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Vojnosanitetski pregled
2020, vol. 77, br. 2, str. 189-195
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 02/03/2020
doi: 10.2298/VSP180120071S
Creative Commons License 4.0
Vaskularni endotelni faktor rasta kao potencijalni prognostički faktor kod T3N0 stadijuma karcinoma rektuma
aKlinički centar Srbije, Klinika za digestivnu hirurgiju – I hirurška, Beograd
bKlinički centar Srbije, Klinika za digestivnu hirurgiju – I hirurška, Beograd + Univerzitet u Beogradu, Medicinski fakultet
cUniverzitet u Beogradu, Medicinski fakultet, Institut za patološku anatomiju

e-adresa: sekulic038@yahoo.com

Sažetak

Uvod/Cilj. Karcinom rektuma još uvek predstavlja veliki zdravstveni problem. Iako je hirurško lečenje primarno, široko je prihvaćena činjenica da je kombinovana terapija često indikovana u tretmanu ove bolesti. Lokalni ili distalni recidiv javlja se kod oko 20% bolesnika sa karcinomom rektuma T3NO stadijuma. Danas postoji potreba za prognostičkim biomarkerima uz čiju pomoć se mogu predvideti bolesnici sa visokim rizikom od recidiva bolesti. Cilj ove studije bio je da se ispita prognostički potencijal vaskularnog endotelnog faktora rasta (VEGF) kod bolesnika sa T3N0 staadijumom karcinoma rektuma. Metode. Retrospektivnom studijom bila su obuhvaćena 163 bolesnika sa T3N0 stadijumom karcinomom rektuma, operisana na III Odeljenju Klinike za digestivnu hirurgiju (Prva hirurška klinika), Kliničkog centra Srbije u Beogradu. Imunohistohemijski je ispitivana ekspresija VEGF. Podaci su prikupljani u prospektivno dizajniranoj bazi podataka. Kao parametri od interesa definisani su pojava udaljenih metastaza i preživljavanje. Preživljavanje i vreme do recidiva bolesti pocenjivano je na osnovu Kaplan-Meier-ove metode i log-rank testa. Reziltati. U studiju su bila uključena 102 muškarca i 61 žena. Prosečna starost ispitanika bila je 62 godine (31-88 godina), a postoperativno praćenje iznosilo je u proseku 81 mesec (4-177 meseci). Kod šest bolesnika je dijagnostikovan lokalni, a kod 31 udaljeni recidiv bolesti. Tri faktora su pokazala značajnu povezanost sa udaljenim metastazama: ekspresija VEGF, mucinozni adenokarcinomi i diferencijacija tumora. Kod bolesnika sa pozitivnom ekspresijom VEGF preživljavanje je bilo lošije u odnosu na bolesnike sa negativnom ekspresijom VEGF (65% i 59%, redom; log-rank test p < 0,05). Zaključak. Povišena ekspresija VEGF kod T3N0 stadijuma karcinoma rektuma, zajedno sa standardnim histopatološkim karakteristikama tumora, može dati dovoljno informacija za definisanje bolesnika sa visokim rizikom od pojave recidiva bolesti i lošijom prognozom.

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