Mesane tümörlerinde p53, Ki67, bcl-2 ve MDM-2 ekspresyonu ve klinikopatolojik parametreler ile ilişkisi

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Tezin Türü: Tıpta Uzmanlık

Tezin Yürütüldüğü Kurum: Gazi Üniversitesi, Tıp Fakültesi, PATOLOJİ ANABİLİM DALI, Türkiye

Tezin Onay Tarihi: 2003

Tezin Dili: Türkçe

Öğrenci: İPEK IŞIK GÖNÜL

Danışman: AYŞE DURSUN

Özet:

64 SUMMARY The two most important parameters that determines the prognosis and treatment in transitional cell carcinomas, which are the most commonly seen tumours of the bladder, are grading and staging. Recently, two new classification systems (WHO/ISUP 1998 and WHO/ISUP 1999) for grading of urothelial neoplasms have been published and the most widely grading system throughout the world, WHO 1 973 grading system is being critised. The present study examined 72 patients with transitional cell carcinomas that were graded according to the WHO 1973, WHO/ISUP 1998 and WHO/ISUP 1999 consensus classifications. The relationships between tumour grades in three different systems and stage, angiolymphatic invasion, mitotic index, Kİ67, p53, MDM-2 and bcl-2 expressions together with their prognostic significance were investigated. We found a significant correlation between pathologic stage, mitotic index, angiolymphatic invasion and tumour grades according to the three different systems (p 0.05). Kİ67 and p53 expressions correlated with tumour grades in WHO 1973 grading system (p 0.05). As a result. WHO 1973 grading system is still the international standart for the classification and grading of urothelial neoplasms. It can distinguish the tumours in different prognostic groups which show a significant difference in Kİ67 and p53 expressions. WHO/ISUP 1998 and WHO/ISUP 1999 grading systems are not overtly superior to WHO 1973 system. But if "urothelial neoplasm of low malignant potential" category of the WHO/ISUP 1998 and 1999 grading systems is distinguished from gradel tumours in WHO 1 973 system, more precise prognostic information can be obtained. Proliferative activity of the tumors determined by Kİ67 expression and p53 expression could be used in the determination of the prognosis when used together with grading systems and staging.