Dergiler / Patoloji Bülteni / 2000 / Cilt: 17 - Sayı: 3
Uzun kemik osteosarkomlarında klinikopatolojik prognostik etmenler ve P-glikoprotein ekspresyonu
- Dergi
- Patoloji Bülteni
- Sayfa
- 159–162
- DOI
- —
Özet
Osteosarkom olgularında neoadjuvan kemoterapi ve ekstremite koruyucu cerrahi uygulamalarında konvansiyonel klinikopatolojik prognostik etmenler yanısıra çok ilaçlı kemoterapiye gelişen direnç mekanizmalarından birinde rol alan P-glikoproteinin ekspresyonu önem taşımaktadır. Bu çalışmada preoperatif neoadjuvan kemoterapi alan (n=22) ve almayan (n=22) uzun kemik osteosarkom olgularında yaş, semptom süresi, travma/patolojik kırık varlığı, metastaz, metastazın yeri ve zamanı, uygulanan terapi süreleri ve türleri, tümörün yayılımı, nekroz yüzdesi, grade gibi parametreler ve kemoterapi alan grupta P-glikoprotein ekspresyonu immunhistokimyasal olarak araştırılarak belirlenen parametre-ler ve ekspresyon ile prognoz arasındaki ilişki incelendi. Her iki grupta metastaz ortaya çıkma süreleri kısaldıkça sağkalım kısalıyordu (p 0.05).
Abstract
In application of neoadjuvant chemotherapy and limb-salvage procedures in osteosarcoma patient, expression of P-glycoprotein, which plays a role in multidrug resistance, is an important fact besides the clinicopathologic prognostic parameters. In this study, patients to whom preoperative neoadjuvant chemotherapy has been given (n=229) and has not been given (n=22) were examined by their age, duration of symptoms, existence of trauma/pathologic fracture, metastases, site and timing of metastases, types and duration of therapies, extension of the tumor, percentage of necrosis and grade. P-glycoprotein expression of the tumor, percentage of necrosis and grade. P-glycoprotein expression was determined immunohistochemically in the chemotherapy group. The suggested parameters and P-glycoprotein status was statisticaly analyzed in relation to survival. There was a significant relation between the time to develop metastases and survival (p<0.05). The duration of symptoms was seemingly important in the survival (p=0.084). The presence of trauma/pathologic fracture, metastases; percentage of necrosis, size of the tumor, frade, type of therapy, time elapse between biopsy and therapy were not statistically significant in regard of survival. Immunohistologically, 85.7 % of the cases were expressing P-glycoprotein in 38 % of which expression was strong (+++). Presence, strength of expression were not found to affect survival, grade, metastases, percentage of necrosis (p>0.05).