PEMBE OLTULU, Rabia KÜPELİ, FAHRİYE KILINÇ, MEHMET SİNAN İYİSOY, HACI HASAN ESEN, Salim GÜNGÖR, MUSTAFA CİHAT AVUNDUK, Lema TAVLI, Sıdıka FINDIK

İnvaziv Meme Karsinomlu Olgularda İmmunhistokimyasal Olarak Human Epidermal Growth Faktör 2 (Her2) 2+/ Amplifiye ve Her2 2+/ Amplifiye Olmayan Grupların Histopatolojik Ve Klinik Prognostik Parametreler Açısından Karşılaştırılması

Amaç: İnvaziv meme kanserli (İMK) hastalarda pek çok prognostik kriterden biri olan Her2 (Human epidermal growth factor receptor 2) durumunun belirlenmesi önemlidir. İmmünohistokiyasal olarak Her2 2+ ve geni amplifiye olan veya Her2 3+ olan İMK‘li hastalar anti-Her2 tedavisine alınır. Her2 2+ immünekspresyonu olan ancak gen amplifikasyonu bulunmayanlar anti-Her2 tedavisi almazlar. Çalışmamızda; immunhistokimyasal olarak Her2 2+/amplifiye ve Her2 2+/amplifiye olmayan İMK‘li hasta gruplarını histopatolojik prognostik parametreler açısından karşılaştırdık. Böylece Her2 2+/amplifiye olmayan grubun prognostik durumunun belirlenmesi ile literatüre katkı sağlamak istedik. Gereç ve Yöntem: Toplam 76 İMK vakası retrospektif olarak çalışmaya dahil edildi. Tümör hormon reseptör fenotipi, yaş, grade, lenfovasküler invazyon, perineural invazyon, aksiller lenf nodu durumu belirlendi. Çalışma, Her2 2+/amplifiye ve Her2 2+/amplifiye olmayan tümörler üzerine yoğunlaştı. Her2 ekspresyon durumu ASCO/CAP (American Society of Clinical Oncology/College of American Pathologists) rehberi ile ortaya koyuldu. Bulgular: Her2 2+/amplifiye ve HER2 2+/amplifiye olmayan İMK‘li hastalar arasında çoğu histopatolojik prognostik parametre açısından anlamlı fark yoktu. Sadece progesteron ekspresyon oranları Her2 2+/amplifiye olmayan grupta anlamlı derecede daha yüksekti (p=0.001) Sonuç: Her2 2+/amplifiye olmayan hastalar hem Her2 2+/amplifiye hastalarla hem de Her2 (+) ve Her2 (–) hastalarla histopatolojik prognostik parametreler açısından birbirine benzer sonuçlar içermektedir. İlaveten gruplarda, istatistiksel olarak anlamlı olmasa da, Her2 pozitifliği arttıkça daha fazla lenfovasküler invazyon oranları tespit edildi. Çalışmamız Her2 (+) vakaların tamamının anti-Her2 tedavisine alınması gerekliliğini savunan çalışmalarla uyumlu sonuçlar içermektedir. Şu an için Her2 1+ vakalar anti-Her2 tedavisine alınamasa bile en azında tüm Her2 2+ vakaların gen amplifikasyon durumuna bakılmaksızın anti-Her2 tedavisine alması hastalığın seyrine olumlu yönde katkı sağlayabilir.

Comparison of the Histopathological and Clinical Prognostic Parameters in Human Epidermal Growth Factor 2 (Her2) 2+/ Amplified and Her2 2+/Non- Amplified Groups of the Cases with Invasive Breast Carcinoma

Objective: Determining the Her2 (human epidermal growth factor receptor 2) status which is one of the prognostic criteria in patients with invasive breast cancer is an important factor. The patients with Her2 3+ and Her2 2+/amplified are treated with anti-Her2 treatment. The patients with Her2 2+/non-amplified are not treated with anti-Her2 treatment. In this study; The patients with Her2 2+/amplified and Her2 2+/non-amplified were compared in terms of histopathologic prognostic parameters. Thus, we aimed to determine the prognostic status of the Her2 2+/ nonamplified group. Methods: A total of 76 breast cancer patients were retrospectively included in this study. Tumor hormonal receptor phenotype, age, grade, lymphovascular invasion, perineural invasion, axillary lymph node status were determined. The study was focused on Her2 2+/amplified and Her2 2+/nonamplified tumors. Her2 expression status was analyzed using ASCO/CAP (American Society of Clinical Oncology/College of American Pathologists) guidelines. Results: There was no statistically significant difference between the patients with Her2 2+/amplified and Her2 2+/non-amplified in terms of many histopathological parameters. Only the progesterone expression ratios of Her2 2+/non-amplified group were higher than others (p=0.001) Conclusion:. Her2 2+/non-amplified patients have similar results in terms of histopathological prognostic parameters with both Her2 2 +/amplified patients and Her2 (+) and Her2 (-) patients. More lymphovascular invasion rates were detected as Her2 positivity increased. The present study includes results consistent with studies advocating the necessity of taking all Her2(+) cases into anti-Her2 treatment. We at least think that all Her2 2+ patients should receive anti-Her2 therapy regardless of the amplification.

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ISSN: 1309-3878
Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Düzce Üniversitesi Tıp Fakültesi Aile Hekimliği AD adına Yrd.Doç.Dr.Cemil Işık Sönmez