Mikst tipte hücre morfolojisine sahip gastrointestinalstromal tümörlerde mitoz sayısının hücre tipi ile ilişkisi
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Dosyalar
Tarih
2020
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Gastrointestinalstromal tümörlerde (GİST) hastalık progresyonunu veprognozu belirleyen en önemli parametre tümörün risk grubudur. Risk grubu; tümör çapı, mitoz sayısı ve tümör yerleşim yeri verileri kullanılarakbelirlenir. Bu çalışmada daha önce literatürde örneğine rastlamadığımız mikst tipte hücre morfolojisine sahip GİST' lerde hücre tipi (iğsi-epiteloid) ile mitoz sayısı arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntem: Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Tıbbi Patoloji Anabilim Dalı Laboratuarında 2008–2019 yılları arasında "Mikst Tip Gastrointestinal Stromal Tümör" olarak raporlanmış 35 adet vakanın Hematoksilen&Eozin ve immunhistokimyasal PHH3 (mitozu gösterir) boyalıpreparatları arşivden çıkarıldı. Klinik ve patolojik verilerinde eksiklik tespit edilen 2 olgu çalışmadan çıkarıldı. Toplam 33 olgu ışık mikroskobu altında tekrar değerlendirildi. İmmunhistokimyasal PHH3 boyalı preparatlardatümörlerde iğsi ve epiteloid alanlardaki mitoz sayısı (5 mm2 - 25 büyük büyütme alanında)hücre tiplerine göre ayrı ayrı sayılıp not edildi. Elde edilen mitoz sayısı baz alınarak, hücre tiplerine göre risk gruplandırmaları yeniden yapıldı. Ayrıca olguların demografik (yaş ve cinsiyet) ve diğer patolojik verileri (tümör boyutu ve anatomik lokalizasyonu) kaydedildi. Elde edilen veriler SPSS (Statistical PackagefortheSocialSciences) 24.0 paket programı kullanılarak analiz edildi. Tüm değişkenler için frekans (sayı), yüzde (%), aritmetik ortalama (mean) ± standart sapma (x±ss), ortanca (median), en düşük- en yüksek (min- max) değerler gibi tanımlayıcı istatistikler kullanıldı. Bulgular: Çalışmaya toplamda 33 mikst hücreli GİST vakası dahil edilmiştir. Vakaların 16 tanesi kadın (%48,5), 17 tanesi erkek (%51,5) tir. Vakaların ortalama yaşı61,69±13,63, ortanca yaş 63 (min: 29, max: 85) olarak bulunmuştur.Vakaların 13 tanesi ince barsak (%39,4), 12 tanesi mide (%36,4), 7 tanesi batın içi (%21,2), 1 tanesi rektum (%3) yerleşimlidir. Vakaların ortalama tümör çapı 11,07±6,39 cm, ortanca tümör çapı 9,5 cm (min: 3 cm- max: 30 cm)dir.İğsi alandaki ortalama mitoz sayısı 9,51±13,14, ortanca mitoz sayısı 6 (min: 1, max:74) dir. Epiteloid alandaki ortalama mitoz sayısı 15,03±16,42, ortanca mitoz sayısı 11 (min: 2, max:88) dir.Epiteloid alandaki ortalama ve ortanca mitoz sayısı iğsi alana göre daha yüksek tespit edilmiştir. 33 vakanın 31'inde epiteloid alandaki, 2 tanesinde ise iğsi alandaki mitoz sayısı daha yüksek tespit edilmiştir. İğsi ve epiteloid alanlardaki mitoz sayılarına göre risk gruplaması yapıldığında iğsi alandaki mitoz sayısı yüksek çıkan 2 olguda epiteloid alan ile karşılaştırıldığında risk grubu değişmezken, epiteloid alandaki mitoz sayısı yüksek çıkan 31 olgunun 8 tanesinde risk grubu iğsi alana göre daha yüksek tespit edilmiştir. Sonuç:Mikst tipte hücre morfolojisine sahip GİST'lerdeepiteloid hücre morfolojisindeki alanlarda mitoz sayısı,iğsihücre morfolojisindeki alanlardaki mitoz sayısına göre daha yüksek olduğundan tümörün risk sınıflaması yapılırken mitoz sayımının epiteloid alandan yapılmasını önermekteyiz. Anahtar Kelimeler: Gastrointestinal stromal tümör, Mitoz sayısı, Hücre tipi, Risk grubu
The most important parameter determining the prognosis and progression of the gastrointestinal stromal tumors is the risk group of the tumour. The risk group is determined using tumor diameter, number of mitosis and tumor location data. In this study, we aimed to evaluate the relationship between the cell type (spindle- epithelioid) and the number of mitosis in GİSTs with mixed type cell morphology, which we have not encountered in the literature before. Method: Hematoxylin&Eosin and immunohistochemical PHH3 (indicating mitosis) colored preparations of 35 cases reported as Mixed Type Gastrointestinal Stromal Tumor between 2005 and 2019 in the laboratuary of Necmettin Erbakan University, Faculty of Meram Medicine Department of Pathology were removed from the archive. 2 cases were removed from the study which have deficiency on their clinical and pathological data. 33 cases in total were re-evaluated under the light microscope. In the immunohistochemical PHH3 colored preparations, the number of mitosis in the spindle and epithelioid areas of the tumors (5 mm2 - 25 highpowerfields) were counted and noted separately according to the cell types. Based on the number of mitosis, obtained risk stratification was made according to cell types. In addition, the demographic (age and gender) and other pathological data (tumor size and anatomical localization) were recorded. The obtained data were analyze dusing the SPSS (Statistical Package for the Social Sciences) 24.0 package program. Descriptive statistics such as frequency (number), percentage (%), arithmetic mean (mean) ± standard deviation (x ± sd), median, minimum-maximum (min-max) values were used for all variables. Findings: A total of 33 mixed cell GIST cases were included in the study. 16 of the cases are female (48.5%), 17 of them are male (51.5%). The mean age of the cases was found as 61.69 ± 13.63, the median age was found as 63 (min: 29, max: 85). 13 of the cases are located in the small intestine (39.4%), 12 of them are located in the stomach (36.4%), 7 of them are in the abdomen (21.2%), and 1 of them is in the rectum (3%). vii The mean tumor diameter of the cases is 11.07±6,39 cm, and the median tumor diameter is 9,5 cm (min: 3-max: 30). The average number of mitosis in the spindle area is 9,51±13,14, the median number of mitosis is 6 (min: 1, max: 74).The average number of mitosis in the epithelioid area is 15,03±16,42, the median number of mitosis is 11 (min: 2, max: 88). The median and mean number of mitosis in the epithelioid area was detected higher than in the spindle area. In 31 of the 33 cases, the number of mitosis was detected higher in the epithelioid area and in 2 of them in the spindle area. When risk grouping was made according to the number of mitosis in the spindle and epithelioid areas, the risk group did not change in 2 cases with high mitosis in the spindle area compared to the epithelioid area, while the risk group was found to be higher in 8 of 31 cases with high mitosis in the epithelioid area compared to the spindle area. Result: In GISTs with mixed type cell morphology, since the number of mitosis in areas with epithelioid cell morphology is higher than the number of mitoses in areas with spindle cell morphology, were commend that the mitosis counting should be performed from the epithelioid area whilec lassifying the risk of the tumor. Keywords: Gastrointestinal stromal tumor, Mitosis number, Cell type, Risk group
The most important parameter determining the prognosis and progression of the gastrointestinal stromal tumors is the risk group of the tumour. The risk group is determined using tumor diameter, number of mitosis and tumor location data. In this study, we aimed to evaluate the relationship between the cell type (spindle- epithelioid) and the number of mitosis in GİSTs with mixed type cell morphology, which we have not encountered in the literature before. Method: Hematoxylin&Eosin and immunohistochemical PHH3 (indicating mitosis) colored preparations of 35 cases reported as Mixed Type Gastrointestinal Stromal Tumor between 2005 and 2019 in the laboratuary of Necmettin Erbakan University, Faculty of Meram Medicine Department of Pathology were removed from the archive. 2 cases were removed from the study which have deficiency on their clinical and pathological data. 33 cases in total were re-evaluated under the light microscope. In the immunohistochemical PHH3 colored preparations, the number of mitosis in the spindle and epithelioid areas of the tumors (5 mm2 - 25 highpowerfields) were counted and noted separately according to the cell types. Based on the number of mitosis, obtained risk stratification was made according to cell types. In addition, the demographic (age and gender) and other pathological data (tumor size and anatomical localization) were recorded. The obtained data were analyze dusing the SPSS (Statistical Package for the Social Sciences) 24.0 package program. Descriptive statistics such as frequency (number), percentage (%), arithmetic mean (mean) ± standard deviation (x ± sd), median, minimum-maximum (min-max) values were used for all variables. Findings: A total of 33 mixed cell GIST cases were included in the study. 16 of the cases are female (48.5%), 17 of them are male (51.5%). The mean age of the cases was found as 61.69 ± 13.63, the median age was found as 63 (min: 29, max: 85). 13 of the cases are located in the small intestine (39.4%), 12 of them are located in the stomach (36.4%), 7 of them are in the abdomen (21.2%), and 1 of them is in the rectum (3%). vii The mean tumor diameter of the cases is 11.07±6,39 cm, and the median tumor diameter is 9,5 cm (min: 3-max: 30). The average number of mitosis in the spindle area is 9,51±13,14, the median number of mitosis is 6 (min: 1, max: 74).The average number of mitosis in the epithelioid area is 15,03±16,42, the median number of mitosis is 11 (min: 2, max: 88). The median and mean number of mitosis in the epithelioid area was detected higher than in the spindle area. In 31 of the 33 cases, the number of mitosis was detected higher in the epithelioid area and in 2 of them in the spindle area. When risk grouping was made according to the number of mitosis in the spindle and epithelioid areas, the risk group did not change in 2 cases with high mitosis in the spindle area compared to the epithelioid area, while the risk group was found to be higher in 8 of 31 cases with high mitosis in the epithelioid area compared to the spindle area. Result: In GISTs with mixed type cell morphology, since the number of mitosis in areas with epithelioid cell morphology is higher than the number of mitoses in areas with spindle cell morphology, were commend that the mitosis counting should be performed from the epithelioid area whilec lassifying the risk of the tumor. Keywords: Gastrointestinal stromal tumor, Mitosis number, Cell type, Risk group
Açıklama
Anahtar Kelimeler
Gastrointestinal stromal tümör, Mitoz sayısı, Hücre tipi, Risk grubu, Gastrointestinal stromal tumor, Mitosis number, Cell type, Risk group
Kaynak
WoS Q Değeri
Scopus Q Değeri
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Künye
Gökalp, F. (2020). Mikst tipte hücre morfolojisine sahip gastrointestinalstromal tümörlerde mitoz sayısının hücre tipi ile ilişkisi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Tıbbi Patoloji Anabilim Dalı, Konya.
