The correlation with prognostic factors of bcl-2 and cathepsin D in invasive ductal carcinomas

Yıl 2018, Cilt: 2 Sayı: 3, 186 - 218, 12.11.2018

Mustafa Kösem İbrahim Gelincik , İrfan Bayram , Mehmet Çetin Kotan Ayhan Yıldırım

Öz

Introduction: Invasive ductal carcinoma which
is cancers of the breast is the most common cancer of the breast in women. In this
tumors, early diagnosis and appropriate medical treatment is to influence
markedly to life span. For this reason, cancers of the breast is occured
intesify at therapy with chemotherapotic agents and hormonal treatment for the
purpose of prevention systemic spread and prognosis determination of works in
the last years. Just reliable determinatives are necessary, because of not to
be adequate to orientate treatment and prognosis only classıc parameters. For
this reason, it was evaluated the correlation with each other and other
prognostic factors of bcl-2 and cathepsin D in invasive ductal carcinomas of
the breast in the present study.

Materials and methods: In the present study. it
was included 50 cases diagnosed with invasive ductal carcinoma and examined
mastectomy and axillary dissection material. Slides stained  with estrogen, progesterone and c-erbB-2 were
reviewed again and done scoring separately for each slide.Also in the present
study it was stained bcl-2 and cathepsin D expression in 50 invasive ductal
carcinomas by immünhistochemistry, and evaluated the correlation with other
prognostic factors and each other.

Results: A strong positive relationship was not
detected between bcl-2 expression with other prognostic factors and cathepsin D
protein, while a strong positive relationship was detected between bcl-2
expression with low nuclear grade and progesterone receptor’ status. A strong
correlation was not observed between cathepsin D expression with oestrogen
receptor’ status and progesterone receptor’ status and c-erbB-2 oncogene
amplification and other prognostic factors, while a strong correlation was also
observed between cathepsin D expression with high nuclear grade and blood
vessel invasion and lymph-vessel invasion and perineural invasion.

Conclusion: Bcl-2 is thought to be important in
determining of invasive ductal carcinoma cases with low grade, while cathepsin
D is thought to be important in determining of invasive ductal carcinoma cases
with high grade and invasion ability. 

Anahtar Kelimeler

Invasive ductal carcinoma, Bcl-2, Cathepsin D, Immunohistochemistry

İnvaziv duktal karsinomlarda bcl 2 ve katepsin D’nin prognostik faktörlerle ilişkisi

Öz

GİRİŞ

Meme
kanserlerinden invaziv duktal karsinom, kadınlarda en sık görülen meme
kanseridir. Bu tümörlerde erken tanı ve uygun tedavi yaşam süresini önemli
ölçüde etkilemektedir. Bu nedenle son yıllardaki çalışmaların, meme kanserlerinde prognozu belirleme ve sistemik
yayılımı önleme amacıyla hormonal ve kemoterapötik ajanlarla tedavide
yoğunlaştığı görülmektedir. Sadece klasik parametrelerin prognozu ve tedaviyi
yönlendirmede yeterli olmaması nedeniyle yeni, güvenilir belirleyicilere gerek
vardır. Bu nedenle bu çalışmada, memenin
invaziv duktal karsinom (İDK)’unda bcl-2 ve katepsin D’nin birbirleriyle ve
diğer prognostik faktörlerle olan
ilişkisi araştırıldı.

GEREÇ VE YÖNTEM

2004-2006 yılları
arasında Yüzüncü Yıl Üniversitesi Tıp Fakültesi Patoloji Ana Bilim Dalında
mastektomi ve aksiller diseksiyon materyali incelenen ve invaziv duktal karsinom tanısı alan 50
adet olgu çalışmaya alındı. Bu
olguların tümör diferansiyasyonu, histolojik derece ve nükleer skor (NS)’ları ile
mitoz sayısı Bloom Richardson'a göre ayrı ayrı değerlendirildi. Bunun yanısıra tümör çevresi lenfatik, kan damarı
ve perinöral invazyonun varlığı araştırıldı.
Tümörün deri ile ilişkisi saptandı.
Tümör çapı ve aksiller lenf nodlarının durumu değerlendirildi. Multifokal ve
multisentrik tümörlerde, en büyük
tümörün çapı ele alındı. Östrojen, progesteron ve c-erbB-2 ile boyanmış olan
lamlar tekrar gözden geçirilerek her biri için ayrı ayrı skorlama yapıldı.

Ayrıca 50 invaziv duktal
karsinom olgusu, bcl-2 ve katepsin D ile immünhistokimyasal olarak boyandı ve
her biri için ayrı ayrı skorlama yapılarak sonuçlar birbirleri ve diğer
prognostik faktörlerle karşılaştırılarak değerlendirildi.

BULGULAR

Progesteron reseptörü ve
düşük NS ile bcl-2 ekspresyonu arasında güçlü pozitif bir ilişki tespit
edilirken katepsin D ve diğer prognostik faktörlerle bcl-2 ekspresyonu arasında
güçlü pozitif bir ilişki tespit edilmedi. Perinöral invazyon, lenf damarı
invazyonu, kan damarı invazyonu ve yüksek NS ile katepsin D ekspresyonu
arasında güçlü pozitif bir ilişki gözlenirken diğer prognostik faktörler,
c-erbB2, progesteron reseptörü, östrojen reseptörü ile katepsin D ekspresyonu
arasında güçlü bir ilişki gözlenmedi.

SONUÇ

Bcl-2’nin düşük dereceli, katepsin D’nin ise yüksek dereceli ve
invazyon yeteneği kazanmış invaziv duktal karsinom olgularının belirlenmesinde önemli
olabileceği düşünülmektedir.

Anahtar Kelimeler

İnvaziv duktal karsinom, bcl-2, katepsin D, İmmunhistokimya

Kaynakça

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