Mide kanserinde adropin ve hipoksi ile indüklenebilir faktör -1 alfa’nın önemi

Öz

Amaç: Mide kanseri tüm dünyada ki yeni kanser vakalarının %5,6’sını oluşturur ve beşinci en sık görülen kanser türüdür. Kansere bağlı ölüm sıralamasında ise üçüncü sırada yer almaktadır. Lokalileri mide kanserinde, günümüzde ki standart neoadjuvan tedavi ile hastaların yalaşık % 75’ine uygun rezeksiyon yapılabilmektedir. Hastaların iki yıllık hayatta kalma oranları yaklaşık %70 iken bu oran beşinci yılda %45’lere düşmektedir. Bir çok kanser türünde erken tanı ile yüksek küratif tedavi oranları ve uzun süreli sağkalım başarısı sağlanmasına rağmen mide kanseri için malesef aynı durum sözkonusu değildir ve karşılanmamış tedavi ihtiyacı devam etmektedir. Adropin, vücudumuzda birçok dokudan salgılanan; başlıca enerji homeostazisi, anjiyogenez, hücre proliferasyonu ve hücre göçü süreçlerinde düzenleyici rolü olan bir peptittir. Hipoksi ile indükenebilir faktör (HIF) ise dokularda oksijen seviyeleri düşünce aktive olur ve hücrelerin büyümesi, gelişmesi ve farklılaşmasını regüle eder. Yeni tanı almış lokal ileri mide kanseri hastalarında ki adropin ve HIF-1α sevyeleri ile sağlıklı bireylerdeki adropin ve HIF1-α seviyeleri karşılaştırılarak, adropinin ve HIF1-α’nın mide kanseri patogenezi üzerinde rolü ve tedavi yanıt oranlarının adropin ve HIF-1α seviyeleri ile ilişkisinin araştırılması amacıyla prosektif bir çalışma planlandı. Gereç ve Yöntemler: Yeni tanı almış, neoadjuvan kemoterapi alacak olan lokalileri mide kanserli hastalar ve sağlıklı kontrol grubu arasında adropin ve HIF-1α düzeyleri karşılaştırıldı. Ayrıca tedaviyi tamamlayan hastalarda klinik ve patolojik yanıt oranları ile adropin ve HIF-1α düzeyleri arasında bir ilişki olup olmadığına bakıldı. Bulgular: Adropin, mide kanserli hastalarda istatistiksel anlamlı olarak daha düşük, HIF-1α düzeyleri ise mide kanserli hastalarda istatistiksel anlamlı olarak daha yüksek bulundu. Adropin ve HIF-1α düzeyleri ile klinik yanıt, patolojik yanıt, operabilite durumu, yeni patolojik T (ypT) ve yeni patolojik N (ypN) evreleri gibi çeşitli klinik değişkenler arasında anlamlı bir farklılık görülmedi. Sonuç: Daha önce araştırılmamış olan ve literatür taraması yoluyla herhangi bir veri tespit edilemeyen adropin ve mide kanseri arasındaki ilişkiyi ortaya koymak önemliydi. Adropin ve HIF-1α'nın mide kanserinde rol oynayan iki önemli faktör olduğu açıktır. Ayrıca adropin ve HIF-1α mide kanserinin erken teşhisi için iki önemli parametre olabilir. Adropin ve HIF-1α'nın mide kanserindeki rolünü aydınlatmak için daha fazla çalışmaya ihtiyaç vardır.

Anahtar Kelimeler

• adropin
• hif-1 alfa
• mide kanseri

The Importance of Adropin and Hypoxia Inducible Factor-1 Alpha in Gastric Cancer

Öz

Aim: Gastric cancer accounts for 5.6% of all new cancer cases worldwide and is the fifth most common type of cancer. It ranks third in cancer-related mortality. With the current standard neoadjuvant treatment of localised gastric cancer, appropriate resection can be performed in approximately 75% of patients. While the two-year survival rate of patients is approximately 70 %, this rate decreases to 45 % in the fifth year. Although high curative treatment rates and long-term survival success are achieved with early diagnosis in many cancer types, unfortunately the same is not the case for gastric cancer and the unmet need for treatment continues. Adropin is a peptide secreted from many tissues in our body and has a regulatory role in energy homeostasis, angiogenesis, cell proliferation and cell migration processes. Hypoxia-inducible factor (HIF) is activated when oxygen levels decrease in tissues and regulates the growth, development, and differentiation of cells. A prospective study was planned to investigate the role of adropin and HIF-1α on the pathogenesis of gastric cancer and the relation of treatment response rates with adropin and HIF-1α levels by comparing adropin and HIF-1α levels in newly diagnosed locally advanced gastric cancer patients with adropin and HIF-1α levels in healthy individuals. Material and Methods: Adropin and HIF-1α levels were compared between newly diagnosed patients with localised gastric cancer receiving neoadjuvant chemotherapy and healthy control group. We also examined whether there was a correlation between clinical and pathological response rates and adropin and HIF-1α levels in patients who completed the treatment. Results: Adropin levels were statistically significantly lower and HIF-1α levels were statistically significantly higher in patients with gastric cancer. No significant difference was observed between adropin and HIF-1α levels and various clinical variables such as clinical response, pathological response, operability status, new pathological T (ypT) and new pathological N (ypN) stages.. Conclusion: It was important to demonstrate the relationship between adropin and gastric cancer, which had not been previously investigated and for which no data were identified through a literature review. It is obvious that adropin and HIF-1α are two important factors involved in gastric cancer. In addition adropin and HIF-1α may be two important parameters for early diagnosis of gastric cancer. Further studies are needed to elucidate the role of adropin and HIF-1α in gastric cancer.

Anahtar Kelimeler

• adropin
• hif-1 alpha
• gastrik cancer

Kaynakça

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