Akciğer adenokarsinomu, akciğer skuamöz hücreli karsinomu ve plevral mezotelyoma olgularında BCL-2 ve survivin ekspresyonunun değerlendirilmesi
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Tarih
2021
Yazarlar
Dergi Başlığı
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Cilt Başlığı
Yayıncı
Kırıkkale Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Dünyada, akciğer karsinomu ve plevral mezotelyoma sıklığı giderek artmakta ve yılda yaklaşık 2,2 milyon yeni akciğer karsinomu vakası ile 14.200 yeni plevral mezotelyoma vakasının olduğu bildirilmektedir. Programlanmış hücre ölümünde ortaya çıkan anormallikler karsinomların oluşumunda ve progresyonunda önemli rol oynar. Genetik yolaklarla düzenlenen programlı hücre ölümünde yolakların çalışma ve kontrol edilme süreçlerinde oluşacak bozulmalar kontrolsüz hücre büyümesine ve tümör gelişimine neden olur. Söz konusu süreçlerde görev alan bcl-2, apopitozu inhibe ederek programlı hücre ölümüne engel olduğu tespit edilmiş ilk proteindir. Survivin ise apopitozu düzenleyen öneml b r prote n ailesinin mensubu olup, belirlenen ilk inhibitörlerden biridir. Çalışmamızda, akciğer adenokarsinomu, skuamöz hücreli karsinom (SHK) ve plevral mezotelyomalarda, survivin ve bcl-2 ekspresyonları ve tümörü infiltre eden lenfositlerin (TIL) progresyondaki rollerinin incelenmesi amaçlandı. Ayrıca, klinikopatolojik parametrelerle söz konusu belirteçlerin karşılaştırılması da hedeflenmiştir. Metod: Bu çalışmada akciğer adenokarsinomu, SHK ve plevral mezotelyomada immunohistokimyasal bcl-2 ve survivin ekspresyonları, TIL varlığı ve TIL'lerde bcl-2 ekspresyonu araştırıldı. Elde edilen verilerin klinikopatolojik parametrelerle karşılaştırılması ve immun belirteçlerin korelasyonları değerlendirilmiştir. Bulgular: Çalışma grupları; 29 akciğer adenokarsinomu, 18 SHK, 10 plevral mezotelyoma ve kontrol grubu olarak 12 normal akciğer parankiminden oluşmaktadır. Solid tip adenokarsinomlarda asiner tipe göre LVİ, plevral invazyon ve lenf nodu metastazı yüksek saptandı (sırasıyla p=0,001, p<0,001, p=0,039). Adenokarsinom grubunda, plevra invazyonu bulunmayan olgularda invazyon bulunanlara göre daha yüksek TIL varlığı tespit edilmiştir (p=0,013). SHK grubunda, adenokarsinom grubuna göre anlamlı şekilde daha yüksek TIL varlığı saptandı (p=0,04). İleri evredeki SHK'da TIL'lerin anlamlı ölçüde azaldığı izlenmiştir (p=0,004). SHK'da TIL'lerdeki bcl-2 ekspresyonu, evre I olan olgularda evre II-III'e göre daha fazla saptandı (p=0,045). SHK'da survivin ile TIL'lerdeki bcl-2 ekspresyonu arasında pozitif korelasyon tespit edilmiştir (p=0,001, rho=0,693). SHK'da survivin ile TIL'lerde bcl-2 koekspresyonu bulunan olguların, daha düşük pT (p=0,025) ve daha düşük klinik evrede (p=0,019) bulundukları saptanmıştır. TIL'lerdeki bcl-2 ekspresyonu adenokarsinom grubunda 70 yaş üzeri olgularda daha az (p=0,01) ve erkeklerde daha fazla (p=0,04) olarak bulundu. Adenokarsinom ve plevral mezotelyoma arasında survivin ile TIL'lerdeki bcl-2 ekspresyonu arasında korelasyon saptanmamıştır. Gruplar arasında, tümörde survivin ile bcl-2 ekspresyonu bakımından anlamlı fark saptanmamıştır. Normal akciğer parankiminde her iki belirteç ile ekspresyon izlenmemiştir. Sonuç: Elde ettiğimiz bulgular bir arada değerlendirildiğinde, erken evre SHK olgularında bcl-2 bakımından pozitif TIL varlığının yüksek düzeyde saptanmış olması ayrıca tümörde survivin ve TIL'de bcl-2 koekspresyonlarının tespit edilmiş olmaları söz konusu belirteçlerin SHK'da iyi bir prognostik faktör olabileceğini düşündürmektedir.
Objective: The incidence of lung carcinoma and pleural mesothelioma is increasing in the world, and it is reported that there are approximately 2.2 million new lung carcinoma cases and 14,200 new pleural mesothelioma cases annually. Abnormalities that occur in programmed cell death play an important role in the formation and progression of carcinomas. In programmed cell death, which is regulated by genetic pathways, disruptions in the working and controlling processes of pathways cause uncontrolled cell growth and tumor development. Bcl-2, which is involved in these processes, is the first protein found to prevent apoptosis by inhibiting programmed cell death. Survivin, on the other hand, is a member of an important protein family that regulates apoptosis and is one of the first inhibitors identified. In our study, it was aimed to examine the roles of survivin and bcl-2 expressions and tumor-infiltrating lymphocytes (TIL) in progression in lung adenocarcinoma, squamous cell carcinoma (SCC) and pleural mesotheliomas. In addition, it was aimed to compare the clinicopathological parameters with the aforementioned markers. Methods: In this study, the expression of bcl-2 and survivin in lung adenocarcinoma, squamous cell carcinoma (SHC) and pleural mesothelioma was examined, as well as the presence of tumor-infiltrating lymphocytes (TIL) and bcl-2 expression in TILs were investigated. Comparison of the obtained data with clinicopathological parameters and correlations of immune markers were evaluated. Results: Working groups; 29 lung adenocarcinomas, 18 SCCs, 10 pleural mesotheliomas and 12 normal lung parenchyma as the control group. LVI, pleural invasion and lymph node metastasis were higher in solid type adenocarcinomas compared to acinar type (p=0.001, p<0.001, p=0.039, respectively). TIL was found to be higher in the adenocarcinoma group than in the cases without pleural invasion (p=0.013). We found significantly higher TIL in the SCC group than in the adenocarcinoma group (p=0.04). TIL was significantly lower in advanced tumors in the SCC group (p=0.004). Bcl-2 expression in TILs in SCC was found to be higher in patients with stage I than stage II-III (p=0.045). A positive correlation was found between survivin and bcl-2 expression in TILs in SCC (p=0.001, rho=0.693). In addition, cases with simultaneous expression of survivin in SCC and bcl-2 in TILs had lower pT (p=0.025) and lower clinical stage (p=0.019). Bcl-2 expression in TILs was found to be lower in the adenocarcinoma group in cases over 70 years of age (p=0.01) and higher in males (p=0.04). No correlation was found between survivin and bcl-2 expression in TILs between adenocarcinoma and pleural mesothelioma. In addition, no significant difference was found between the groups in terms of survivin and bcl-2 expression in the tumor. Expression of both markers was not observed in normal lung parenchyma. Conclusion: When our findings were evaluated together, the high level of bcl-2 positive TIL in SCC cases and the detection of survivin in the tumor and bcl-2 coexpression in TIL made us think that these markers may be a good prognostic factor in early stage SCC.
Objective: The incidence of lung carcinoma and pleural mesothelioma is increasing in the world, and it is reported that there are approximately 2.2 million new lung carcinoma cases and 14,200 new pleural mesothelioma cases annually. Abnormalities that occur in programmed cell death play an important role in the formation and progression of carcinomas. In programmed cell death, which is regulated by genetic pathways, disruptions in the working and controlling processes of pathways cause uncontrolled cell growth and tumor development. Bcl-2, which is involved in these processes, is the first protein found to prevent apoptosis by inhibiting programmed cell death. Survivin, on the other hand, is a member of an important protein family that regulates apoptosis and is one of the first inhibitors identified. In our study, it was aimed to examine the roles of survivin and bcl-2 expressions and tumor-infiltrating lymphocytes (TIL) in progression in lung adenocarcinoma, squamous cell carcinoma (SCC) and pleural mesotheliomas. In addition, it was aimed to compare the clinicopathological parameters with the aforementioned markers. Methods: In this study, the expression of bcl-2 and survivin in lung adenocarcinoma, squamous cell carcinoma (SHC) and pleural mesothelioma was examined, as well as the presence of tumor-infiltrating lymphocytes (TIL) and bcl-2 expression in TILs were investigated. Comparison of the obtained data with clinicopathological parameters and correlations of immune markers were evaluated. Results: Working groups; 29 lung adenocarcinomas, 18 SCCs, 10 pleural mesotheliomas and 12 normal lung parenchyma as the control group. LVI, pleural invasion and lymph node metastasis were higher in solid type adenocarcinomas compared to acinar type (p=0.001, p<0.001, p=0.039, respectively). TIL was found to be higher in the adenocarcinoma group than in the cases without pleural invasion (p=0.013). We found significantly higher TIL in the SCC group than in the adenocarcinoma group (p=0.04). TIL was significantly lower in advanced tumors in the SCC group (p=0.004). Bcl-2 expression in TILs in SCC was found to be higher in patients with stage I than stage II-III (p=0.045). A positive correlation was found between survivin and bcl-2 expression in TILs in SCC (p=0.001, rho=0.693). In addition, cases with simultaneous expression of survivin in SCC and bcl-2 in TILs had lower pT (p=0.025) and lower clinical stage (p=0.019). Bcl-2 expression in TILs was found to be lower in the adenocarcinoma group in cases over 70 years of age (p=0.01) and higher in males (p=0.04). No correlation was found between survivin and bcl-2 expression in TILs between adenocarcinoma and pleural mesothelioma. In addition, no significant difference was found between the groups in terms of survivin and bcl-2 expression in the tumor. Expression of both markers was not observed in normal lung parenchyma. Conclusion: When our findings were evaluated together, the high level of bcl-2 positive TIL in SCC cases and the detection of survivin in the tumor and bcl-2 coexpression in TIL made us think that these markers may be a good prognostic factor in early stage SCC.
Açıklama
Tıp Fakültesi, Tıbbi Patoloji Ana Bilim Dalı
Anahtar Kelimeler
Patoloji, Pathology
