SERUM GALEKTİN-3 VE DİFERANSİYE TİROİD KANSER İLİŞKİSİ
Öz
Özet:
DİFERANSİYE
TİROİD KANSERLERİNDE GALEKTİN-3
Amaç: Diferansiye tiroid kanserli (DTK)
hastalarda total tiroidektomi sonrası risk skorlamasına göre verilen I-131
(radyoiyot) ile ablasyon, tüm dünyada ve ülkemizde sıklıkla kullanılan bir
tedavi yöntemidir. Kanser gelişimindeki rolü açıklanamamakla birlikte,
Galektin-3’ün artmış ekspresyonunun tümör hücrelerinin adhezyon ve
motilitelerini değiştirerek metastaz potansiyelini artırdıkları
bildirilmektedir. Araştırmalara göre Galektin-3 (Gal-3) özellikle papiller
tiroid kanserlerinde olmak üzere DTK’da pozitiftir.
Bu çalışmada amacımız, DTK nedeniyle total
tiroidektomili, ardından yüksek doz radyoiyot ablasyon tedavisi alma amacı olan
hastalarda ölçülen serum Galektin-3 (sGal-3) seviyelerinin, hastaların tüm vücut
tarama sintigrafileri ile değerlendirilerek prognostik ilişkisinin varlığının
araştırılmasıdır.
Gereç ve Yöntem: sGal-3 seviyeleri Abbott i
sistem otoanalizörde çalışıldı. İyi prognoz göstergesi ve ablasyon başarısı;
TSH stimüle durumda iken, serum Tg seviyeleri ölçülemeyecek kadar düşük düzeyde
(stimüle Tg <1ng/ml veya non-stimüle Tg <0.2 ng/ml), normal fizik muayene
bulguları ve/veya ablasyon sonrası 8-12. ayda yapılan düşük doz radyoiyot tüm
vücut tarama sintigrafisi negatif olan, lenf nodu veya uzak metastaz ile uyumlu
radyolojik ve klinik bulgusu olmayan olgular olarak kabul edildi.
Bulgular: Çalışmaya 48 hasta dahil edildi.
Hastaların ikisinde sGal-3 seviyesi sınırda yüksek, diğerlerinde normaldi. İmmünohistokimyasal olarak galectin-3 bakılan
hastalardan 25’inde galectin-3 pozitif iken, 23’ünde negatifti. İmmünohistokimyasal olarak bakılan Gal-3-ile
sGal-3 seviyeleri arasında korelasyon yoktu (p=0.663). Ablasyon başarısı ile
sGal-3 arasında anlamlı ilişki yoktu (p>0.05).
Sonuç: Bu çalışmada ablasyon başarısı ile
sGal-3 düzeyleri arasında anlamlı ilişki bulunamadı. Bunun nedeni, sGal-3’ün
tümör dokusundan kaynaklanması ve ancak sGal-3 ölçümü için yapılan örnekleme
sırasında anlamlı tümör yükünün bulunmaması olabilir. Bu nedenle, sGal-3’ün
normal seviyelerde olmasının iyi prognoz göstergesi olduğunu düşünmekteyiz.
Anahtar Kelimeler: Galektin-3; Differensiye Tiroid
Kanserleri; Ablasyon
Abstract:
GALECTIN-3
ON DIFFERENTIAL THYROID CANCERS
Aim: I-131 (radioiodine) ablation following total thyroidectomy in
patients with differential thyroid cancer (DTC) is a routine treatment method. Increased expression of
Galectin-3 in tumor cells has been shown to alter adhesion and motility
resulting with increased metastatic potential although its role in cancer development has not been demonstrated
yet. Galectin-3 (Gal-3) was declared positive in DTC, especially in papillary
thyroid carcinomas.
The aim of study is to
investigate whether there is a prognostic association between serum Galectin-3
levels measured in patients with total thyroidectomy due to DTC, followed by
high-dose radioiodine ablation therapy and whole body screening scintigraphy.
Materials and Methods: sGal-3 levels were studied in the Abbott i system autoanalyzer. Success of ablation and good prognosis were defined via too low Tg levels under TSH stimulation, normal physical examination findings and/or post-ablation negative low dose whole body radioiodine scintigraphy 8 to 12 months after ablation, absence of any findings suggesting lymph node and distant metastasis in radiological or clinical evaluation.
Findings: Forty-eight patients were included in the study. sGal-3 levels were within the normal range in whole patients of whom two had values close to upper limit.Immunohistochemically, galectin-3 was positive in 25 of the patients, whereas negative in other 23. There was no correlation between immunohistochemically evaluated levels of Gal-3 and sGal-3 (p = 0.663). The relationship between ablation success and sGal-3 was not statistically significant (p> 0.05).
Conclusion: There was no significant relationship between ablation success and sGal-3.A possible explanation for this result might be excretion of sGal-3 from the tumor tissue and absence of tumour tissue at the time of sampling for sGal-3 in the study population. In conclusion, the authors suggest that sGal-3 is a good prognostic indicator when it is at normal levels during ablation.Key Words: Galectin-3; Differential Thyroid
Cancers; Ablation
Anahtar Kelimeler
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