Epitelyal Over Kanserinde Retroperitoneal Lenf Nodu Metastazı Etkileyen Faktörlerin Araştırılması

Year 2017, Volume: 20 Issue: 2, 13 - 22, 08.03.2019

Hediye Dağdeviren , Ali İsmet Tekirdağ Özgür Akbayır

Abstract

Amaç: Bu çalışmada, epitelyal over kanserli hastalarda lenf nodu tutulumu ile ilişkili faktörleri araştırıldı. Over kanserinin önemli
yayılım yollarından biri lenfatik yayılımdır. Bu tip yayılım sıklıkla ileri evrelerde görülür. Bu nedenle, over kanserinde lenf nodu
tutulumunu etkileyen faktörlerin belirlenmesi ve bu faktörlere yönelik yeni tedavi yöntemlerinin geliştirilmesi için elzemdir.
Gereç ve Yöntem: Çalışmamızda, son 10 yıl içerisinde Bakırköy Jinekoloji ve Pediatri eğitimi araştırma hastanesine başvuran ve
opere edilen over kanseri olgularını değerlendirildi ve tek merkezli ve homojen bir hasta grubunda klinik ve patolojik faktörler
olası lenf nodu tutulumu açısından araştırıldı.
Bulgular: Buna göre, preoperatif CA-125 protein seviyesi lenf nodu negatif olan hastalarda (469±954), pozitif olanlara göre
(1307±2937) anlamlı olarak daha düşük bulundu (p=0,004 <0,05). Ayrıca, CA-125 değeri ile hastalığın cerrahi evresi arasında
istatistiksel olarak anlamlı bir ilişki saptandı ve CA-125 düzeyi artışı ile lenf nodu tutulumunun arttığı tespit edildi (p<0.04). Bunun
yanında, preoperatif CA-125 yüksekliği ve omentum tutulumu ile lenf nodu tutulumu arasında pozitif ilişki tespit edildi, ancak
tümör histolojisi ve grade ile lenf nodu tutulumu arasında herhangi bir ilişki bulunmadı.
Sonuçlar: Çalışmadan elde edilen bulgular ışığında; Epitelyal over kanserinde lenfatik tutulum varlığı 5 yıllık sağ kalım açısından
önemli olduğu ve evre artışı ile lenfatik tutulum arasında pozitif korelasyon olduğu tespit edildi. Bu konuda yürütülecek tüm
risk faktörlerinin bir arada değerlendirildiği geniş serili çalışmalarla lenf nodu tutulumuna etki eden faktörlerin histopatolojik ve
moleküler etkileri aydınlatılabilir. 

Keywords

Over kanseri, lenf nodları, metastaz

The Investigation of The Factors Affecting Retroperitoneal Lymph Node Metastasis In Epithelial Ovarian Cancer

Abstract

Objective: In this study, the factors associated with lymph node involvement in patients with epithelial ovarian cancer were investigated. One of the major spreading ways of ovarian cancer is lymphatic spread. This type of spread is often seen in advanced
stages. Therefore, it is essential to determine the factors aff ecting lymph node involvement in ovarian cancer and to develop new
treatment methods for these factors.
Material and Method: In our study, the ovarian cancer cases who were admitted to Bakırköy Gynecology and Pediatrics Education Research Hospital and operated in the last 10 years were evaluated and clinical and pathological factors in terms of possible
lymph node involvement in a single-centered and homogeneous patient group were investigated.
Results: Accordingly, pre-operative CA-125 protein levels were signifi cantly determined lower in patients with negative lymph
node (469 ± 954) than those with positive lymph node (1307 ± 2937) (p = 0.004 <0.05). In addition, a statistically signifi cant relationship was detected between CA-125 value and the surgical stage of the disease and lymph node involvement was determined
to be increased with the increase in CA-125 level (p <0.04). Besides, a positive relationship was determined between high preoperative CA-125 levels and omentum involvement and lymph node involvement, but no relationship was found between tumor
histology and grade and lymph node involvement.
Conclusion: In the light of the fi ndings obtained from the study; it was detected that the presence of lymphatic involvement in
epithelial ovarian cancer was important for 5-year survival and that there was a positive correlation between the stage increase
and lymphatic involvement. The histopathological and molecular eff ects of factors aff ecting lymph node involvement can be
enlightened by a large series of studies in which all risk factors in this regard are evaluated together. 

Keywords

Ovarian cancer, Lymph node, Metastasis

References

• 1. Ayhan A. Epiteliyal over kanserleri. Jinekolojik Onkoloji 2002. p. 133.
• 2. DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, et al. Cancer treatment and survivorship statistics, 2014. CA: a cancer journal for clinicians2014;64:252-71.
• 3. Quirk JT, Natarajan N. Ovarian cancer incidence in the United States, 1992-1999. Gynecologic oncology2005;97:519-23.
• 4. Smith EM, Anderson B. The effects of symptoms and delay in seeking diagnosis on stage of disease at diagnosis among women with cancers of the ovary. Cancer1985;56:2727-32.
• 5. Yancik R, Ries LG, Yates JW. Ovarian cancer in the elderly: an analysis of Surveillance, Epidemiology, and End Results Program data. American journal of obstetrics and gynecology1986;154:639-47.
• 6. Zhang M, Lee AH, Binns CW. Reproductive and dietary risk factors for epithelial ovarian cancer in China. Gynecologic oncology2004;92:320-6.
• 7. Fathalla MF. Incessant ovulation--a factor in ovarian neoplasia? Lancet1971;2:163.
• 8. Vine MF, Calingaert B, Berchuck A, Schildkraut JM. Characterization of prediagnostic symptoms among primary epithelial ovarian cancer cases and controls. Gynecologic oncology2003;90:75-82.
• 9. Olson SH, Mignone L, Nakraseive C, Caputo TA, Barakat RR, Harlap S. Symptoms of ovarian cancer. Obstetrics and gynecology2001;98:212-7.
• 10. Levi F, Franceschi S, La Vecchia C, Ruzicka J, Gloor E, Randimbison L. Epidemiologic pathology of ovarian cancer from the Vaud Cancer Registry, Switzerland. Annals of oncology : official journal of the European Society for Medical Oncology1993;4:289-94.
• 11. Katsube Y, Berg JW, Silverberg SG. Epidemiologic pathology of ovarian tumors: a histopathologic review of primary ovarian neoplasms diagnosed in the Denver Standard Metropolitan Statistical Area, 1 July-31 December 1969 and 1 July-31 December 1979. International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists1982;1:3-16.
• 12. Bast RC, Jr., Klug TL, St John E, Jenison E, Niloff JM, Lazarus H, et al. A radioimmunoassay using a monoclonal antibody to monitor the course of epithelial ovarian cancer. The New England journal of medicine1983;309:883-7.
• 13. Saygili U, Guclu S, Uslu T, Erten O, Demir N, Onvural A. Can serum CA-125 levels predict the optimal primary cytoreduction in patients with advanced ovarian carcinoma? Gynecologic oncology2002;86:57-61.
• 14. Chi DS, Venkatraman ES, Masson V, Hoskins WJ. The ability of preoperative serum CA-125 to predict optimal primary tumor cytoreduction in stage III epithelial ovarian carcinoma. Gynecologic oncology2000;77:227-31.
• 15. Kamura T, Jeon JD. Lymph node metastasis in a gynecologic malignancy. Yonsei medical journal2002;43:783-91.
• 16. Merino MJ, Jaffe G. Age contrast in ovarian pathology. Cancer1993;71:537-44.
• 17. Bidzinski M, Radziszewski J, Panek G, Danska-Bidzinska A. [Risk of lymph node metastases in patients with ovarian cancer]. Ginekologia polska2003;74:671-6.
• 18. Chen SS, Lee L. Incidence of para-aortic and pelvic lymph node metastases in epithelial carcinoma of the ovary. Gynecologic oncology1983;16:95-100.
• 19. Tsuruchi N, Kamura T, Tsukamoto N, Akazawa K, Saito T, Kaku T, et al. Relationship between para-aortic lymph node involvement and intraperitoneal spread in patients with ovarian cancer--a multivariate analysis. Gynecologic oncology1993;49:51-5