Prostatın benign, prekürsör ve malign epitelyal proliferasyonlarında ERG ile PTEN ekspresyonlarının araştırılması ve bulguların klinikopatolojik korelasyonu

Banu Sarsık Kumbaracı; Emre Kanat; Umut Aykutlu; Fuat Kızılay; Sait Şen

doi:10.19161/etd.1209075

EN TR

Investigation of ERG and PTEN expressions in benign, precursor and malignant epithelial proliferations of prostate and clinicopathological correlation of findings

Abstract

Aim: Prostate cancer is a clinically and molecularly heterogeneous cancer type with different clinical course and a wide range of treatments. Especially "prostatic intraepithelial neoplasia" (PIN), "atypical intraductal proliferation" (AIP) and "intraductal carcinoma" (IDC) are diagnoses that create difficulty in differential diagnosis in terms of having similar morphological features, and they are entities with different patient treatment and follow-up. In our study, we aimed to determine the expression levels of ERG and PTEN in these lesions and to investigate the prognostic and diagnostic value of these biomarkers.

Materials and Methods: Eighty seven cases diagnosed as “Adenocarcinoma” in radical prostatectomy or needle biopsy materials in the Department of Medical Pathology of EUTF in 2011-2012 were included in the study. Histopathologically, areas containing AIP, IDC and PIN were determined. ERG and PTEN expressions were evaluated in these areas immunohistochemically.
Results: IDC was determined in 6 of the cases, AIP in 29 and PIN in 52 cases. IDC and AIP were more common in tumors with DG 3 and above. Prostate carcinomas accompanied by IDC and AIP had a shorter survival time (p=0.043). In tumors containing IDC and AIP, ERG and PTEN status were consistent with the invasive component. In addition, ERG was positive in all IDC areas. Heterogeneous staining was observed with PTEN, and PTEN was more negative in the areas of invasive carcinoma and IDC (p=0.63). Although ERG positivity and PTEN negativity were not statistically significant, it was noted that they supported the diagnosis of AIP.
Conclusion: Especially in intraductal lesions that cause differential diagnosis, ERG positivity and PTEN negativity should not be ignored in biopsies that may accompany clinically important prostate carcinoma, and the patient should be followed up with treatment accordingly.

Keywords

Prostatın benign, prekürsör ve malign epitelyal proliferasyonlarında ERG ile PTEN ekspresyonlarının araştırılması ve bulguların klinikopatolojik korelasyonu

Öz

Amaç: Prostat kanseri farklı klinik gidişata ve geniş bir tedavi yelpazesine sahip, klinik ve moleküler olarak oldukça heterojen bir kanser türüdür. Özellikle “prostatik intraepitelyal neoplazi” (PİN), “atipik intraduktal proliferasyon” (AİP) ve “intraduktal karsinom” (İDK) benzer morfolojik özelliklere sahip olması açısından ayırıcı tanı zorluğu yaratan tanılar olup, hasta tedavi ve takibi de farklı olan antitelerdir. Çalışmamızda bu lezyonlarda ERG ve PTEN ekspresyon düzeylerini belirlemeyi ve bu biyobelirteçlerin prognostik ve diagnostik değerini araştırmayı amaçladık.
Gereç ve Yöntem: EÜTF Tıbbi Patoloji Anabilim Dalında 2011-2012 yılında radikal prostatektomi veya iğne biyopsi materyallerinde “Adenokarsinom” tanısı almış 87 olgu çalışmaya alındı. Histopatolojik olarak AİP, İDK ve PİN içeren alanlar belirlendi. immunohistokimyasal olarak bu alanlarda ERG ve PTEN ekspresyonları değerlendirildi.
Bulgular: Olguların 6’sında İDK, 29’unda AİP ve 52’sinde PİN belirlendi. İDK AİP, DG 3 ve üstünde olan tümörlerde daha fazla görüldü. İDK ve AİP in eşlik ettiği prostat karsinomlarının sağ kalım süresi daha kısaydı (p=0.043). İDK ve AİP içeren tümörlerde ERG ve PTEN durumu invaziv komponentle uyum içindeydi. Ayrıca tüm İDK alanlarında ERG pozitifti. PTEN ile heterojen boyanma görülmüş olup, PTEN’in invaziv karsinom ve İDK alanlarında negatifliği daha fazlaydı (p=0,63).
ERG pozitifliği ve PTEN negatifliği istatistiksel olarak anlamlı olmamakla birlikte AİP tanısını desteklediği dikkati çekti.
Sonuç: Özellikle ayırıcı tanı sorunu yaratan intraduktal lezyonlarda ERG pozitifliği ve PTEN negatifliği klinik öneme sahip prostat karsinomuna eşlik edebileceği için özellikle biyopsilerde gözardı edilmemeli ve hasta tedavi ile takibi buna göre yapılmalıdır.

Anahtar Kelimeler

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Banu Sarsık Kumbaracı ^*
0000-0003-4775-3942
Türkiye

Emre Kanat
0000-0001-8876-7975
Türkiye

Umut Aykutlu
0000-0002-9373-0912
Türkiye

Fuat Kızılay
0000-0003-1856-0404
Türkiye

Sait Şen
0000-0002-1100-6657
Türkiye

Yayımlanma Tarihi

12 Aralık 2022

Gönderilme Tarihi

18 Mart 2022

Kabul Tarihi

13 Mayıs 2022

Yayımlandığı Sayı

Yıl 2022 Cilt: 61 Sayı: 4

DOI

https://doi.org/10.19161/etd.1209075

IZ

https://izlik.org/JA59WD69RZ

Kaynak Göster

RIS / Bibtex

Vancouver

1.Banu Sarsık Kumbaracı, Emre Kanat, Umut Aykutlu, Fuat Kızılay, Sait Şen. Prostatın benign, prekürsör ve malign epitelyal proliferasyonlarında ERG ile PTEN ekspresyonlarının araştırılması ve bulguların klinikopatolojik korelasyonu. ETD. 01 Aralık 2022;61(4):577-85. doi:10.19161/etd.1209075