Kaposi sarkom ve taklitçi lezyonları arasında COX-2'nin tanıya katkısı ve klinikopatolojik parametrelerle ilişkisinin değerlendirilmesi
Küçük Resim Yok
Tarih
2023
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmada temel olarak Kaposi sarkomu (KS) ve taklitçi lezyonları arasında siklooksijneaz-2 (COX-2)'nin immunekspresyonu açısından fark olup olmadığının araştırılması, ikincil olarak ise COX-2 ekspresyonunun klinik ve hematolojik parametreler ile ilişkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza Düzce Üniversitesi Tıp Fakültesi Hastanesi'nde 2012-2022 yılları arasında biyopsi örneği alınan KS tanılı 37 hasta ve ayırıcı tanıda KS ile karışıp insan herpes virüsü-8 (HHV-8) immunohistokimyasal olarak çalışılan 37 vaka dahil edilmiştir. Patolojik olarak KS tanısı alan, kesitleri COX-2 ve CD34 boyası ile optimal boyanan olgular çalışmaya dahil edilmiştir. Hastalara ait demografik ve klinik bilgiler ile ilgili veri toplamak için hastanemiz veri tabanı bilgi sistemi kullanılmıştır. Hastaların yaş, cinsiyet, tanı anındaki hemogram parametreleri (lökosit, nötrofil, lenfosit, ortalama trombosit hacmi (MPV)), üre ve kreatinin değerleri kaydedilerek, nötrofil lenfosit oranı (NLO) ve trombosit lenfosit oranı (TLO) hesaplanmıştır. Çalışmaya dahil edilen tüm hastaların arşivdeki parafine gömülmüş deri örneklerinden kesitler hazırlanarak histokimyasal inceleme ile HHV-8, CD34 ve COX-2 protein miktarları değerlendirilmiştir. Bulgular: KS hastalarında erkek/kadın oranı ve hastalığın görülme yaşı kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek saptanmıştır (sırasıyla; p=0,018, p<0,001). KS hastalarının histolojik progresyon evrelerine göre; 19'u (%51,4) tümör evresinde, 8'i (%21,6) plak evresinde, 10'u (%27,0) yama (patch) evresindeydi. KS hastalarının tümünde (%100) HHV-8 immünreaktivitesi gözlenmiştir. KS hastalarının 33'ünde (%89,2), kontrol grubundaki vakaların 16'sında (%43,2) sitoplazmik diffüz paternde COX-2 immünreaksiyonu gözlenmiştir. KS ve kontrol grubu arasında COX-2 ve CD34 boyanma dereceleri açısından anlamlı fark saptanmıştır (sırasıyla; p<0,001, p<0,001). KS hastalarında lezyon evreleri(tümör, plak, yama) arasında CD34 boyanma derecesi açısından anlamlı fark saptanmıştır (p<0,001) ancak COX-2 boyanma derecesi açısından anlamlı fark saptanmamıştır (p=0,728). KS hastalarında NLO ve TLO değerleri COX-2 boyanma derecesi yüksek olan grupta COX-2 boyanma derecesi düşük olan gruba göre anlamlı derecede yüksek saptanmıştır (sırasıyla; p=0,002, p=0,016). Tümör evresindeki KS hastalarının HHV-8 skoru yama evresindeki hastaların HHV-8 skoruna kıyasla anlamlı daha yüksek bulunmuştur (p=0,036). Sonuç: COX-2'nin KS'nin gelişiminde önemli bir rol oynadığı ve KS ayırıcı tanısında kullanılan HHV-8, CD34'e ek olarak tanısal amaçlı kullanılabileceği sonucuna varılmıştır. Ayrıca COX-2 overekspresyonun inflamasyon ile karakterize daha yüksek NLO ve TLO ile korele olduğu görülmüştür. Bu bulguların KS'nin patogenetik süreci ve tümörün prognozu açısından önemli olabileceği düşünülmüştür. Bulgularımızın desteklenmesi için daha geniş seriler ve daha ileri moleküler ve genetik çalışmalar ile desteklenen çalışmalara ihtiyaç vardır. ANAHTAR KELİMELER: Kaposi sarkomu, COX-2, HHV-8, CD34, immunohistokimya
Aim: In this study, it was mainly aimed to investigate whether there is a difference in immune expression of cyclooxygnease-2 (COX-2) between Kaposi sarcoma (KS) and mimicry lesions, and secondly, to determine the relationship of COX-2 expression with clinical and hematological parameters. Materials and Methods: In our study, 37 patients diagnosed with KS, whose biopsy samples were taken at Düzce University Medical Faculty Hospital between 2012 and 2021, and 37 cases that were mixed with KS in the differential diagnosis and studied human herpes virus-8 (HHV-8) immunohistochemically were included in our study. Cases with pathological diagnosis of KS and optimally stained sections with COX-2 and CD34 stains were included in the study. Our hospital database information system was used to collect data on demographic and clinical information of patients. Age, gender, hemogram parameters (leukocyte, neutrophil, lymphocyte, mean platelet volume (MPV)), urea and creatinine values of the patients were recorded, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (TLR) were calculated. HHV-8, CD34 and COX-2 protein amounts were evaluated by histochemical examination by preparing sections from paraffin-embedded skin samples in the archive of all patients included in the study. Results: Male/female ratio and median age were found to be statistically significantly higher in KS patients compared to the control group (respectively; p=0.018, p<0.001). According to the histological progression stages of KS patients; 19 (51.4%) were at tumor stage, 8 (21.6%) were at plaque stage, and 10 (27.0%) were at patch stage. HHV-8 immunoreactivity was observed in all (100%) patients with KS. COX-2 immunoreaction in a cytoplasmic diffuse pattern was observed in 33 (89.2%) of the KS patients and 16 (43.2%) of the control group. A significant difference was found between the KS and control groups in terms of COX-2 and CD34 staining degrees (p<0.001, p<0.001, respectively). There was a significant difference in CD34 staining grade between lesion stages (tumor, plaque, patch) in KS patients (p<0.001) but no significant difference was found in COX-2 staining grade (p=0.728). In KS patients, NLR and TLR values were found to be significantly higher in the group with high COX-2 staining than in the group with low COX-2 staining (respectively; p=0.002, p=0.016). The HHV-8 score of KS patients in the tumor stage was found to be significantly higher than the HHV-8 score of the patients in the patch stage (p=0.036). Conclusions: It was concluded that COX-2 plays an important role in the development of KS and can be used for diagnostic purposes in addition to HHV-8, CD34, which is used in the differential diagnosis of KS. In addition, COX-2 overexpression was found to be correlated with higher NLR and TLR, which is characterized by inflammation. These findings were thought to be important in terms of the pathogenetic process of KS and the prognosis of the tumor. Studies supported by larger series and further molecular and genetic studies are needed to support our findings. KEYWORDS: Kaposi sarcoma, COX-2, HHV-8, CD34, immunohistochemistry
Aim: In this study, it was mainly aimed to investigate whether there is a difference in immune expression of cyclooxygnease-2 (COX-2) between Kaposi sarcoma (KS) and mimicry lesions, and secondly, to determine the relationship of COX-2 expression with clinical and hematological parameters. Materials and Methods: In our study, 37 patients diagnosed with KS, whose biopsy samples were taken at Düzce University Medical Faculty Hospital between 2012 and 2021, and 37 cases that were mixed with KS in the differential diagnosis and studied human herpes virus-8 (HHV-8) immunohistochemically were included in our study. Cases with pathological diagnosis of KS and optimally stained sections with COX-2 and CD34 stains were included in the study. Our hospital database information system was used to collect data on demographic and clinical information of patients. Age, gender, hemogram parameters (leukocyte, neutrophil, lymphocyte, mean platelet volume (MPV)), urea and creatinine values of the patients were recorded, neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (TLR) were calculated. HHV-8, CD34 and COX-2 protein amounts were evaluated by histochemical examination by preparing sections from paraffin-embedded skin samples in the archive of all patients included in the study. Results: Male/female ratio and median age were found to be statistically significantly higher in KS patients compared to the control group (respectively; p=0.018, p<0.001). According to the histological progression stages of KS patients; 19 (51.4%) were at tumor stage, 8 (21.6%) were at plaque stage, and 10 (27.0%) were at patch stage. HHV-8 immunoreactivity was observed in all (100%) patients with KS. COX-2 immunoreaction in a cytoplasmic diffuse pattern was observed in 33 (89.2%) of the KS patients and 16 (43.2%) of the control group. A significant difference was found between the KS and control groups in terms of COX-2 and CD34 staining degrees (p<0.001, p<0.001, respectively). There was a significant difference in CD34 staining grade between lesion stages (tumor, plaque, patch) in KS patients (p<0.001) but no significant difference was found in COX-2 staining grade (p=0.728). In KS patients, NLR and TLR values were found to be significantly higher in the group with high COX-2 staining than in the group with low COX-2 staining (respectively; p=0.002, p=0.016). The HHV-8 score of KS patients in the tumor stage was found to be significantly higher than the HHV-8 score of the patients in the patch stage (p=0.036). Conclusions: It was concluded that COX-2 plays an important role in the development of KS and can be used for diagnostic purposes in addition to HHV-8, CD34, which is used in the differential diagnosis of KS. In addition, COX-2 overexpression was found to be correlated with higher NLR and TLR, which is characterized by inflammation. These findings were thought to be important in terms of the pathogenetic process of KS and the prognosis of the tumor. Studies supported by larger series and further molecular and genetic studies are needed to support our findings. KEYWORDS: Kaposi sarcoma, COX-2, HHV-8, CD34, immunohistochemistry
Açıklama
Anahtar Kelimeler
Dermatoloji, Dermatology
