Mevlüt ÇETİN, Nesibe KAHRAMAN ÇETİN, Sevin KIRDAR, M. Gökhan ERPEK, İbrahim METEOĞLU

LARİNKS PRİMER SKUAMÖZ HÜCRELİ KARSİNOMLARINDA HUMAN PAPİLLOMA VİRÜS SIKLIĞI, p53 ve Ki-67 EKSPRESYONLARININ KLİNİKOPATOLOJİK KORELASYONU

AMAÇ: Larinks kanseri gelişiminde son yıllarda Human Papillomavirüs (HPV) enfeksiyonları üzerinde durulmaktadır. Bu çalışmada larinks Skuamöz hücreli karsinom (SHK)'larında HPV varlığının immünohistokimyasal ve Polimeraz zincir reaksiyonu (PZR) dizisi hibrizasyon yöntemiyle araştırılması, ayrıca p53, Ki-67 ekspresyonunun HPV varlığı ve klinikopatolojik parametrelerle ilişkisinin ortaya konması amaçlanmıştır.GEREÇ ve YÖNTEM: Larinks SHK nedeniyle opere edilen 47 olgu retrospektif olarak çalışmaya alındı. Parafinli bloklardan hazırlanan kesitlere Avidin-Biyotin kompleks sistemiyle panHPV, HPV-16, HPV-18, p53 ve Ki-67 immünohistokimyasal boyaları uygulandı. Parafin bloklardan hazırlanan kesitlerden DNA izolasyonu yapıldı. Sonrasında HPV varlığı HybriBio HPV Genoarray Test ile araştırıldı.BULGULAR: PZR-array hibridizasyon yöntemi ile olguların 15'inde (% 31,9) poliklonal HPV pozitifliği saptanmıştır. İki olguda literatürden farklı olarak HPV 68 bulunmuştur. HPV (PZR) pozitif bulunan olgularda anlamlı düzeyde yüksek Ki-67 boyanması (p=0,01) saptanmıştır. Tümörlerde diferansiyasyon azaldıkça p53 (p=0,041) ekspresyonunun arttığı görülmüştür. Ki-67 ile panHPV (p=0,004) ve HPV-16 (p=0,002) boyanması karşılaştırıldığında, pozitif olgularda Ki-67 ekspresyonunun yüksek olduğu gözlenmiştir.SONUÇ: Formalin fiske parafine gömülü dokular HPV varlığının gösterilmesinde kullanılabilir. HybriBio HPV Genoarray test metodu diğer metodlara göre kullanımı oldukça basittir ve HPV-DNA saptanmasında kıymetli bir araç olabilir. Literatür araştırıldığında şimdiye kadar HPV 68 virüsünün larinks SHK'larında saptanmadığı görülmüştür. Ki-67 ve p53 ekspresyonları larinks SHK'larında iyi veya kötü prognoz açısından yol gösterici olabilir

Anahtar Kelimeler:

Human papillomavirüs, larinks, PCR, p53, Ki-67, immünohistokimya

Frequency of Human Papillomavirus in Larynx Squamous Cell Carcinoma, Clinicopathological Correlation of p53 and Ki-67 Expressions

OBJECTIVE: Human Papillomavirus (HPV) infections have been discussed with regard to laryngeal carcinogenesis recent years. This study investigated the presence of HPV in larynx squamous cell carcinomas (SCC) via immunohistochemical and Polymerase chain reaction (PCR) array hybridization method and the relationship between p53, Ki-67 expression with HPV presence and clinicopathologic parameters. MATERIAL and METHODS: 47 patients who had been operated for larynx SCC were retrospectively included in the study. PanHPV, HPV-16, HPV-18, p53 and Ki-67 immunohistochemical stains were applied to crosssections obtained from waxed blocks by means of Avidin-Biyotin complex system. DNA was isolated from the cross-sections. The presence of HPV was investigated via a HybriBio HPV GenoArray diagnostic kit. RESULTS: Polyclonal HPV positivity was detected only in 15 (31.9%) cases by means of PCR-array hybridization method. Contrary to the literature, HPV-68 was found in two cases. In HPV (PCR)-positive cases, Ki-67 staining was found at high grade (p=0.01). The expression of p53 (p=0.041) increases as differentiation decreases in tumors. When comparing Ki-67, panHPV (p=0.004) and HPV-16 (p=0.002) staining, the expression of Ki-67 is higher than others in positive cases. CONCLUSION: Formalin-fixed paraffin-embedded tissues can be used to indicate the presence of HPV. The use of the HybriBio HPV GenoArray test was much more straightforward than other methods and is useful in detecting HPV-DNA. In the literature, no HPV-68 virus was detected in larynx SCCs until recently. The expression of Ki-67 and p53 could be central to prognosis in larynx SCCs.

Keywords:

Human papillomavirus, larynx, PCR, p53, Ki-67, immunohistochemistry,

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