Germ hücreli testis tümörü'nde mikrorna-371a-3p seviyesi ileklinik evre, patolojik risk faktörleri ve metastatik hastadaprognostik risk grupları ilişkisinin değerlendirilmesi
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Dosyalar
Tarih
2021
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
GiriĢ ve Amaç: Genomun epigenetik regülasyonunda rol oynayan Mikro ribonükleikasit‟lerin
(miR/miRNA) klasik serum tümör belirteçlerine göre Germ hücreli testis tümörü (GCT)‟ye
daha sensitif ve spesifik olduğu saptanmıştır. Çalışmamızda GCT saptanan hastalarda tanı
anındaki miR-371a-3p seviyeleri ile hastalığın klinik evresi, evre 1 hastalarda patolojik risk
faktörleri ve metastatik hastalarda International Germ Cell Cancer Collaborative (IGCCCG)
sınıflamasına göre prognostik gruplarla olan korelasyonu araştırmayı amaçladık.
Materyal-Metod: Ocak 2019-Mayıs 2021 tarihleri arasında kliniğimizde GCT saptanan 60
hastanın ameliyat öncesi-sonrası, 40 sağlıklı katılımcının serum miR-371a-3p seviyeleri
ölçüldü. GCT hastalarının preoperatif kontrastlı toraks ve abdomen tomografi (BT)‟leri
çekilerek klinik evreleme yapıldı. Hastalarda patolojik risk faktörleri ve IGCCCG prognostik
gruplar belirlendi. miRNA-371a-3p ekspresyon ölçümü kantitatif real time PCR ile yapıldı.
Hastaların tanı anında miRNA-371a-3p düzeyleri ile evre ilişkisi, evre 1 hastalarda patolojik
risk faktörleri; metastatik hastalarda ise prognostik gruplarla olan ilişki istatistiksel olarak
değerlendirildi.
Bulgular: Kontrol grubu ile kıyaslandığında GCT‟de tanı anında miR-371a-3p‟nin
sensitivitesi % 98.3, spesifitesi % 95 olarak saptandı (AUC:0.997 (% 95 Cl 99-100) p<0.001).
Tanı anında; klinik evre 1 hastalıkta ortalama 38, klinik evre 2 hastalıkta ortalama 57, klinik
evre 3 hastalıkta ortalama 86 kat daha fazla eksprese edilmekteydi. Tüm evrelerdeki hastalar
göz önünde bulundurulduğunda tanı anında ortalama miR-371a-3p ekspresyon düzeyi non
seminom hastalarında seminom hastalarına göre 1.5 kat daha yüksekti (p:0.008).
Preoperatif dönemde 21 hastada Alfa-fetoprotein (AFP), 17 hastada Beta human chorionic
gonadotropin (bHCG), 12 hastada Laktat dehidrogenaz (LDH) artışı mevcuttu. Postoperatif 2.
haftada 13 (% 61) hastada AFP, 11 (% 64.7) hastada bHCG, 8 (% 66.6) hastada LDH
değerlerinde düşüş mevcuttu. Belirtecin ekspresyon seviyeleri hastalığın klinik evresi, primer
tümör boyutu ve IGCCCG kötü prognostik grupla ilişkili idi. Evre 1 hastalıkta ise tümör
boyutuyla ilişkili olup, seminom hastalarında Rete testis invazyonu ve nonseminom
hastalarında Lenfovasküler invazyonla ilişkili değildi.
Sonuç: miR-371a-3p klasik serum tümör belirteçlerine göre daha yüksek sensitivite ve
spesifiteye sahiptir. Belirteç primer tümör boyutu, klinik evre ve IGCCCG kötü prognostik risk
grubuyla koraledir.
Introduction: Microribonucleic acids (miR), which play a role in the epigenetic regulation of the genome, were found to be more sensitive and specific for Germ cell testicular tumor (GCT) than classical serum tumor markers. In our study, we aimed to investigate the correlation between miR-371a-3p levels at the time of diagnosis and the clinical stage of the disease, pathological risk factors in stage 1 patients, and prognostic groups according to the International Germ Cell Cancer Collaborative (IGCCCG) classification in metastatic patients. Methods: Between January 2019 and May 2021, serum miR-371a-3p levels were measured in 60 GCT patients, pre- and postoperatively, and 40 healthy participants. Clinical staging was performed by taking preoperative contrast-enhanced thorax and abdomen tomography of the GCT patients. Pathological risk factors and IGCCCG prognostic groups were determined in the patients. miRNA-371a-3p expression levels was measured by quantitative real time PCR. Relationship between miRNA-371a-3p levels and stage, pathological risk factors in stage 1 patients and the prognostic groups in metastatic patients was statistically evaluated. Results: Compared with the control group, the sensitivity of miR-371a-3p at the time of diagnosis was 98.3% and the specificity was 95% in GCT (AUC:0.997 (% 95 Cl 99-100) p<0.001). The marker was expressed on average 38 fold in clinical stage 1 disease, 57 fold in clinical stage 2 disease, and 86 fold in clinical stage 3 disease. Considering patients at all stages, the mean miR-371a-3p expression level at the time of diagnosis was 1.5 times higher in non-seminoma patients than in seminoma patients (p:0.008). In the preoperative period, Alpha-fetoprotein (AFP) increased in 21 patients, Beta human chorionic gonadotropin (bHCG) in 17 patients, and Lactate dehydrogenase (LDH) increased in 12 patients. In the postoperative 2nd week, there was a decrease in AFP in 13 (61%) patients, in bHCG in 11 (64.7%) patients, and in LDH values in 8 (66.6%) patients. While the expression levels of the marker are associated with the clinical stage of the disease, primary tumor size and IGCCCG poor prognostic group; it was not associated with pathological risk factors in stage 1 disease. Conclusions: miR-371a-3p has higher sensitivity and specificity than classical serum tumor markers. The marker correlates with primary tumor size, clinical stage, and IGCCCG poor prognostic risk group.
Introduction: Microribonucleic acids (miR), which play a role in the epigenetic regulation of the genome, were found to be more sensitive and specific for Germ cell testicular tumor (GCT) than classical serum tumor markers. In our study, we aimed to investigate the correlation between miR-371a-3p levels at the time of diagnosis and the clinical stage of the disease, pathological risk factors in stage 1 patients, and prognostic groups according to the International Germ Cell Cancer Collaborative (IGCCCG) classification in metastatic patients. Methods: Between January 2019 and May 2021, serum miR-371a-3p levels were measured in 60 GCT patients, pre- and postoperatively, and 40 healthy participants. Clinical staging was performed by taking preoperative contrast-enhanced thorax and abdomen tomography of the GCT patients. Pathological risk factors and IGCCCG prognostic groups were determined in the patients. miRNA-371a-3p expression levels was measured by quantitative real time PCR. Relationship between miRNA-371a-3p levels and stage, pathological risk factors in stage 1 patients and the prognostic groups in metastatic patients was statistically evaluated. Results: Compared with the control group, the sensitivity of miR-371a-3p at the time of diagnosis was 98.3% and the specificity was 95% in GCT (AUC:0.997 (% 95 Cl 99-100) p<0.001). The marker was expressed on average 38 fold in clinical stage 1 disease, 57 fold in clinical stage 2 disease, and 86 fold in clinical stage 3 disease. Considering patients at all stages, the mean miR-371a-3p expression level at the time of diagnosis was 1.5 times higher in non-seminoma patients than in seminoma patients (p:0.008). In the preoperative period, Alpha-fetoprotein (AFP) increased in 21 patients, Beta human chorionic gonadotropin (bHCG) in 17 patients, and Lactate dehydrogenase (LDH) increased in 12 patients. In the postoperative 2nd week, there was a decrease in AFP in 13 (61%) patients, in bHCG in 11 (64.7%) patients, and in LDH values in 8 (66.6%) patients. While the expression levels of the marker are associated with the clinical stage of the disease, primary tumor size and IGCCCG poor prognostic group; it was not associated with pathological risk factors in stage 1 disease. Conclusions: miR-371a-3p has higher sensitivity and specificity than classical serum tumor markers. The marker correlates with primary tumor size, clinical stage, and IGCCCG poor prognostic risk group.
Açıklama
Anahtar Kelimeler
Germ hücreli testis tümörü, Mikrorna, miR-371a-3p, Germ cell tumor, Microrna
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Kılınç, M. T. (2021). Germ hücreli testis tümörü'nde mikrorna-371a-3p seviyesi ileklinik evre, patolojik risk faktörleri ve metastatik hastadaprognostik risk grupları ilişkisinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Cerrahi Tıp Bilimleri Bölümü Üroloji Anabilim Dalı, Konya.
