Meme karsinomlarında tümör tomurcuklanmasının prognostik parametreler ile ilişkisi
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Dosyalar
Tarih
2022
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Yayıncı
Trakya Üniversitesi Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Meme kanseri, kadınlarda en sık görülen ve ölüme en sık neden olan kanserdir. Meme kanseri, farklı biyolojik ve klinik davranışlar sergileyen heterojen bir malignitedir. Vakaların çoğunluğunu özel tipte olmayan invaziv meme karsinomları oluşturur. Çalışmamıza, tümör tomurcuklanmasının prognostik parametrelerle karşılaştırılması amacıyla özel tipte olmayan invaziv meme karsinomu tanılı 278 vaka dahil edildi. Vakalara ait tümör odak sayısı, tümör boyutu, histolojik tümör derecesi, patolojik tümör evresi, lenf nodu durumu, lenfatik, kan damarı ve perinöral invazyon durumu, eşlik eden in situ duktal karsinom varlığı, biyobelirteçler ile tanımlanan alt tipleri ve Ki-67 proliferasyon indeksi değerlendirilmiştir. Tanı yaşı, rekürrens ve ölüm durumu, genel sağkalım ve hastalıksız sağkalım süreleri kaydedilmiştir. Elde edilen bulgulara göre, yüksek dereceli tümör tomurcuklanmasının daha büyük tümör boyutu, daha ileri patolojik tümör evresi, lenf nodu metastazı, lenfatik invazyon ve kan damarı invazyonu, artmış rekürrens ve ölüm riski ile ilişkili olduğu, genel sağkalım ve hastalıksız sağkalım süresini kısalttığı saptanmıştır. Vakalar patolojik tümör evrelerine göre ayrıldığında, yüksek dereceli tümör tomurcuklanmasının patolojik tümör evresi 1, 2 ve 3 ise lenf nodu metastazını ve lenfatik invazyonu arttırdığı görüldü. Vakalar biyobelirteçler ile tanımlanan alt tiplere göre gruplandırıldığında, yüksek dereceli tomurcuklanma ile luminal A, luminal B (insan epidermal büyüme faktör reseptörü 2 negatif / pozitif) ve triple negatif meme karsinomu olan vakalarda lenf nodu metastazının ve lenfatik invazyonun arttığı görüldü. Ek olarak, yüksek dereceli tomurcuklanması ile luminal A vakalarda artmış tümör boyutu, insan epidermal büyüme faktör reseptörü 2 pozitif vakalarda azalmış hastalıksız sağkalım, triple negatif meme karsinomu vakalarında ise artmış rekürrens riski, azalmış hastalıksız sağkalım arasında anlamlı ilişki tespit edildi. Sonuç olarak, meme karsinomlarında tümör tomurcuklanması, rutin pratikte kolaylıkla kullanılabilir. Olumsuz prognostik bir histolojik parametre olarak faydalı olabileceği ve hastaların klinik yönetimine katkı sağlayacağı düşünülmektedir.
Breast cancer is the most common cancer and the most common cause of death for women. Breast cancer is a heterogeneous malignancy with different biological and clinical behaviors. Non-specific types of invasive breast carcinomas account for the majority of cases. In our study, 278 cases with a diagnosis of non-specific type of invasive breast carcinoma were included in the study in order to compare tumor budding with prognostic parameters. Tumor foci count, tumor size, histological tumor grade, pathological tumor stage, lymph node status, lymphatic, blood vessel and perineural invasion status, presence of concomitant ductal carcinoma in situ, subtype defined by biomarkers, Ki-67 proliferation index were evaluated. Age, recurrence and death status, overall survival and disease-free survival times were recorded. According to the findings, it was determined that high-grade tumor budding was associated with larger tumor size, more advanced pathological tumor stage, lymph node metastasis, lymphatic and blood vessel invasion, increased risk of recurrence and death, and shortened overall survival and disease-free survival. When cases were separated according to pathological tumor stages, it was found that high-grade budding increased lymph node metastasis and lymphatic invasion if pathological tumor stages 1, 2 and 3. When the cases were grouped into subtypes defined by biomarkers, it was observed that lymph node metastasis and lymphatic invasion increased for luminal A, luminal B (human epidermal growth factor receptor 2 negative / positive) and triple negative breast carcinoma cases in the presence of high-grade budding. In addition, high grade tumor budding was significantly associated with larger tumor size for luminal A cases, decreased disease free survival for human epidermal growth factor receptor 2 positive cases, increased risk of recurrence and decreased disease free survival for triple negative breast carcinoma cases. In conclusion, tumor budding in breast carcinomas can be easily used in routine practice. It is thought that it may be useful as an unfavorable prognostic histological parameter and contribute to the clinical management of patients.
Breast cancer is the most common cancer and the most common cause of death for women. Breast cancer is a heterogeneous malignancy with different biological and clinical behaviors. Non-specific types of invasive breast carcinomas account for the majority of cases. In our study, 278 cases with a diagnosis of non-specific type of invasive breast carcinoma were included in the study in order to compare tumor budding with prognostic parameters. Tumor foci count, tumor size, histological tumor grade, pathological tumor stage, lymph node status, lymphatic, blood vessel and perineural invasion status, presence of concomitant ductal carcinoma in situ, subtype defined by biomarkers, Ki-67 proliferation index were evaluated. Age, recurrence and death status, overall survival and disease-free survival times were recorded. According to the findings, it was determined that high-grade tumor budding was associated with larger tumor size, more advanced pathological tumor stage, lymph node metastasis, lymphatic and blood vessel invasion, increased risk of recurrence and death, and shortened overall survival and disease-free survival. When cases were separated according to pathological tumor stages, it was found that high-grade budding increased lymph node metastasis and lymphatic invasion if pathological tumor stages 1, 2 and 3. When the cases were grouped into subtypes defined by biomarkers, it was observed that lymph node metastasis and lymphatic invasion increased for luminal A, luminal B (human epidermal growth factor receptor 2 negative / positive) and triple negative breast carcinoma cases in the presence of high-grade budding. In addition, high grade tumor budding was significantly associated with larger tumor size for luminal A cases, decreased disease free survival for human epidermal growth factor receptor 2 positive cases, increased risk of recurrence and decreased disease free survival for triple negative breast carcinoma cases. In conclusion, tumor budding in breast carcinomas can be easily used in routine practice. It is thought that it may be useful as an unfavorable prognostic histological parameter and contribute to the clinical management of patients.
Açıklama
Anahtar Kelimeler
Epitelyal mezenkimal geçiş, İnvaziv meme karsinomu, Prognostik parametre, Tümör tomurcuklanması, Epithelial mesenchymal transition, Invasive breast carcinoma, Prognostic parameter, Tumor budding
