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Vojnosanitetski pregled
2015, vol. 72, br. 11, str. 982-988
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 06/11/2015
doi: 10.2298/vsp140605101s
Uticaj ekspresije Ki-67 i E-kaderina na limfovaskalarnu invaziju kod urotelnog karcinoma gornjeg urotrakta
aUniverzitet u Nišu, Medicinski fakultet, Katedra Patologija
bUniverzitet u Nišu, Medicinski fakultet, Katedra Patofiziologija
cUniverzitet u Nišu, Medicinski fakultet, Katedra Anatomija
dUniverzitet u Nišu, Medicinski fakultet, Katedra Farmakologija sa toksikologijom

e-adresa: slavicastojnev@gmail.com

Projekat

Etiologija, dijagnostika, prevencija, i terapija endemske nefropatije i sa njom povezanih tumora urotela - značaj istraživanja genoma i proteoma (MPNTR - 175092)

Sažetak

Uvod/Cilj. Urotelni karcinom gornjeg dela urinarnog trakta (UUT-UC) čini 5% malignih neoplazmi koje potiču iz tranzicionalnog epitela, ali je invazivniji nego karcinom mokraćne bešike. Limfovaskularna invazija (LVI) je pokazatelj biološki agresivnog karcinoma, kao i okultnih metastaza. Cilj istraživanja bilo je ispitivanje povezanosti LVI i imunohistohemijske ekspresije dva često rutinski primenjivana biomarkera, Ki-67 i E-kaderina, u UUT-UC. Metode. Patohistološka analiza i određivanje prisustva LVI urađeni su na uzorcima UUT-UC dobijenih od 106 bolesnika podvrgnutih nefroureterektomiji. Ekspresija Ki- 67 i E-kaderina procenjivana je imunohistohemijskom metodom. Rezultati. Prekomerna ekspresija Ki-67 zabeležena je kod 38% bolesnika, dok je 45% tumora pokazalo izmenjenu ekspresiju E-kaderina. Prisustvo LVI bilo je značajno udruženo sa stadijumom, gradusom tumora, nepapilarnim načinom rasta, nodularnim tipom invazije, visokim Ki-67 proliferativnim indeksom i aberantnom ekspresijom E-kaderina. Analizom logističkih modela regresije utvrđeno je da karakteristike tumora poput stadijuma, gradusa, načina rasta i invazije (p < 0,001), kao i ekspresija Ki-67 i E-kaderina (p < 0,001), značajno predviđaju prisustvo LVI. U prvom modelu samo solidna arhitektura tumora i nodularni način invazije (p < 0,05) predstavljali su značajne prediktore LVI. Drugi model utvrdio je da povećana ekspresija Ki-67 povećava verovatnoću za LVI (p < 0.05). Zaključak. Rezultati istraživanja ukazuju na to da prekomerna ekspresija Ki-67 predstavlja nezavisni prediktor LVI u UUT-UC. Ekspresija Ekaderina ne doprinosi značajno proceni verovatnoće prisustva LVI. To naglašava značaj određivanja Ki-67 proliferativnog indeksa u ovom tumoru u rutinskoj patološkoj praksi. Bolesnike sa prekomernom ekspresijom Ki-67, posebno kod tumora sa solidnim rastom i nodularnim tipom invazije, trebalo bi pažljivije pratiti nakon hirurškog lečenja.

Ključne reči

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