Tp53 Expression and Ki-67 Proliferation Index in Surface Epithelial-Stromal Tumors of the Ovary and Their Relationship with the Histopathological Prognostic Parameters

Yıl 2011, , 394 - 408, 01.04.2011

Sevgiye Kaçar Özkara Sevgiye Kaçar Özkara Deniz Filinte

https://doi.org/10.5174/tutfd.2010.04204.2

Öz

Objective: To investigate TP53 and Ki-67 expressions in malignant, borderline and benign epithelial ovarian tumors; correlate results with histopathological parameters; compare TP53 and Ki-67 expressions and discuss ovarian carcinogenesis. Material and Methods: Standard immunohistochemistry was performed in 100 malignant, 27 borderline and 31 benign tumors and 42 non-tumoral ovarian epithelia. Results: TP53 overexpression was higher in malignant (61.0%) than in borderline tumors (40.7%); in malignant cases above 50 years-of-age, with high grade and in undifferentiated and serous subtypes. Carcinomas with solid architecture in serous, high mitosis in non-serous and high pleomorphism in both subtypes; lymph node involvement, and advanced stage also showed higher expressions of TP53 (p<0.05). The mean Ki-67 index was 41.3% in malignant and 17.2% in borderline tumors. Ki-67 index tended to increase with increasing grade, and decrease with lymph node involvement. The coexpression of proteins according to grade, lymph node involvement and stage in different subtypes, showed significant differences and correlations. Conclusion: Our findings support the role of TP53 overexpression in development of “borderline” and malignant epithelial ovarian tumors. The degree of TP53 expression differed in terms of histopathological parameters; and was correlated with Ki-67 index. Especially in early stages, these biological factors could provide additional information to stratify patients for case specific therapies. Turkish Başlık: Overin Yüzey Epitelyal-Stromal Tümörlerinde Tp53 Ekspresyonu ve Ki-67 Proliferasyon İndeksi ve Histopatolojik Prognostik Parametrelerle İlişkileri Anahtar Kelimeler: Over tümörleri, p53, Ki-67 Amaç: Malign, “borderline” ve benign epitelyal over tümörlerinde TP53 ve Ki-67 ekspresyonlarını; karsinomlarda histopatolojik parametrelerle ilişkisini; farklı özelliklerdeki olgu gruplarında TP53 ve Ki-67 ekspresyonlarını araştırmak; overde karsinogenezi tartışmak. Gereç ve Yöntemler: Yüz'ü malign, 27'si “borderline” ve 31'i benign, toplam 158 epitelyal over tümörü ve 42 non-tümöral over dokusunda standart immunohistokimya tekniği kullanıldı. Bulgular: TP53 aşırı-ekspresyonu, “borderline” tümörlere (%40.7) kıyasla malignlerde (%61.0); 50 yaş üstündeki; yüksek dereceli, az/indiferansiye ve seröz; solid yapılanmalı seröz, yüksek pleomorfizm dereceli seröz ve non-seröz, yüksek mitotik indeksli non-seröz subtiplerde; lenf nodu tutulumu gösteren, ileri evredeki karsinomlarda daha yüksekti (p<0.05). Ortalama Ki-67 indeksleri, malignlerde %41.3, “borderline” tümörlerde %17.2 olup; fark anlamlıydı. Karsinomların Ki-67 indeksleri, dereceleri yükseldikçe artarken; lenf nodu tutulumlu olgularda azalma gösterdi. Karsinomların farklı subtiplerinin, derecelerine, lenf nodu tutulumları ve evrelerine göre, TP53 ekspresyonları ve Ki-67 indeksleriyle ilişkilerinde farklılıklar saptandı. Sonuç: TP53 aşırı-ekspresyonunun, malign ve “borderline” over tümörlerinin gelişimindeki rolünü desteklemektedir. Karsinomlarda, TP53 ekspresyonunun derecesi, yaş, histopatolojik subtip, derece, pleomorfizm, yapılanma özelliği, mitotik aktivite, lenf nodu tutulumu ve evre ile ilişkili olarak farklılık; Ki-67 proliferasyon indeksi ile de korelasyon göstermektedir. Malign epitelyal over tümörlerinin bu biyolojik parametrelere göre de ayrılması, gelecekte daha olguya özgün tedavi protokollerinin belirlenmesinde, özellikle erken evrede önemli olabilir.

Anahtar Kelimeler

Ovarian tumors, p53, Ki-67

Overin Yüzey Epitelyal-Stromal Tümörlerinde Tp53 Ekspresyonu ve Ki-67 Proliferasyon İndeksi ve Histopatolojik Prognostik Parametrelerle İlişkileri

Öz

Amaç: Malign, “borderline” ve benign epitelyal over tümörlerinde TP53
ve Ki-67 ekspresyonlarını; karsinomlarda histopatolojik parametrelerle ilişkisini; farklı özelliklerdeki olgu gruplarında TP53 ve Ki-67 ekspresyonlarını
araştırmak; overde karsinogenezi tartışmak.
Gereç ve Yöntemler: Yüz’ü malign, 27’si “borderline” ve 31’i benign, toplam
158 epitelyal over tümörü ve 42 non-tümöral over dokusunda standart
immunohistokimya tekniği kullanıldı.
Bulgular: TP53 aşırı-ekspresyonu, “borderline” tümörlere (%40.7) kıyasla
malignlerde (%61.0); 50 yaş üstündeki; yüksek dereceli, az/indiferansiye
ve seröz; solid yapılanmalı seröz, yüksek pleomorfizm dereceli seröz ve
non-seröz, yüksek mitotik indeksli non-seröz subtiplerde; lenf nodu tutulumu
gösteren, ileri evredeki karsinomlarda daha yüksekti (p < 0.05). Ortalama
Ki-67 indeksleri, malignlerde %41.3, “borderline” tümörlerde %17.2
olup; fark anlamlıydı. Karsinomların Ki-67 indeksleri, dereceleri yükseldikçe artarken; lenf nodu tutulumlu olgularda azalma gösterdi. Karsinomların
farklı subtiplerinin, derecelerine, lenf nodu tutulumları ve evrelerine göre,
TP53 ekspresyonları ve Ki-67 indeksleriyle ilişkilerinde farklılıklar saptandı.
Sonuç: TP53 aşırı-ekspresyonunun, malign ve “borderline” over tümörlerinin
gelişimindeki rolünü desteklemektedir. Karsinomlarda, TP53 ekspresyonunun
derecesi, yaş, histopatolojik subtip, derece, pleomorfizm,
yapılanma özelliği, mitotik aktivite, lenf nodu tutulumu ve evre ile ilişkili
olarak farklılık; Ki-67 proliferasyon indeksi ile de korelasyon göstermektedir.
Malign epitelyal over tümörlerinin bu biyolojik parametrelere göre de
ayrılması, gelecekte daha olguya özgün tedavi protokollerinin belirlenmesinde,
özellikle erken evrede önemli olabilir

Anahtar Kelimeler

Over tümörleri, p53, Ki-67

Kaynakça

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