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Böbreğin Renal Hücreli Karsinomlarında Ki-67 Proliferasyon indeksi, p53 Expresyonu, AgNOR Sayısı ve Prognostik Faktörlerin, Histopatolojik Tip ve Derecelendirme ile ilişkisi

The Relationship of Ki-67 Proliferation Index, p53 Expression, AgNOR Number and Prognostic Factors in Kidney's Renal Cell Carcinomas with Histopathological Type and Grading

Journal Name:

  • Fırat Tıp Dergisi

Publication Year:

  • 2010

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Abstract (2. Language): 
Objective: Renal cell carcinomas, the most common malignant kidney tumor, ranks third among urological tumors. The patients with renal cell carcinoma usually have bad prognosis. In this study, in the samples prepared by nephrectomy materials belonging to incidents with renal cell carcinoma, by comparing P53 ve Ki-67 immunohistochemically, AgNOR's chromophobe qualities histochemically, it was aimed to evaluate the benefit of them as prognostic criteria. Materials and Methods: Nephrectomy materials diagnosed with renal cell carnicoma were taken into study between 1994 and 2002 in our department. Sections of 54 incidents were looked into and diagnoses were confirmed. Prognostic factors were re-evaluated. Ki-67 P53 and AgNOR chromophobe methods were applied to the prepared sections as immunohistochemically. Results: Ki-67 PI was determined to be 4.55% in transparent RCC, 3,33% in granular RCC, 3,66%in chromoplobe RCC, 28,7% in fusiform cell carcinoma,0,3% in cystic RCC, and it was found out that Ki-67 PI displayed differences according to histopathological types in renal cell carnicomas. There was a significant difference between PI of fusiform RCC and PI of other types of RCC (p<0.001). Conclusion: In conclusion, we decided to that the parameters as prognostic factors, because of studies showing differences between the reliability in determining the prognosis was not enough.
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Abstract (Original Language): 
Amaç: En sık görülen malign böbrek tümörü olan renal hücreli karsinomlar, ürolojik tümörler içerisinde 3. sıradadır. Renal hücreli karsinomu olan hastalar genellikle kötü prognoza sahiptir. Bu çalışmamızda, renal hücreli karsinomlu olgulara ait nefrektomi materyallerinden hazırlanan örneklerde, immünhistokimyasal olarak P53 ve Ki-67, histokimyasal olarak AgNOR'un boyanma özelliklerini karşılaştırarak, bunların prognostik kriterler olarak yararının değerlendirilmesi amaçlandı. Gereç ve Yöntemler: 1994-2002 yılları arasında Renal hücreli karsinom tanısı alan nefrektomi materyalleri çalışmaya alındı. Toplam 54 olgunun tanıları doğrulandı. Prognostik faktörler yeniden değerlendirildi. İmmünohistokimyasal olarak Ki-67, P53 ve AgNOR boyama yöntemi uygulandı. Bulgular: Ki-67 PI şeffaf RCC'de %4.55, granüler RCC'de %3.33, kromofob RCC'de %3.66, iğsi hücreli karsinomda %28.7, kistik RCC'de %0.3 olarak belirlendi ve Ki-67 PI'nin renal hücreli karsinomlarda histopatolojik tiplere göre değişiklikler gösterdiği saptandı. İğsi RCC'nin PI'si ile diğer tip RCC'lerin PI'leri arasında anlamlı bir farklılık bulunmaktaydı (P<0.001). Diğer gruplar arasında bulgular benzerdi. Ki-67 PI şeffaf RCC'de %4.55, granüler RCC'de %3.33, kromofob RCC'de %3.66, iğsi hücreli karsinomda %28.7, kistik RCC'de %0.3 olarak belirlendi ve Ki-67 PI'nin renal hücreli karsinomlarda histopatolojik tiplere göre değişiklikler gösterdiği saptandı. İğsi RCC'nin PI'si ile diğer tip RCC'lerin PI'leri arasında anlamlı bir farklılık bulunmaktaydı (P<0.001) Sonuç: Prognostik faktör olarak belirtilen parametrelerin, çalışmalar arasında farklılıklar göstermesi nedeniyle prognozu belirlemede güvenilirliklerinin yeterli olmadığına karar verilmiştir.
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