZFUTTU

Ki-67/Mib-1 Proliferasyon İndeksinin Hidatiform Mol Tanısındaki Klinik Değeri

Amaç: Gestasyonel trofoblastik hastalıklarda Ki-67 indeksinin önemi hala tartışılan bir konudur. Bu çalışmanın amacı proliferasyon markerlarından olan Ki-67’nin trofoblastik hastalıklarda ayırıcı tanıda herhangi bir değerinin olup olmadığını belirlemektir.Gereç ve Yöntemler: Çalışmaya, komplet hidatidiform mol tanısı almış n = 32 veya parsiyel mol tanısı almış n = 6 hastaların patoloji raporları dahil edildi. Çalışmaya dahil edilen tüm hastaların kliniği 1 yıl boyunca izlendi. Parafin bloklar immünhistokimyasal olarak boyandı ve bilgisayarla asiste görüntü analiz sistemi ile Ki-67 antijeni açısından incelendi.Bulgular: Maternal yaş, gravida, uterus büyüklüğü, hemoglobin, serum β-hCG seviyesi gibi devamlı değişkenlerin hiçbiri Ki-67 indeksi ile anlamlı korele değildi p>0.05 . Ki-67 indeksi, vajinal kanama, hiperemezis, asemptomatik prezentasyon, gebelik yaşı ile tutarlılık, teka lutein kisti, hipertiroidizm, GTN gelişimi ya da remisyonu gibi semptom ve şikayetlerle korele değildi. Fakat parsiyel molde Ki-67 indeksi [median=8 IQR=11.00 ] , komplet mole göre [median=21 IQR=43.00 ] daha düşük bulundu Z=1.944; p=0.050 .Sonuç: Bizim çalışmamızdaki datalar, Ki-67 indeksinin komplet mol ile parsiyel mol ayırımında umut verici bir marker olduğunu göstermektedir. Bizim bulgularımızın prospektif çalışmalarla desteklenmesi gerekmektedir.

Anahtar Kelimeler:

Hidatidiform mol, Ki-67, görüntü analizi

The Clinical Value Of Ki-67/Mib-1 Proliferation Index In Hydatidiform Mole

Aim: The significance of Ki-67 index in gestational trophoblastic diseases remains a controversial issue. This study was designed to determine whether proliferation marker, Ki-67, in trophoblastic tissue would have any clinical discriminatory value.Material and Methods: The pathology reports of patients with diagnosis of complete hydatidiform mole CHM n=32 or partial hydatidiform mole PHM n=6 were included. All the patients in this study were followed up with clinical records for one year. Paraffin blocks were stained immune histochemically and computer-assisted image analysis system was used to detect Ki-67 antigen.Results: None of the continuous variables including maternal age, gravidity, size of the uterus, hemoglobin, preevacuation serum β-hCG levels were significantly correlated with Ki-67 index p>0.05 . Ki-67 index was not discriminative for symptoms and signs including vaginal bleeding, hyperemesis, asymptomatic presentation, consistency with gestational age, theca lutein cysts, hyperthyroidism, development of GTN or remission p>0.05 . On the other hand, PHMs were found to have lower Ki-67 index [median=8 IQR=11.00 ] than CHMs [median=21 IQR=43.00 ] Z=1.944; p=0.050 .Conclusion: It is our opinion that in the light of current data, it seems Ki-67 index has promising value in discriminating complete and partial HMs. Further prospective studies will help to determine the prognostic value for adverse clinical outcome.

Keywords:

Hydatidiform mole, Ki-67, image analysis,

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