Endometrium karsinomlarında immünohistokimyasal olarak yanlış-eşleşme onarım (MMR) protein ekspresyonunun prognostik parametreler ile ilişkisinin araştırılması

Gürdeniz Serin; Pınar Savaş; Necmettin Özdemir; Osman Zekioğlu; Levent Akman

doi:10.19161/etd.1262422

EN TR

Investigation of the association of immunohistochemical mismatch repair (MMR) protein expression with prognostic parameters in endometrial carcinomas

Abstract

Aim: The most crucial development in endometrial carcinomas has been molecular classification in recent years. In this classification, tumors were divided into: 1-POLE mutant group, 2-Microsatellite instable (MSI) group, 3-High copy number group (P53 mutation), 4-Low copy number group. Among these groups, POLE and MSI groups stand out with their better prognosis and potential to benefit from immune-checkpoint inhibitors. We aimed to compare the prognostic parameters of cases with and without nuclear expression loss in MMR proteins (MLH-1, PMS-2, MSH-2, MSH-6) by immunohistochemically (IHC). Materials and Methods: In our department, 80 patients diagnosed with endometrial carcinoma in hysterectomy materials between 2017 and 2020 and whose MMR proteins were evaluated by IHC were included. Cases with and without MMR loss were compared in tumor size, histological grade (HG), myometrial invasion depth, lymphovascular invasion (LVI), and cervical involvement. Results: There was a loss of any MMR proteins in 46.3% (37/80) of the cases. When the cases were compared in terms of loss of MMR protein expression, the histological grade was III in 45.9% (17/37) of cases with loss and 27.9% (12/43) of cases without a loss (p:0.03). There was no difference between the two groups regarding myometrium 1/2 external invasion, cervical stromal involvement, and LVI. Conclusion: Loss of the MMR proteins was found in approximately half of the cases in our study. The most common loss was MLH1 and PMS2. HG of patients with loss of nuclear expression in MMR proteins tends to be significantly higher than cases without loss.

Keywords

Endometrium karsinomlarında immünohistokimyasal olarak yanlış-eşleşme onarım (MMR) protein ekspresyonunun prognostik parametreler ile ilişkisinin araştırılması

Öz

Amaç: Endometrium karsinomlarında son yıllardaki en önemli gelişme moleküler sınıflama olmuştur. Bu sınıflamada tümörler dört gruba ayrılmıştır: 1-POLE mutant grup, 2-Mikrosatellit instabil (MSİ) grup, 3-Yüksek kopya sayısı grubu (P53 mutasyonu), 4-Düşük kopya sayısı grubu. Bu gruplardan POLE ve MSİ grup daha iyi prognoza sahip olması ve immün-kontrol inhibitör tedavisinden fayda görebilme potansiyelleri ile öne çıkmaktadır. Çalışmamızda immünohistokimyasal (İHK) yöntemle MMR proteinlerinde (MLH-1, PMS-2, MSH-2, MSH-6) nükleer ekspresyon kaybı olan ve olmayan olguların prognostik paramaterelerinin karşılaştırılması amaçlanmıştır. Gereç ve Yöntem: Bölümümüzde 2017-2020 yılları arasında histerektomi materyalinde endometrium karsinomu tanısı almış ve İHK olarak MMR proteinlerinin değerlendirildiği 80 hasta çalışmaya alınmıştır. MMR kaybı olan ve olmayan olgular tümör boyutu, histolojik derece (HD), myometrial invazyon derinliği, lenfovasküler invazyon (LVİ) ve servikal tutulum açısından karşılaştırılmıştır. Bulgular: Olguların 37’sinde (%46,3) MMR proteinlerinin herhangi birinde kayıp mevcutken, 43’ünde (%53,7) kayıp izlenmemiştir. MMR protein nükleer ekspresyon kaybı açısından olgular karşılaştırıldığında, kayıp saptanan olguların %45,9'da (17/37), kayıp saptanmayan olguların ise %27,9'da (12/43) histolojik derece III'tü (p:0,03). Myometrium 1/2 dış invazyon, servikal stromal tutulum ve LVİ açısından iki grup arasında istatistiksel olarak anlamlı bir fark saptanmamıştır. Sonuç: Çalışmamızdaki olguların yaklaşık yarısında MMR proteinlerinin en az birinde kayıp saptanmıştır. En sık kayıp MLH-1 ve PMS-2 kaybı olarak ortaya çıkmıştır. MMR proteinlerinde nükleer ekspresyon kaybı izlenen olguların HD’si kayıp saptanmayan olgulara göre istatistiksel olarak anlamlı şekilde daha yüksek olma eğilimindedir.

Anahtar Kelimeler

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Gürdeniz Serin ^*
Türkiye

Pınar Savaş
Türkiye

Necmettin Özdemir
Türkiye

Osman Zekioğlu
Türkiye

Levent Akman
Türkiye

Yayımlanma Tarihi

15 Mart 2023

Gönderilme Tarihi

19 Nisan 2022

Kabul Tarihi

6 Temmuz 2022

Yayımlandığı Sayı

Yıl 2023 Cilt: 62 Sayı: 1

DOI

https://doi.org/10.19161/etd.1262422

IZ

https://izlik.org/JA69XN53DS

Kaynak Göster

RIS / Bibtex

Vancouver

1.Gürdeniz Serin, Pınar Savaş, Necmettin Özdemir, Osman Zekioğlu, Levent Akman. Endometrium karsinomlarında immünohistokimyasal olarak yanlış-eşleşme onarım (MMR) protein ekspresyonunun prognostik parametreler ile ilişkisinin araştırılması. ETD. 01 Mart 2023;62(1):41-7. doi:10.19161/etd.1262422