Naslov (srp)

„Туморско пупљење и неоангиогенеза као прогностички фактори карцинома дебелог црева“

Autor

Ђерковић, Бранислав В.

Doprinosi

Кнежевић, Милан

Opis (eng)

Introduction: Tumor Budding and Angiogenesis are very actual parameters that follow the colon cancer, and are associated with the survival of such patients. High grade tumor budding is associated with tumor dedifferentiation and is an important sign of tumor invasion. Cells that are separated from the main tumor mass, have lost their contact points, making it easier to metastasize. On the other hand, synchronous growth of blood vessels is necessary for tumor growth. Increasing angiogenesis in tumor increases the likelihood that tumor cells will enter the circulation and cause the occurrence of distant metastases. Tumor swelling and neoangiogenesis are potential indicators of aggressive behaviour of colon cancer in the future. Objective: The main goal of the study was to examine the histopathological characteristics of colon carcinomas, primarily the degree of tumor budding and the number of capillary vessels compared to the level of tumor histological differentiation, tumor stage and its metastatic potential. Goal was to determine the presence of tumor buds and MDV (microvascular density) relative to the morphometric parameters of the tumor (size, macroscopic type of tumor, histological type of tumor, depth of stromal invasion, presence of lymphocytes in stroma under the tumor, etc.). Additionally, evaluate the degree of expression of CD 105 (Endoglin) receptor in colorectal cancer, as well as the comparison of the degree of this expression of the CD 105 receptor (Endoglina) and grade of MVD expression. Methods: The research was carried out at the Priština Medical Faculty, headquartered in Kosovska Mitrovica, at the Department of Pathology, and the Laboratories of the Institute of Pathology, University of Belgrade. A retrospective cohort study was performed on the operative material of 102 patients with colon cancer. The number of detected tumor buds is divided into two groups: low tumor buds (less than 10), and high levels, more than 10 buds at the x200 magnification field of microscope. After immunohistochemistry with CD 105, as a marker of endothelial cells, the density of microscopic blood vessels (MVD) was determined. The number of KS is classified into two groups based on the median: a group with a low degree/level of angiogenesis and a group with a high degree of angiogenesis. The statistical 8 analysis used X2 test, Fisher test, univariate regression analysis. The effect of the indicators on the prognosis of survival was analyzed by the method of multivariate regression - Cox regression test. Statistical data processing was done with IBM - SPSS Statistics v. 20, a software package for Windows, where p ≤ 0.05 was considered to be a statistically significant value. When p ≤ 0,01, the result is considered highly statistically significant. Results: In this paper, there was found to be a statistically significant association between the "high grade" tumor budding on the one hand and the histological grade, lymphatic invasion, venous invasion, perineural invasion, metastases in regional lymph nodes, the presence of mucus and degree of angiogenesis in tumor on the other hand. In addition, there was found to be a statistically significant association between a high degree of angiogenesis on the one hand and an invasion of lymphatic wessels, a degree of expression of CD 105, and a "high grade" tumor budding in the tumor on the other hand. Conclusion: A statistically high association between tumor budding and neoangiogenesis in colorectal cancer was found. High grade tumor budding increases with increasing TNM stage and tumor histological grade, while tumor angiogenesis is unrelated to the tumor stage of tumor grade of colon cancer.

Opis (srp)

Uvod: Tumorsko pupljenje i angiogeneza su jako aktuelni parametri koji se prate kod karcinoma debelog creva, a često se dovode u vezu sa preživljavanjem ovakvih pacijenata. Izraženo tumorsko pupljenje upućuje na dediferencijaciju tumora i predstavlja važan znak tumorske invazije. Ćelije koje su se odvojile od tumorske mase, izgubile su kontaktne veze, pa lakše metastaziraju. Sa druge strane, za rast tumora je neophodan i sinhroni rast krvnih sudova. Povećavanje vaskularizacije angiogenezom, povećava verovatnoću da će tumorske ćelije ući u cirkulaciju i izazvati pojavu udaljenih metastaza. Tumorsko pupljenje i neoangiogeneza su potencijalni pokazatelji agresivnijeg ponašanja karcinoma debelog creva u budućnosti. Cilј: Osnovni cilј istraživanja je bio ispitati histopatološke karakteristike karcinoma kolona, pre svega stepen tumorskog puplјenja i broja kapilarnih krvnih sudova u odnosu na histološki stepen diferencijacije tumora, patološki stadijum tumora i njegov metastatski potencijal. Odrediti zastuplјenost tumorskog puplјenja i MDV (microvasvcular density) u odnosu na morfometrijske parametre tumora (veličina, makroskopski tip tumora, histološki tip tumora, stepen invazije u stromu, prisustvo limfocita u stromi ispod tumora i sl.). Osim toga, ispitati stepen ekspresije CD 105 (Endoglin) receptora kod karcinoma debelog creva, kao i komparacija stepena ekspresije CD 105 receptora (Endoglina) i MVD. Metode: Istraživanje je sprovedeno na Medicinskom fakultetu u Prištini sa sedištem u Kosovskoj Mitrovici, na odseku za patologiju, i laboratoriji Instituta za patologiju, Univerziteta u Beogradu. Rađena je retrospektivna kohortna studija koja je sprovedena na operativnom materijalu 102 pacijenta sa karcinomom debelog creva. Broj detekrovanih tumorskih pupolјaka podelјen je u dve grupe: nizak nivo tumorskih pupolјaka (manje od 10), i visok nivo, kada je prisutno više od 10 puplјaka na polјu uvećanja x200. Nakon imunohistohemijskog bojenja sa CD 105, kao markerom endotelnih ćelija, određena je gustina mikroskopskih krvnih sudova (MVD). Broj novonastalih KS je na osnovu medijane 6 klasifikovan u dve grupe: grupa sa niskim stepenom angiogeneze i grupa sa visokim stepenom angiogeneze. U statističkoj analizi korišten je X² test, Fisher-ov test, univarijantna regresiona analiza. Uticaj pokazatelјa na prognozu preživlјavanja analiziran je metodom multivarijatne regresije tj. Cox-ovim regresionim testom. Statistička obrada podataka je urađena u IBM – SPSS Statistics v. 20, softverski paket za Windows, pri čemu je p ≤ 0.05 smatrano za statistički značajnu vrednost. Kada je vrednost p ≤ 0,01, rezultat je smatran visoko statistički značajnim. Rezultati: U ovom radu nađeno je da postoji statistički značajna povezanost između “High grade” tumorskog pupljenja sa jedne strane i histološkog gradusa, invazije limfatika, invazije vena, perineuralne invazije, metastaza u regionalnim limfnim nodusima, prisustva mucina i stepena angiogeneze u tumoru sa druge strane. Osim toga nađeno je da postoji statistički značajna povezanost između visokog stepena angiogeneze sa jedne strane i invazije limfatika, stepena ekspresije CD 105 , kao i “High grade” tumorskog pupljenja u tumoru sa druge strane. Zalјučak: Nađena je statistički visoka povezanost između tumorskog pupljenja i neoangiogeneze kod karcinoma debelog creva. “High grade” tumorsko pupljenje se povećava sa povećanjem stadijuma po TNM-u i tumorskim gradusom, dok tumorska angiogeneza nije povezana sa stadijumom i gradusom karcionoma debelog creva.

Jezik

srpski

Datum

2017

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