Epitelyal Over Kanserinde Retroperitoneal Lenf Nodu Metastazı Etkileyen Faktörlerin Araştırılması

Amaç: Bu çalışmada, epitelyal over kanserli hastalarda lenf nodu tutulumu ile ilişkili faktörleri araştırıldı. Over kanserinin önemli yayılım yollarından biri lenfatik yayılımdır. Bu tip yayılım sıklıkla ileri evrelerde görülür. Bu nedenle, over kanserinde lenf nodu tutulumunu etkileyen faktörlerin belirlenmesi ve bu faktörlere yönelik yeni tedavi yöntemlerinin geliştirilmesi için elzemdir. Gereç ve Yöntem: Çalışmamızda, son 10 yıl içerisinde Bakırköy Jinekoloji ve Pediatri eğitimi araştırma hastanesine başvuran ve opere edilen over kanseri olgularını değerlendirildi ve tek merkezli ve homojen bir hasta grubunda klinik ve patolojik faktörler olası lenf nodu tutulumu açısından araştırıldı. Bulgular: Buna göre, preoperatif CA-125 protein seviyesi lenf nodu negatif olan hastalarda (469±954), pozitif olanlara göre (1307±2937) anlamlı olarak daha düşük bulundu (p=0,004 <0,05). Ayrıca, CA-125 değeri ile hastalığın cerrahi evresi arasında istatistiksel olarak anlamlı bir ilişki saptandı ve CA-125 düzeyi artışı ile lenf nodu tutulumunun arttığı tespit edildi (p<0.04). Bunun yanında, preoperatif CA-125 yüksekliği ve omentum tutulumu ile lenf nodu tutulumu arasında pozitif ilişki tespit edildi, ancak tümör histolojisi ve grade ile lenf nodu tutulumu arasında herhangi bir ilişki bulunmadı. Sonuçlar: Çalışmadan elde edilen bulgular ışığında; Epitelyal over kanserinde lenfatik tutulum varlığı 5 yıllık sağ kalım açısından önemli olduğu ve evre artışı ile lenfatik tutulum arasında pozitif korelasyon olduğu tespit edildi. Bu konuda yürütülecek tüm risk faktörlerinin bir arada değerlendirildiği geniş serili çalışmalarla lenf nodu tutulumuna etki eden faktörlerin histopatolojik ve moleküler etkileri aydınlatılabilir. 

The Investigation of The Factors Affecting Retroperitoneal Lymph Node Metastasis In Epithelial Ovarian Cancer

Objective: In this study, the factors associated with lymph node involvement in patients with epithelial ovarian cancer were investigated. One of the major spreading ways of ovarian cancer is lymphatic spread. This type of spread is often seen in advanced stages. Therefore, it is essential to determine the factors aff ecting lymph node involvement in ovarian cancer and to develop new treatment methods for these factors. Material and Method: In our study, the ovarian cancer cases who were admitted to Bakırköy Gynecology and Pediatrics Education Research Hospital and operated in the last 10 years were evaluated and clinical and pathological factors in terms of possible lymph node involvement in a single-centered and homogeneous patient group were investigated. Results: Accordingly, pre-operative CA-125 protein levels were signifi cantly determined lower in patients with negative lymph node (469 ± 954) than those with positive lymph node (1307 ± 2937) (p = 0.004 <0.05). In addition, a statistically signifi cant relationship was detected between CA-125 value and the surgical stage of the disease and lymph node involvement was determined to be increased with the increase in CA-125 level (p <0.04). Besides, a positive relationship was determined between high preoperative CA-125 levels and omentum involvement and lymph node involvement, but no relationship was found between tumor histology and grade and lymph node involvement. Conclusion: In the light of the fi ndings obtained from the study; it was detected that the presence of lymphatic involvement in epithelial ovarian cancer was important for 5-year survival and that there was a positive correlation between the stage increase and lymphatic involvement. The histopathological and molecular eff ects of factors aff ecting lymph node involvement can be enlightened by a large series of studies in which all risk factors in this regard are evaluated together. 

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