Kolorektal kanserli hastalarda tümör taraflılığının önemi ve diğer klinikopatolojik özelliklerle ilişkisi

Öz

Amaç: Kolorektal kanser (KRK) en yaygın ve ölümcül hastalıklardan biridir ve hastaların sınıflandırılmasında prognostik faktörler çok önemlidir. Bu çalışmada, KRK hastalarında CDX2 ekspresyonu, serum CEA düzeyi ve tümör taraflılığının önemini değerlendirmeyi amaçladık. Materyal ve Metot: Eylül 2014-Aralık 2019 tarihleri arasında hastalık evresine bakılmaksızın kolorektal kanser tanısı alan hastalar dahil edildi. KRK tanısı primer veya metastatik lezyondan elde edilen patolojik doku bulguları ile doğrulandı. Serum CEA düzeyi, primer tümör taraflılığı (sağ taraf veya sol taraf), CDX2 ekspresyonu ve elde edilen diğer demografik özellikler çalışma değişkeni olarak kaydedildi. Tüm çalışma analizleri SPSS sürüm 22 istatistik yazılımı (IBM Corporation) kullanılarak yapıldı. Bulgular: KRK'lu 152 hasta dahil edildi, 64 hasta (% 42.1) kadın, 88 hasta (% 57.9) erkek, ortalama yaş 55 (18-93 yaş) idi. Serum CEA düzeyi <3.5ng / ml olan hastalarda ve CEA düzeyi> 3.5 ng / ml olan hastalarda ortalama sağkalım sırasıyla 35.1 ve 26.6 aydı ve gruplar arasındaki fark istatistiksel olarak anlamlıydı (p = 0.006). Hastalık evresi ile serum CEA düzeyi arasında pozitif korelasyon vardı, metastatik hastalarda serum CEA düzeyi metastatik olmayan hastalara göre daha yüksekti (p = 0.009). Doku CDX2 ekspresyonu açısından, on bir hastada (% 7.2) CDX2 ekspresyon negatif, 136 hastada (% 89.5) CDX2 ekspresyon pozitif bulundu. CDX2 ekspresyon durumuna göre hastaların OS oranları arasındaki fark anlamlı değildi (p = 0.7). Sol taraflı hastaların sağ taraflılara göre daha uzun süre hayatta kalmasına rağmen, fark anlamlı değildi, medyan OS sırasıyla 67.6 ve 29.7 aydı (p = 0.3). Ortalama takip süresi 24.1 aydı. Sonuç: Serum CEA düzeyi, CRC hastaları için belirgin bir prognostik faktör olarak bulundu. Ek olarak CDX2 ekspresyonu pozitif ve sol taraflı primer tümörlerin literatürde bildirildiği gibi daha uzun sağkalımı vardı. Ayrıca, tümör taraflılığı ve serum CEA düzeyine dayanan hasta sınıflama modelimiz umut verici sonuçlar elde etmiştir, ancak daha büyük ve prospektif çalışmalarla doğrulanması gerekmektedir.

Anahtar Kelimeler

• CDX2
• CEA
• kolorektal kanser
• serum
• tumor gelişim tarafı

The importance of the tumor sidedness and its relationship with other clinicopathological features in patients with colorectal cancer

Öz

Aim: Colorectal cancer (CRC) is one of the most common and mortal diseases and prognostic factors have a crucial role in stratifying patients. We aimed to evaluate the importance of CDX2 expression, serum CEA level, and tumor sidedness in CRC patients. Material and Method: Patients diagnosed with colorectal cancer between September 2014 and December 2019 were included in the study. Serum CEA level, primary tumor bias, CDX2 expression and other demographic characteristics were recorded as variables. All study analyzes were performed using SPSS version 22 statistical software (IBM Corporation). Results: 152 patients with CRC were included, 64 (42.1%) of patients were female and 88 (57.9%) of patients were male, the median age of patients was 55(range 18-93). The median survival of patients with serum CEA level < 3.5ng/ml, and the patients with CEA level > 3.5 ng/ml was 35.1 and 26.6 months, respectively, and the difference between groups was a statistically significant (p=0.006). There was a positive correlation between disease stage and serum CEA level, metastatic patients had higher serum CEA level than non-metastatic patients (p=0.009). In terms of tissue CDX2 expression, eleven patients (7.2%) had CDX2 expression negative, 136 (89.5%) of patients had CDX2 expression positive. The difference between OS rates of patients according to CDX2 expression status was not significant (p=0.7). Despite the longer survival of patients with left-sided than right-sided, the difference was not significant, the median OS was 67.6 and 29.7 months, respectively (p=0.3). The median follow-up time was 24.1 months. Conclusion: The serum CEA level was found as a clear prognostic factor for CRC patients. Additionally, CDX2 expression positive and left-sided primary tumors had longer survival as reported in the literature. Also, our patient stratification model based on tumor sidedness and serum CEA level obtained promising outcomes but need to be confirmed by larger and prospective trials.

Anahtar Kelimeler

• CDX2
• CEA
• colorectal cancer
• serum
• sidedness

Kaynakça

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