Mesanenin ürotelyal karsinomlarında maspin ekspresyonunun tümör derece ve evresi ile ilişkisi

Abstract

Amaç: Mesanenin ürotelyal karsinomlarında maspin’in immünhistokimyasal yöntemle ekspresyon’u araştırılmış, klinikopatolojik parametreler ile ilişkilerinin incelenmesi amaçlanmıştır.

Giriş: Maspin serpin (serin proteaz inhibitörü) ailesinin bir üyesidir ve çeşitli tümör tiplerinde, tümör büyümesi ve anjiyogenez inhibitörü olduğu ve metastazı baskılayıcı olduğu gösterilmiştir. Mesane tümörlerinde prognozu belirleyen en önemli faktörler, tümörün histolojik derecesi ve evresidir.

Gereç ve Yöntemler: Çalışmaya alınan örnekler, 2005-2011 yılları arasında transüretral rezeksiyon-mesane (TUR-M) yapılarak Gaziantep Üniversitesi Tıp Fakültesi Patoloji Anabilim Dalı tarafından ürotelyal karsinom tanısı almış 67 vakadan oluşuyordu. Vakalar DSÖ/ISUP 2004 derecelendirme sistemine göre 3’ü DMPPÜN, 25’i DDÜK, 39’ı YDÜK olarak sınıflandırıldı. Patolojik evreleme sistemine göre 35 pTa, 17 pT1, 12 pT2, 1 pT3, 2 pT4 vakadan oluşmakta idi. Çalışmamızda histolojik derece ile invazyon ve pT evre arasında anlamlı derecede bir ilişki bulundu. Histolojik derece arttıkça invazyon ve pT evre anlamlı olarak artış göstermekteydi (p=0,001). 

Bulgular: Çalışmamızda 57 (%85,1) tümör olgusu maspin pozitifliği gösterdi. Maspin ekspresyon seviyesine göre 4 olgu (%6) +1, 26 olgu (%38.8) +2, 27 olgu (%40.3) +3 olarak dağılım gösterdi. Maspin pozitifliği istatistiksel olarak anlamlı olmasa da noninvaziv ve düşük dereceli olgularda daha fazla idi. 

Maspin ekspresyon seviyesi dikkate alındığında histolojik derece ve pT evre ile anlamlı ilişkili saptandı (p=0,009, p=0.020). Maspin ekspresyon skoru pT evre ve histolojik derece ile anlamlı negatif korelasyon saptandı (r=-0.283, p=0.020) (r=-0.316, p=0.009). Maspin ekspresyon ile tümör rekürrensi ve tümör nedenli ölüm arasında anlamlı bir korelasyona rastlanmadı (p =0,933,p=0.208).

Sonuç: Mesane ürotelyal karsinomlarında maspin ekspresyonu düşük derece ve evre ile ilişkilidir. Bulgularımız mesane tümörlerinde maspin ekspresyonunun değerlendirilmesinin tümörün davranışının tahmininde yararlı bir prognostik belirleyici olabileceğini düşündürmektedir.

Keywords

• Mesane ürotelyal karsinomu,maspin,immünhistokimya

The relationship of maspin expression with tumor grade and stage in urothelial carcinomas of the urinary bladder

Abstract

Abstract

Object: In this study we aimed to investigate maspin expressions by immunhistochemistry in bladder urothelial carsinomas and to examine the relationship with clinicopathologic parameters.

Introduction: Maspin is a member of the serpin (serine protease inhibitor) family and has been shown to be a suppressor of tumor growth and an inhibitor of angiogenesis as well as metastasis in several types of tumors. The most important factors in determining the prognosis in the urinary bladder tumors are the histological grade and stages. 

Material and Methods: The samples were obtained from the 67 cases underwent transurethral resection-bladder(TUR-B) between the 2005-2011, which diagnosed with urothelial carcinomas at Gaziantep University School of Medicine Department of Pathology. The cases according to the WHO / ISUP 2004 grading system were; 3 PUNLMP, 25 LGUC, 39 HGUC.

Results:They are distributed as 35 pTa, 17 pT1, 12 pT2, 1 pT3, 2 pT4 according to pathologic staging. Histologic grading was significantly related with invasion and pT staging. As the histologic grade was increased, invasion and pT staging were increased significantly (p=0,001). In this study, 57 (%85,1) tumoral cases were positive for maspin. According to maspin expression level, the cases were classified as 4 (%6) 1+, 26 (%38.8) 2+, 27 (%40.3) 3+. Although it was not statistically significant, maspin positivity was higher in noninvasive and low grade tumors. Considering maspin expression level, it was significantly associated with histologic grading and pT staging (p=0,009, p=0.020). Maspin expression score was significantly negatively correlated with pT staging and histologic grading (r=-0.283, p=0.020) (r=-0.316, p=0.009). There was no correlation between the maspin expression and tumor recurrence and tumorrelated death (p =0,933,p=0.208). 

Conclusion:According to our results, maspin expression seems to be related with lower histologic grade and stage in bladder urothelial carsinomas. Our findings suggested that the evaluation of maspin expression in bladder tumors is useful prognostic marker for predicting the tumor behavior.

Keywords

• Bladder Urothelial carcinomas,Maspin,Immunohistochemistry

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