Metastaz supressör genlerden NM23’ün mide kanserindeki prognostik önemi

Öz

Amaç: Metastaz, mide kanserli hastaların prognozunda ve tedavi stratejilerinin belirlenmesinde kritik öneme sahiptir. Bu nedenle metastaz baskılayıcı genler üzerine çalışmalar yoğunlaşmıştır. Bu çalışmada da, mide kanserlerinde NM23 ekspresyonunun özelliklerinin belirlenmesi, anti-metastatik ve prognostik öneminin araştırılması amaçlanmıştır.

Yöntemler: 1 Ocak 2009 - 1 Ocak 2010 tarihleri arasında mide kanseri nedeniyle opere edilen 90 hasta çalışmaya alındı. Spesmen kesitlere immünohistokimyasal boyama uygulandı. İmmünohistokimyasal boyama sonuçları, tümöre bitişik normal gastrik mukoza ile beraber değerlendirildi. Normal dokuya göre tümör hücresinin NM23 ile boyanma derecesi: “negatif-zayıf boyanma” ve “kuvvetli boyanma” olmak üzere iki grup olarak değerlendirildi. Her iki grup, lenf nodu metastazı, vasküler invazyon, perinöral invazyon, tümör diferesiasyon derecesi, tümör evresi ve uzak metastaz için değerlendirildi.

Bulgular: Lenf nodu metastazı bulunan 58 hastanın %70,7’si negatif –zayıf boyanma gösterirken %29,3’ü kuvvetli boyanma özelliği gösterdi. Lenf nodu metastazı bulunmayan 32 hastanın ise %40,6’sı negatif-zayıf boyanma özelliğine, %59,4’ü kuvvetli boyanma özelliğine sahipti. NM23 ekspresyonundaki azalmanın, lenf nodu metastazındaki artışa neden olduğu gösterildi (P=0,01). Ayrıca istatistiksel anlamlılık bulunmamakla beraber, negatif-zayıf boyanma gösteren grupta, uzak metastaz, kötü diferesiasyon derecesi, evre III ve evre IV tümörlerin oranı belirgin olarak daha yüksekti. Bu bulgularda NM23’ün anti-metastatik özelliğini destekledi. 

Sonuç: Bu çalışma NM23 ekspresyonunun, mide kanserli hastalarda, lenf nodu metastazı için anti-metastatik özelliğe sahip olduğunu gösterdi.

Anahtar Kelimeler

• Mide kanseri,İmmünohistokimyasal boyama,NM23

Prognostic significance of metastasis-suppressor gene NM23 in gastric carcinoma

Abstract

Aim: Metastasis is critical in the prognosis of gastric cancer patients and in deciding on treatment strategies. Therefore, studies have concentrated on metastasis suppressor genes. This study aimed to identify the characteristics of NM23 expression in gastric cancer and to investigate its anti-metastatic and prognostic significance.

Methods: Ninety patients who underwent surgery for gastric cancer between January 1, 2009 and January 1, 2010 were included in this study. Immunohistochemical staining was applied to specimen sections. The results of the immunohistochemical staining were evaluated with the normal gastric mucosa adjacent to the tumor. The degree of NM23 staining of tumor cell compared to the normal tissue was evaluated in two groups of “negative-weak staining” and “strong staining”. Both groups were analyzed for lymph node metastasis, vascular invasion, perineural invasion, degree of tumor differentiation, tumor stage and distant metastasis.

Results: Among 58 patients with lymph node metastasis, 70.7% showed negative-weak staining and 29.3% showed strong staining. Among 32 patients with no lymph node metastasis, 40.6% had negative-weak staining and 59.4% had strong staining. Decrease in NM23 expression was shown to cause an increase in lymph node metastasis (P=0.01). Furthermore, while there was no statistical significance, the rates of distant metastasis, degree of poor differentiation, tumors in stage III and stage IV were apparently higher in the negative-weak staining group. These results were in line with the anti-metastatic property of NM23. 

Conclusion: This study showed that NM23 expression had anti-metastatic properties for lymph node metastasis in gastric cancer patients.

Keywords

• Gastric carcinoma,Immunohistochemical staining,NM23

Kaynakça

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