Mesanenin Ürotelyal Karsinomlarında Tümör Tomurcuklanmasının Prognostik Önemi: İki Farklı Tümör Tomurcuklanma Değerlendirme Yönteminin Karşılaştırılması

Öz

Giriş: Çalışmamızda ürotelyal karsinomlarda tümör tomurcuklanmasının (TT) prognoza etkisini ortaya koymayı ve en sık kullanılan alternatif metod (AM) ile Uluslararası Tümör Tomurcuklanması Konsensus Konferans (ITBCC) sistemini karşılaştırmayı amaçladık.TT, rutin Hematoksilen&Eozin boyalı preparatlarda kolayca değerlendirilebilmektedir. Yapılan çalışmalarda TT’nin birçok organ kanserinde prognostik parametrelerle ilişkili olduğu bulunmuştur. TT değerlendirmesi, birçok organ kanserinde ITBCC’ye veya alternatif olarak farklı yazarlar tarafından kullanılan farklı değerlere dayanmaktadır. Materyal ve Methot: Çalışmaya 2010’dan 2016’ya kadar, sistektomi veya sistoprostatektomi ile cerrahi evreleme yapılan ve en az 5 yıl takip edilen vakalardan oluşan kırk sekiz ürotelyal kanser dahil edildi. Tüm hematoksilen ve eozin boyalı preparatlar, ITBCC ve AM’ye göre TT durumu açısından yeniden değerlendirildi. Bulgular: ITBCC’ye göre TT, pT, lenfovasküler invazyon, lenf nodu tutulumu(LNT), tümör evresi ve 5 yıllık mortalite ile korele değildi (p=0.102, p=0.722, p = 0.165, p=0.431, p=0.524). AM’ye göre, TT, pT ilerledikçe daha sıktı ve LNT ile marjinal olarak ilişkiliydi (p=0.027, p=0.058). TT ile genel sağkalım arasında ilişki yoktu (p=0.130). Sonuç: Çalışmamızda AM’deki eşik değeri ITBCC önerisinden daha faydalı bulduk. TT’nin bazı prognostik parametrelerle ilişkisi prognozla da ilişkili olabileceğini düşündürse de, genel sağkalım ile bir ilişki bulunamadı. Bu durum vaka sayımızla ilgili olabilir.

Prognostic Significance of Tumor Budding in Urothelial Carcinomas of the Bladder: Comparison of Two Different Tumor Budding Evaluation Methods

Abstract

Aim: In our study, we aimed to reveal the effect of tumor budding(TB) on prognosis in urothelial carcinomas and to compare the most commonly used alternative method (AM) and the International Tumor Budding Consensus Conference (ITBCC) system. TB can be easily assessed on routine hematoxylin and eosin-stained slides. In studies, TB was found to be associated with prognostic parameters in many organs. TB assessment in many organ cancers is based on ITBCC or alternatively different values used by different authors. Material and Method: Forty-eight urothelial cancers were obtained from 2010 to 2016 that was comprised of those having undergone surgical staging with a cystectomy or cystoprostatectomy and at least 5 years followed up. All hematoxylin and eosin-stained slides were re-evaluated for the status of TB according to ITBCC and AM. Results: According to ITBCC TB was not correlated with pT, lymphovascular invasion, lymph node involvement (LNI), tumor stage and 5-year mortality (p=0.102, p=0.722, p=0.165, p=0.431, p=0.524). According to AM, TB was more frequent as pT advanced, and was marginally associated with LNI (p=0.027, p=0.058). There was no relationship between TB and overall survival (p=0.130). Conclusion: We found the cut-off value in AM more useful than ITBCC recommendations. Although the association of TB with some of the prognostic parameters suggests that it may also be associated with prognosis, no relationship was found with overall survival. This may be related to the number of our cases.

Keywords

• Tumor budding
• Urothelial carcinoma
• Bladder cancer

Kaynakça

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