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The presence of dysplasia in patients with ulcerative colitis and p53 and Ki-67 expression in dysplastic mucosa

Yıl 2014, Cilt: 13 Sayı: 2, 41 - 46, 01.08.2014

Öz

Background and Aims:The risk of developing colorectal cancer increases distinctly for more than 8-10 years from the onset of ulcerative colitis. Mortality and morbidity in patients with ulcerative colitis can be decreased with colonoscopic screening methods. The aim of this study was to investigate the presence of dysplasia histopathologically in patients with ulcerative colitis and to determine p53 and Ki-67 expression rates in dysplastic mucosa using immunohistochemical techniques. Materials and Methods: Fifty-two ulcerative colitis patients who were followed clinically while in remission were enrolled into the study. Total colonoscopy was applied to every patient. Biopsies were taken from the colon and rectum every 10 cm. Presence of dysplasia was detected histopathologically in the biopsy samples, and p53 and Ki-67 expression was investigated immunohistochemically in dysplastic samples. Results: The duration of disease was 8 years. On immunohistochemical examination, positive staining for p53 was detected in 6 patients and positive Ki-67 staining in 3 patients. Conclusions: Dysplasia was found at a higher rate in patients with disease duration >8 years and pancolitis. In our study, the presence of dysplasia in patients with disease duration of

Kaynakça

  • Gyde SN, Prior P, Allan RN, et al. Colorectal cancer in ulcerative coli- tis: a cohort study of primary referrals from three centres. Gut 1988; 29:206-17.
  • Broström O, Löfberg R, Nordenvall B, et al. The risk of colorectal cancer in ulcerative colitis. An epidemiologic study. Scand J Gastro- enterol 1987; 22:1193-9.
  • Winther KV, Jess T, Langholz E, et al. Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County. Clin Gastroenterol Hepatol 2004; 2:1088-95.
  • Rutter MD, Saunders BP, Wilkinson KH, et al. Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis. Gastroenterology 2006; 130:1030-8.
  • Jess T, Rungoe C, Peyrin-Biroulet L. Risk of colorectal cancer in pa- tients with ulcerative colitis: a meta-analysis of population-based co- hort studies. Clin Gastroenterol Hepatol 2012; 10:639-45.
  • Söderlund S, Brandt L, Lapidus A, et al. Decreasing time-trends of colorectal cancer in a large cohort of patients with inflammatory bowel disease. Gastroenterology 2009; 136:1561-7
  • Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001; 48:526-35.
  • Rutter M, Saunders B, Wilkinson K, et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenter- ology 2004; 126:451-9.
  • Loftus EV Jr. Epidemiology and risk factors for colorectal dysplasia and cancer in ulcerative colitis. Gastroenterol Clin North Am 2006; 35:517-31.
  • Ha CY, Newberry RD, Stone CD, Ciorba MA. Patients with late-adult- onset ulcerative colitis have better outcomes than those with early onset disease. Clin Gastroenterol Hepatol 2010; 8: 682-7.e1.
  • Eaden J. Review article: colorectal carcinoma and inflammatory bow- el disease. Aliment Pharmacol Ther 2004;20 (Suppl 4):24-30.
  • Farraye FA, Odze RD, Eaden J, et al. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflam- matory bowel disease. Gastroenterology 2010; 138:738-45.
  • Brentnall TA, Haggitt RC, Rabinovitch PS, et al. Risk and natural his- tory of colonic neoplasia in patients with primary sclerosing cholangi- tis and ulcerative colitis. Gastroenterology 1996; 110:331-8.
  • Broomé U1, Löfberg R, Veress B, Eriksson LS. Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential. Hepatology 1995; 22:1404-8.
  • Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation. Am J Physiol Gastrointest Liver Physiol 2004 ; 287:G7-17
  • Lashner BA, Bauer WM, Rybicki LA, Goldblum JR. Abnormal p53 immunohistochemistry is associated with an increased colorectal cancer-related mortality in patients with ulcerative colitis. Am J Gas- troenterol 2003; 98:1423-7.
  • Andersen SN, Rognum TO, Bakka A, Clausen OP. Ki-67: a useful marker for the evaluation of dysplasia in ulcerative colitis. Mol Pathol 1998; 51:327-32.
  • Fratila OC, Iliaş TI. COX-2 and Ki-67 immunohistochemical markers in the assessment of long-standing ulcerative colitis associated dyspla- sia. Rom J Morphol Embryol 2013; 54:143-9.
  • Bosman FT, Carneiro F, Hruban RH, et al. WHO classification of tu- mours of the digestive system. Switzerland: IARC 2010; 10-2.
  • Biancone L, Michetti P, Travis S, et al. European evidence-based Con- sensus on the management of ulcerative colitis: Special situations. J Crohns Colitis 2008; 2:63-92.
  • Farraye FA, Odze RD, Eaden J, Itzkowitz SH. AGA technical review on the diagnosis and management of colorectal neoplasia in inflamma- tory bowel disease. Gastroenterology 2010; 138:746-74
  • Obrador A, Ginard D, Barranco L. Review article: colorectal cancer surveillance in ulcerative colitis – what should we be doing? Aliment Pharmacol Ther 2006; 24:56-63.
  • Collins PD, Mpofu C, Watson AJ, Rhodes JM. Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease. Cochrane Database Syst Rev 2006; 2:CD000279.
  • Riddell RH, Goldman H, Ransohoff DF, et al. Dysplasia in inflamma- tory bowel disease: standardized classification with provisional clini- cal applications. Hum Pathol 1983; 14:931-68.
  • Lutgens MW, Vleggaar FP, Schipper ME, et al. High frequency of early colorectal cancer in inflammatory bowel disease. Gut 2008; 57:1246-51.
  • Winawer S, Fletcher R, Rex D, et al, Gastrointestinal Consortium Pan- el. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology 2003; 124:544-60
  • Eaden JA, Mayberry JF; British Society for Gastroenterology; Asso- ciation of Coloproctology for Great Britain and Ireland. Guidelines for screening and surveillance of asymptomatic colorectal cancer in pa- tients with inflammatory bowel disease. Gut 2002; 51 (Suppl 5):V10-2.
  • Wong NA, Mayer NJ, MacKell S, et al. İmmunohistochemical assess- ment of Ki67 and p53 expression assists the diagnosis and grading of ulcerative colitis-related dysplasia. Histopathology. 2000 ;37:108-14
  • Carson DA, Lois A. Cancer progression and p53. Lancet 1995; 346:1009-11.

Ülseratif kolitli hastalarda displazi varlığı ve displastik mukozada p53 ve Ki-67 ekspresyonu

Yıl 2014, Cilt: 13 Sayı: 2, 41 - 46, 01.08.2014

Öz

Giriş ve Amaç: Ülseratif kolitin başlangıcından 8-10 yıl sonra kolorektal
kanser gelişim riski artar. Ülseratif kolit hastalarının kansere bağlı
mortalite ve morbiditesi kolonoskopik tarama yöntemleriyle azaltılabilir.
Bu çalışmanın amacı; ülseratif kolit hastalarında histopatolojik olarak
displazi varlığını araştırmak ve immünohistokimyasal tekniklerle displastik
mukozada p53 ve Kİ-67 ekspresyon oranlarını belirlemektir. Gereç
ve Yöntem: Çalışmaya klinik olarak remisyonda olan 52 ülseratif kolit
hastası alındı. Tüm hastalara total kolonoskopi uygulandı ve çekuma kadar
girildi. Kolondan rektuma kadar 10 cm’de bir dört kadran biyopsiler
alındı. Displazi varlığı biyopsi örneklerinde histopatolojik olarak tespit
edildi ve displazi saptanan hastalarda immünohistokimyasal olarak p53
ve Ki-67 ekspresyonu varlığı araştırıldı. Bulgular: Hastaların 32’sinde
hastalık süresi 8 yıldan az, 20’sinde ise 8 yıl ve üzerindeydi. Hastaların
hepsi klinik olarak remisyonda olmasına rağmen endoskopik olarak sadece
%59,6’ı remisyondaydı. Hastalık %44,2 sol kolon ve %55,8 pankolit
yerleşimliydi. Displazi 52 ülseratif kolit hastasının 9’unda (%17,5)
saptandı. Hastalık lokalizasyonu 6 hastada pankolit, 3 hastada ise sol
kolon yerleşimliydi. Displazi, hastalık süresi 8 yıldan fazla olan hastalarda
yüksek saptandı. İmmünohistokimyasal inceleme ile p53 için pozitif
boyanma 6 hastada, Ki-67 boyanması 3 hastada görüldü. Sonuç:
Displazi hastalık süresi 8 yıl ve üzeri olanlarda ve pankolitli olgularda
daha fazla saptanmıştır. Çalışmamızda hastalık süresi 8 yıldan daha az
olanlarda da displazi saptanması, tarama programına erken başlanmalı
mı sorusunu akla getirmektedir.

Kaynakça

  • Gyde SN, Prior P, Allan RN, et al. Colorectal cancer in ulcerative coli- tis: a cohort study of primary referrals from three centres. Gut 1988; 29:206-17.
  • Broström O, Löfberg R, Nordenvall B, et al. The risk of colorectal cancer in ulcerative colitis. An epidemiologic study. Scand J Gastro- enterol 1987; 22:1193-9.
  • Winther KV, Jess T, Langholz E, et al. Long-term risk of cancer in ulcerative colitis: a population-based cohort study from Copenhagen County. Clin Gastroenterol Hepatol 2004; 2:1088-95.
  • Rutter MD, Saunders BP, Wilkinson KH, et al. Thirty-year analysis of a colonoscopic surveillance program for neoplasia in ulcerative colitis. Gastroenterology 2006; 130:1030-8.
  • Jess T, Rungoe C, Peyrin-Biroulet L. Risk of colorectal cancer in pa- tients with ulcerative colitis: a meta-analysis of population-based co- hort studies. Clin Gastroenterol Hepatol 2012; 10:639-45.
  • Söderlund S, Brandt L, Lapidus A, et al. Decreasing time-trends of colorectal cancer in a large cohort of patients with inflammatory bowel disease. Gastroenterology 2009; 136:1561-7
  • Eaden JA, Abrams KR, Mayberry JF. The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 2001; 48:526-35.
  • Rutter M, Saunders B, Wilkinson K, et al. Severity of inflammation is a risk factor for colorectal neoplasia in ulcerative colitis. Gastroenter- ology 2004; 126:451-9.
  • Loftus EV Jr. Epidemiology and risk factors for colorectal dysplasia and cancer in ulcerative colitis. Gastroenterol Clin North Am 2006; 35:517-31.
  • Ha CY, Newberry RD, Stone CD, Ciorba MA. Patients with late-adult- onset ulcerative colitis have better outcomes than those with early onset disease. Clin Gastroenterol Hepatol 2010; 8: 682-7.e1.
  • Eaden J. Review article: colorectal carcinoma and inflammatory bow- el disease. Aliment Pharmacol Ther 2004;20 (Suppl 4):24-30.
  • Farraye FA, Odze RD, Eaden J, et al. AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflam- matory bowel disease. Gastroenterology 2010; 138:738-45.
  • Brentnall TA, Haggitt RC, Rabinovitch PS, et al. Risk and natural his- tory of colonic neoplasia in patients with primary sclerosing cholangi- tis and ulcerative colitis. Gastroenterology 1996; 110:331-8.
  • Broomé U1, Löfberg R, Veress B, Eriksson LS. Primary sclerosing cholangitis and ulcerative colitis: evidence for increased neoplastic potential. Hepatology 1995; 22:1404-8.
  • Itzkowitz SH, Yio X. Inflammation and cancer IV. Colorectal cancer in inflammatory bowel disease: the role of inflammation. Am J Physiol Gastrointest Liver Physiol 2004 ; 287:G7-17
  • Lashner BA, Bauer WM, Rybicki LA, Goldblum JR. Abnormal p53 immunohistochemistry is associated with an increased colorectal cancer-related mortality in patients with ulcerative colitis. Am J Gas- troenterol 2003; 98:1423-7.
  • Andersen SN, Rognum TO, Bakka A, Clausen OP. Ki-67: a useful marker for the evaluation of dysplasia in ulcerative colitis. Mol Pathol 1998; 51:327-32.
  • Fratila OC, Iliaş TI. COX-2 and Ki-67 immunohistochemical markers in the assessment of long-standing ulcerative colitis associated dyspla- sia. Rom J Morphol Embryol 2013; 54:143-9.
  • Bosman FT, Carneiro F, Hruban RH, et al. WHO classification of tu- mours of the digestive system. Switzerland: IARC 2010; 10-2.
  • Biancone L, Michetti P, Travis S, et al. European evidence-based Con- sensus on the management of ulcerative colitis: Special situations. J Crohns Colitis 2008; 2:63-92.
  • Farraye FA, Odze RD, Eaden J, Itzkowitz SH. AGA technical review on the diagnosis and management of colorectal neoplasia in inflamma- tory bowel disease. Gastroenterology 2010; 138:746-74
  • Obrador A, Ginard D, Barranco L. Review article: colorectal cancer surveillance in ulcerative colitis – what should we be doing? Aliment Pharmacol Ther 2006; 24:56-63.
  • Collins PD, Mpofu C, Watson AJ, Rhodes JM. Strategies for detecting colon cancer and/or dysplasia in patients with inflammatory bowel disease. Cochrane Database Syst Rev 2006; 2:CD000279.
  • Riddell RH, Goldman H, Ransohoff DF, et al. Dysplasia in inflamma- tory bowel disease: standardized classification with provisional clini- cal applications. Hum Pathol 1983; 14:931-68.
  • Lutgens MW, Vleggaar FP, Schipper ME, et al. High frequency of early colorectal cancer in inflammatory bowel disease. Gut 2008; 57:1246-51.
  • Winawer S, Fletcher R, Rex D, et al, Gastrointestinal Consortium Pan- el. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology 2003; 124:544-60
  • Eaden JA, Mayberry JF; British Society for Gastroenterology; Asso- ciation of Coloproctology for Great Britain and Ireland. Guidelines for screening and surveillance of asymptomatic colorectal cancer in pa- tients with inflammatory bowel disease. Gut 2002; 51 (Suppl 5):V10-2.
  • Wong NA, Mayer NJ, MacKell S, et al. İmmunohistochemical assess- ment of Ki67 and p53 expression assists the diagnosis and grading of ulcerative colitis-related dysplasia. Histopathology. 2000 ;37:108-14
  • Carson DA, Lois A. Cancer progression and p53. Lancet 1995; 346:1009-11.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Mehmet Bektaş Bu kişi benim

Berna Savaş Bu kişi benim

Hülya Çetınkaya Bu kişi benim

Murat Törüner Bu kişi benim

Arzu Ensarı Bu kişi benim

Beyza Doğanay - Bu kişi benim

İrfan Soykan Bu kişi benim

Ali Tüzün Bu kişi benim

Çağdaş Kalkan Bu kişi benim

Ali Özden Bu kişi benim

Murat Palabıyıkoğlu Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2014
Yayımlandığı Sayı Yıl 2014 Cilt: 13 Sayı: 2

Kaynak Göster

APA Bektaş, M., Savaş, B., Çetınkaya, H., Törüner, M., vd. (2014). Ülseratif kolitli hastalarda displazi varlığı ve displastik mukozada p53 ve Ki-67 ekspresyonu. Akademik Gastroenteroloji Dergisi, 13(2), 41-46. https://doi.org/10.17941/agd.92111

test-5