Oğuz Galip YILDIZ, Serdar SOYUER, İşın SOYUER, Kadir UÇAR, Mete GÜNDOĞ, Bünyamin KAPLAN, Metin ÖZKAN
Gastrektomi sonrası adjuvan kemoradyoterapi uygulanan mide karsinomlu olgularda NF-kB'nin prognostik önemi
AMAÇ Gastrektomiden sonra adjuvan kemoradyoterapi uygulanan mide kanserli olgularda transkripsiyon faktör nükleer faktör kappa B'nin (NF-κB ) progresyonsuz sağkalım ve genel sağkalım yönünden prognostik önemi araştırıldı. GEREÇ VE YÖNTEM Çalışmaya evre II-IV mide karsinomlu gastrektomi ve adjuvan kemoradyoterapi ile tedavi edilen 49 olgu (35 erkek, 14 kadın; median yaş 55; dağılım 22-73) dahil edildi. Tüm olgulara gastrektomi sonrası adjuvan radyoterapi ile eş zamanlı haftada bir kez 250 mg/m2 dozunda haftalık i.v. bolus 5-FU verildi. Kemoradyoterapinin tamamlanmasından 2-4 hafta sonra konsolidasyon amaçlı ardışık dört kür Mayo Rejimi i.v. bolus tarzında uygulandı. Olgulara ait parafin bloklardan yeni kesitler alınarak NF-kB immünohistokimyasal boyası uygulandı. NF-kB için tümör dokusunda nükleer boyanmanın %10'dan az olan olgular negatif, %10'dan fazla olan olgular ise pozitif olarak değerlendirildi. BULGULAR Bu kritere göre yapılan değerlendirmede toplam 49 hastanın 29'unda (%59) NF-kB negatif, 20 hastada (%41) ise NF-kB pozitif boyandı. Gruplar arasında progresyonsuz sağkalım ve genel sağkalım açısından fark olup olmadığı araştırıldı. SONUÇ NF-kB pozitif (%10'dan fazla boyanan) grupta genel sağkalım istatistiksel olarak anlamlı ve daha kısa bulunmuşken, hastalıksız sağkalım yönünden iki grup arasında istatistiksel anlamlı fark gösterilemedi.
Anahtar Kelimeler:
Kemoradyoterapi, mide kanseri/patoloji, immünohistokimya, NF-kappa B, prognostik faktör, sağkalım oranı
Prognostic significance of NF-κB in resectable gastric cancer treated with concomittant chemoradiotherapy
OBJECTIVES The aim of this study is to determine the prognostic value of transcription factor nucleer factor kappa B ( N F -κB) in resectable gastric cancer patients treated with concurrent chemoradiotherapy. METHODS Forty-nine (35 males, 14 females; median age 55; range 2273 years) resectable gastric cancer patients treated with gastrectomy and adjuvant concurrent chemoradiotherapy were enrolled in this study. All patients received weekly 250 mg/ m2 5-FU chemotherapy and radiotherapy concomittantly after gastrectomy. Then patients received 4 cycles i.v bolus FUFA chemotherapy sequentialy as consolidation treatment 2-4 week after chemoradiotherapy. Immunohistochemistry staining was performed on paraffin embedded tissue. NF-κB monoclonal antibodies were used for the staining. RESULTS The progression free surv ival and overall surv ival dif er e nce were anal ised between NF-κB pos it ive and neg at ive groups. For NF-kB a specimen was judged posit ive if more than 10% of the total cancer cells in a single field of view showed a response. CONCLUSION In patients who NF-κB was stained more than 10%, the overall survival was worse and there was statistically significant difference between groups. But in two groups, no statistically significant difference due to disease free survival.
Keywords:
Gastrectomy, Chemotherapy Adjuvant, Stomach Neoplasms, NF-kappa B, Survival Rate, Radiotherapy, Radiation Oncology,
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- ISSN: 1300-7467
- Başlangıç: 2015
- Yayıncı: Ali Cangül