Birgül TOK, Şafak ERSÖZ, GÜLNAME FINDIK GÜVENDİ

Serviksin LSIL, HSIL ve Skuamöz Hücreli Karsinomlarında Biyopsilerde Ki-67, P16, C-erb B2 ve Siklin D1 Ekspresyonunun Önemi

Amaç: Serviksin skuamöz hücreli kanseri (SCC), jinekolojik kanserlerde en sık rastlanan malign tümördür. Skuamoz intraepitelyal lezyonlar (SIL) preinvazif lezyonlar olarak bilinir. Servikal kanser gelişiminde etkili lezyonların derecelendirilmesindeki sorunlardan dolayı lezyonların ayrımında immünohistokimyasal belirteçlerin yararlı olduğu bildirilmiştir. Bu çalışmada, HSIL ve LSIL olgularında Ki-67, p16, siklin D1 ve c-erb-B2 boyama paterninin ekspresyonu ve yoğunluğu araştırılmıştır.Gereç ve Yöntem: Bu çalışmaya 2003-2011 yılları arasında XXX Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı'nda teşhis konan 40 SCC, 40 düşük dereceli SIL (LSIL) ve 40 yüksek grade SIL (HSIL) hasta dahil edildi. Hastaların preparatlarında C-erb-B2, Ki-67, p16 ve siklin D1 ekspresyonları araştırıldı.Bulgular: C-erb-B2, 6 HSIL vakasında (%15), 4 SCC vakasında (%10) ve 2 LSIL vakasında (%5) pozitif boyanma gösterdi. Gruplar arasında istatistiksel olarak anlamlı fark yoktu (p> 0.05). Bununla birlikte SCC'li olgularda c-erb-B2 ile hastalık evresi arasında güçlü bir korelasyon gözlenmiştir (p<0.05, r = 0.891). Ki-67 ekspresyonu, LSIL vakalarının ortalama % 20'sinde, HSIL vakalarının ortalama %35'inde ve SCC vakalarının ortalama %40’ında mevcuttu. Gruplar arasındaki fark, LSIL'den dolayı, istatistiksel olarak anlamlıydı (p<0.05). Siklin D1 ile nükleer boyanma çoğunlukla LSIL'li olgularda gözlendi, ancak sitoplazmik boyanma HSIL ve SCC'li olgularda ağırlıklı olarak gözlendi. Siklin D1 ile, gruplar arasında hiçbir istatistiksel olarak anlamlı fark gözlenmedi (p>0.05). p16 ekspresyonu HSIL'da 39 (%97.5) olguda, LSIL’da 12 olguda (% 30) görüldü. Aradaki fark istatistiksel olarak anlamlıydı (p <0.05). Sonuç: Sonuç olarak, c-erb-B2 ve siklin D1 ekspresyonu bu lezyonların ayrımında yararlı değildir. Bununla birlikte, Ki-67, LSIL'ı HSIL ve SCC'den ayırmak için kullanılabilir. Ayrıca, p16 ekspresyonunun HSIL ve LSIL'ın ayrımında yararlı olduğu sonucuna varılmıştır.

Anahtar Kelimeler:

Ki-67, p16, C-erb-B2, siklin D1, serviks kanseri

The Importance of Ki-67, p16, C-erb-B2, and Cyclin D1 Expressions in LSIL, HSIL, and Cervical Squamous Cell Carcinoma Biopsies

Objective: The squamous cell carcinoma (SCC) of the cervix is the most common malignant tumor of gynecological cancers. Squamous intraepithelial lesions (SILs) are known as a preinvasive lesion. Due to problems in the grading of these lesions that are effective in the development of cervical cancer, immunohistochemical markers are reported to be useful in the differentiation of lesions. In this study, the expression and intensity of the staining pattern of Ki-67, p16, cyclin D1, and c-erb- B2 in HSIL and LSIL cases were investigated.Material and Method: 40 patients with SCC, 40 patients with low grade SIL (LSIL), and 40 patients with high grade SIL (HSIL) who were diagnosed in Department of Pathology of XXX University Medical Faculty between 2003-2011 years were included in this study. C-erb-B2, Ki-67, p16, and cyclin D1 expressions was investigated in the preparations of the patients.Results: C-erb-B2 in 4 cases with SCC (10%), in 6 cases with HSIL (15%), and in 2 cases with LSIL (5%) showed positive staining. There was no statistically significant difference between the three groups (p>0.05). However, in cases with SCC, a strong correlation between c-erb-B2 and the disease stage was observed (p<0.05, r = 0.891). Ki-67 expression was present in average 20% of LSIL cases, average 35% of cases of HSIL, and average 40% of SCC cases. The difference between groups was statistically significant (p<0.05) and due to LSIL. Nuclear staining of cyclin D1 was mainly observed in cases with LSIL, however, cytoplasmic staining was mainly observed in cases with HSIL and SCC. No statistically significant difference between groups was observed with cyclin D1 (p>0.05). p16 expression was found in 39 (97.5%) cases with HSIL, 12 cases (30%) with LSIL. The difference was statistically significant (p<0.05). Conclusion: In conclusion, c-erb-B2 and cyclin D1 expression is not useful in the differentiation of these lesions. However, the Ki-67 may be used to separate LSIL from HSIL and SCC. Also, p16 expression was concluded to be useful in the differentiation of HSIL and LSIL.

Keywords:

Ki-67, p16, C-erb-B2, Cyclin D1, cervical carcinoma,

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