Agustos 2014
Ülseratif kolitli hastalarda displazi varligi ve displastik mukozada p53 ve Ki-67 ekspresyonu
The presence of dysplasia in patients with ulcerative colitis and p53 and Ki-67 expression in dysplastic mucosa
- Ana Sayfa
- Sayılar
- Agustos 2014
- Ülseratif kolitli hastalarda displazi varligi ve displastik mukozada p53 ve Ki-67 ekspresyonu...
Özet
Giris ve Amaç: Ülseratif kolitin baslangicindan 8-10 yil sonra kolorektal kanser gelisim riski artar. Ülseratif kolit hastalarinin kansere bagli mortalite ve morbiditesi kolonoskopik tarama yöntemleriyle azaltilabilir. Bu çalismanin amaci; ülseratif kolit hastalarinda histopatolojik olarak displazi varligini arastirmak ve immünohistokimyasal tekniklerle displastik mukozada p53 ve KI-67 ekspresyon oranlarini belirlemektir. Gereç ve Yöntem:Çalismaya klinik olarak remisyonda olan 52 ülseratif kolit hastasi alindi. Tüm hastalara total kolonoskopi uygulandi ve çekuma kadar girildi. Kolondan rektuma kadar 10 cm?de bir dört kadran biyopsiler alindi. Displazi varligi biyopsi örneklerinde histopatolojik olarak tespit edildi ve displazi saptanan hastalarda immünohistokimyasal olarak p53 ve Ki-67 ekspresyonu varligi arastirildi. Bulgular:Hastalarin 32?sinde hastalik süresi 8 yildan az, 20?sinde ise 8 yil ve üzerindeydi. Hastalarin hepsi klinik olarak remisyonda olmasina ragmen endoskopik olarak sadece %59,6?i remisyondaydi. Hastalik %44,2 sol kolon ve %55,8 pankolit yerlesimliydi. Displazi 52 ülseratif kolit hastasinin 9?unda (%17,5) saptandi. Hastalik lokalizasyonu 6 hastada pankolit, 3 hastada ise sol kolon yerlesimliydi. Displazi, hastalik süresi 8 yildan fazla olan hastalarda yüksek saptandi. Immünohistokimyasal inceleme ile p53 için pozitif boyanma 6 hastada, Ki-67 boyanmasi 3 hastada görüldü. Sonuç: Displazi hastalik süresi 8 yil ve üzeri olanlarda ve pankolitli olgularda daha fazla saptanmistir. Çalismamizda hastalik süresi 8 yildan daha az olanlarda da displazi saptanmasi, tarama programina erken baslanmali mi sorusunu akla getirmektedir.
Abstract
Background and Aims:The risk of developing colorectal cancer increases distinctly for more than 8-10 years from the onset of ulcerative colitis. Mortality and morbidity in patients with ulcerative colitis can be decreased with colonoscopic screening methods. The aim of this study was to investigate the presence of dysplasia histopathologically in patients with ulcerative colitis and to determine p53 and Ki-67 expression rates in dysplastic mucosa using immunohistochemical techniques. Materials and Methods: Fifty-two ulcerative colitis patients who were followed clinically while in remission were enrolled into the study. Total colonoscopy was applied to every patient. Biopsies were taken from the colon and rectum every 10 cm. Presence of dysplasia was detected histopathologically in the biopsy samples, and p53 and Ki-67 expression was investigated immunohistochemically in dysplastic samples. Results: The duration of disease was <8 years in 32 patients and ≥8 years in 20 patients. With respect to endoscopic disease activation, 40.4% of patients had active disease and 59.6% were in remission. Disease in 44.2% of patients was localized in the left colon and 55.8% had pancolitis. Dysplasia was found in 9 of 52 patients (17.5%). When disease localization was investigated, 6 patients had pancolitis, and disease was localized in the left colon in 3 patients. Presence of dysplasia was high in patients with disease duration of >8 years. On immunohistochemical examination, positive staining for p53 was detected in 6 patients and positive Ki-67 staining in 3 patients. Conclusions: Dysplasia was found at a higher rate in patients with disease duration >8 years and pancolitis. In our study, the presence of dysplasia in patients with disease duration of <8 years raises the question of investigating dysplasiaearlier.
