Şeref DOKCU, Mehmet Ali ÇAPARLAR, Özhan ÇETİNDAĞ, Musluh HAKSEVEN, Aydan EROĞLU

Menopoz Durumunun Moleküler Meme Kanseri Alt Tipleri İle İlişkisi.

Amaç Meme kanseri, oldukça farklı biyolojik davranışlar sergileyen ve birçok genomik iz taşıyan heterojen bir hastalık grubudur. Cinsiyet hormonlarına bağımlılığı da menopoz durumu ile ilişkisini belirler. İmmünohistokimyasal (IHC) belirteçlerle yapılan reseptör analizine ve Ki67 düzeyine göre beş moleküler alt tipe ayrılır. Bu çalışmada, tedavi stratejilerimizi belirlemeye yardımcı olmak için menopoz durumu ile bu moleküler alt tipler arasındaki ilişkiyi incelemeyi amaçladık. Gereç ve yöntem 2012-2020 yılları arasında Onkoloji Kliniğimizde meme kanseri nedeniyle ameliyat edilen 250 hastanın veri tabanı geriye dönük olarak incelendi. Hastalar menopoz durumlarına ve klinikopatolojik özelliklerine göre gruplandırıldı. İstatistiksel analiz %95 güven aralığında yapıldı ve 0,05'ten düşük bir p değeri istatistiksel olarak anlamlı kabul edildi. Bulgular Hastalar menopoz durumlarına göre %44.8 (n=112) premenopozal ve %65.2 (n=138) postmenopozal olarak 2 gruba ayrıldı. Yapılan istatistiksel analizde premenopozal kadınlarda Ki67 düzeyi yüksekti (p=0.015). Ayrıca premenopozal kadınlarda görülen tümörler ER negatifliği (p=0.024) ve yüksek histolojik derece (grade3) (p=0.015) ile ilişkiliydi. Postmenopozal kadınlarda luminal alt tip (luminal A, luminal B) meme kanserlerinin, premenopozal kadınlarda ise luminal olmayan alt tiplerin (HER2+, TNBC) daha sık izlendiği bulundu. Sonuç Yakın gelecekteki kişiselleştirilmiş tedavi stratejilerini belirleyecek olan genomik karmaşa hala aydınlatılmayı beklemektedir. Bu bilinmez doğayı anlamamıza yarayacak randomize, prospektif, multidisipliner ve popülasyon tabanlı çalışmalara hala ihtiyaç vardır.

Anahtar Kelimeler:

Meme kanseri, İmmunohistokimyasal analiz, Moleküler alt tip, Menopozal durum

Relationship of Menopausal Status with Molecular Breast Cancer Subtypes

Objective Breast cancer is a heterogeneous disease group that exhibits quite different biological behaviors and bear many genomic traces. Its dependence on sex hormones also determines its relationship with menopausal status. It is divided into five molecular subtypes according to receptor analysis and Ki67 level with immunohistochemical (IHC) markers. This study aimed to examine the relationship between the menopausal status and these molecular subtypes to help determine our treatment strategies. Material and Method The database of 250 patients who were operated on for breast cancer in our Oncology Clinic between 2012 and 2020 was retrospectively analyzed. The patients were grouped by their menopausal status and clinicopathological characteristics. Statistical analysis was made at a 95% confidence interval, and a p-value lower than 0.05 was considered statistically significant. Results The patients were divided into 2 groups by their menopausal status as 44.8% (n = 112) as premenopausal and 65.2% (n=138) as postmenopausal. In the statistical analysis performed, the level of Ki67 was high in premenopausal women (p=0.015). Also, tumors seen in premenopausal women were associated with ER negativity (p=0.024) and high histological grade (grade3) (p=0.015). It was found that luminal subtype (luminal A, luminal B) breast cancers were observed more frequently in postmenopausal women and non-luminal subtypes (HER2+, TNBC) were observed more frequently in premenopausal women. Conclusion The genomic complexity that will determine personalized treatment strategies soon remains to be clarified. There is still a need for randomized, prospective, multidisciplinary, and population-based studies to help us understand this unknown nature.

Keywords:

Breast cancer, İmmunohistochemical analysis, Molecular subtype, Menopausal status,

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