Seröz Ve Müsinöz Over Kanserleri İle Ki-67 İlişkisi

Öz

Amaç: Ki-67, tümör içerisindeki prolifere hücreleri gösterebilen bir antikordur. Ki67 fraksiyonunun daha yüksek olduğu tümörler, daha agresif seyretme eğilimindedirler ve bu vakalarda vasküler invazyona, kötü proliferasyona ve metastaza daha sık rastlanır. Bu çalışmada kolorektal ve mesane karsinomlarında proliferasyon belirteci olarak kullanılan Ki67’nin seröz ve müsinöz over kanserlerinde tümör proliferatif indeksi olarak kullanılabilirliği ve prognoza etkisinin incelenmesi amaçlanmıştır.Yöntem: Bu çalışmada, 1996-2000 yılları arasında, yaşları 17-82 arasında, jinekolojik onkoloji kliniğinde opere edilen, patolojik olarak seröz veya müsinöz over karsinomu tanısı alan 51 olgu değerlendirilmiştir. Patolojideki materyaller rutin doku takip işlemlerinden geçirildikten sonra hazırlanan parafin bloklardan 5 mm’lik kesitler yapılmış ve hematoksilen eozinle HE boyanarak değerlendirilmiştir. Operasyon sonrası alınan tümör örneklerinin rutin patolojik işlemlerden sonra streptoavidin-biotin ortamında primer antikorlar ile Ki-67 immünreaktivitesi değerlendirilmiştir. Bulgular: Patolojik olarak seröz over karsinomu tanısı alan 29 olgu ve müsinöz over karsinomu tanısı alan 22 olgu, stage, grade ve lenf nodu tutulumu açısından değerlendirilmiştir. Seröz tümörlerin % 48’i n=14 Ki67 pozitif saptanırken, müsinöz tümörlerde % 68 n=15 Ki 67 pozitifliği saptanmıştır. Seröz tümörlerde Ki-67 indeksi 13,05; müsinöz tümörlerde ise 22,2 olarak tespit edilmiştir p=0,072 . Tümörün histolojik tipi ile Ki-67 indeksleri arasında korelasyon saptanamamıştır. Ki-67 immünoreaktivitesi ile seröz ve müsinöz over karsinomları arasında stage, grade ve lenf nodu tutulumu ilişkisi araştırılmıştır. Stage artışına paralel olarak Ki-67 reaktivitesi artarken p0.05 .Sonuç: Seröz ve müsinöz karsinomların stage’i artıkça Ki-67 immünreaktivitesi ve proliferatif indekslerinin arttığı bulunmuştur. Buna karşın grade, lenf nodu tutulumu ve histolojik tümör tipi ile Ki-67 reaktivitesi arasında bağlantı saptanmamıştır. Bu bulgular eşliğinde seröz ve müsinöz over kanserlerinde proliferasyon markeri olarak Ki-67 ekspresyonu kullanımının duyarlı bir yöntem olmadığı sonucuna varılmıştır. Seröz ve müsinöz over kanserlerinde proliferasyon markeri olarak Ki-67 kullanımı uygun görülmemekle beraber daha geniş sayıda randomize çalışmaya gerek bulunmaktadır

Anahtar Kelimeler

• Seröz over karsinomu, müsinöz over karsinomu, Ki-67, proliferasyon indeksi

Correlation Between Ki-67 and Serous-Mucinous Ovarian Carcinomas

Abstract

Objective: Ki 67 is a antibody which could be showed proliferation in the cells. High Kİ 67 expression of some tumors have been more aggressive clinical progression, poor prognosis, more vascular invasion and more metastasis than Ki 67 negative tumors. In this study, it was aimed to determine the possibility of using Ki-67, which shows proliferation in serous and mucinous ovarian tumors, as a tumor proliferation index and effect on prognosis.Method: The correlation between Ki-67 and primary antibodies was examined in 51 cases, ages 17-82, which were in the period 1996-2000 pathologically diagnosed, by the routine processes of the pathological preparates in streptoavidin-biotin environment, to have serous and mucinous ovarian carcinomas. Pathologic determination was made Hematoxlene Eosine painting after the routine preparing. Results: It were diagnosed as serous n=29 and musinous n=22 which was determined according to stage, grade and lymph node involment. Ki 67 seropositivity was estabilished in 48 % n=14 of serous and 68 % n=15 of musinous tumors. Ki 67 indexes were found 13,05 in serous and 22,2 in musinous ovarian tumors p=0,072 . There was no correlation between tumour histology and Ki 67 indexes. Correlations between immunoreactivity of Ki-67 and the stage, grade and lymph node metastasis in serous and mucinous ovarian carcinoma were determined. Ki-67 indexes were increased as tumor stage was increased p0.05 .Conclusion: It was determined that as the stage of the serous and mucinous ovarian carcinomas are increased, Ki67 immunoreactivity and proliferation index are also increased. On the other hand, grade, lymph node involvement and histological tumor type were not correlated with Ki-67 reactivity. As a result, Ki-67 can not be used as a sensitive tumor proliferation index in serous and mucinous ovarian carcinomas. It isn’t found suitable that Ki 67 as proliferation marker in ovarian serous and musinous tumors but It needs to more widely randomized study about this issue

Keywords

• Serous ovarian carcinomas, mucinous ovarian carcinomas, Ki-67, proliferation index

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