MEHMET ZENGİN, NEVRA DURSUN, Hüsniye Esra PAŞAOĞLU, Oğuz KOÇ

Pankreatik duktal adenokarsinomlar ve ampüller bölge adenokarsinomlarında HSF-1 ve P53 ekspresyonlarının prognostik faktörlerle ilişkisi

Amaç: Periampüller bölge adenokarsinomları; pankreas ve ampüller bölge tümörlerini içine alan, medikal ve cerrahi tedaviye dirençli ve hızlı metastatik progresyon gösteren tümörlerdir. Isı şok faktörü-1, ısı şok genlerini aktif hale getirir ve malign transformasyon ve kanser hücrelerinde çoğalmayı kolaylaştırır. P53 ise pankreatik kanserlerin %50'sinden fazlasında mutasyona uğrayan tümör baskılayıcı bir gendir. Bu çalışmada HSF-1 ve P53 ekspresyonlarının tümör boyutu, lenf nodu metastazı, tümör evresi, tümör diferansiasyonu ve prognoz ile ilişkisi analiz edilmiştir.Gereç ve Yöntemler: İstanbul Eğitim ve Araştırma Hastanesi'nde uygulanan 69 pankreatikoduodenektomi materyali; HSF-1/P53 ekpresyonu, yaş, cinsiyet, tümör lokalizasyonu, tümör boyutu, tümör evresi, tümörün diferansiasyonu, lenf nodu metastazı varlığı ve prognoz açısından yeniden araştırıldı.Bulgular: Çalışmamızda, %10’un üzerinde boyanma görülen olgularda, büyük tümör boyutu, ileri evre tümör varlığı, yüksek dereceli tümör varlığı, pozitif lenf düğümü ve kötü prognoz daha fazla oranda izlenmiştir. Sonuçlar: Çalışmamız HSF-1 ve P53 ekspresyonlarının, özellikle yüksek dereceli periampüller bölge adenokarsinomlarının gelişiminde rol oynadığını düşündürmektedir. Ayrıca bu iki marker, az differansiye adenokarsinom tanısında diğer parametreler ile birlikte tercih edilebilir.

Anahtar Kelimeler:

Periampüller bölge adenokarsinomları, pankreas, duktal adenokarsinom, ampulla, HSF-1, P53

Relationship of HSF-1 and P53 expressions to prognostic factors in pancreatic ductal adenocarcinomas and ampullary region adenocarcinomas

Aim: Periampullary region adenocarcinomas, which includes pancreatic ductal adenocarcinoma and ampullary carcinoma is one of the malignant tumors with characterized by rapid metastatic progression and resistant to medical and surgical treatments. Heat shock genes are activated by heat shock factor-1 and facilitates malignant transformation and cancer cell proliferation. P53 is a tumor suppressor gene which mutated in more than 50% of pancreatic cancers. In this study, the relation of paramaters which include tumor size, lymph node metastasis, tumor stage, tumor grade and prognosis with HSF-1 and P53 expession was analysed. Material and Methods: 69 pancreaticoduodenectomy materials which performed in the Istanbul Education and Research Hospital were researched entirely about the HSF-1/ P53 expression, age, gender, tumor location, tumor size, tumor stage, tumor grade, presence of lymph node metastasis and prognosis.Results: In our study, tumors which stained >10%, had more percentage in large tumor size, advanced stage tumors, high grade tumors, positive lymph nodes and poor prognosis. Conclusion: Our study suggest that HSF-1 and P53 expression plays role at carcinogenesis of especially high grade periampullary region adenocarcinomas. In addition, these two markers may be preferred in combination with other parameters, at the diagnosis of poor differentiated adenocarcinomas.

Keywords:

Periampullary region adenocarcinomas pancreas, ductal adenocarcinoma, ampullary, HSF-1, P53, prognostic parameters,

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