Endometrial Küretaj Olgularında p16 Ekspresyonunun İmmünohistokimyasal Olarak İncelenmesi

Year 2024, Volume: 46 Issue: 5, 759 - 769, 12.09.2024

Aslıhan Yurtkal , Müjde Canday , Hatice Beşeren

https://doi.org/10.20515/otd.1528994

Abstract

Çalışmamız, hücre döngüsünde yer alan ve endometrium kanseri gelişiminde rol oynayan P16 molekülünün normal epitel, endometrial polip ve prekürsör lezyonlardaki immünohistokimyasal ekspresyonunu araştırmayı amaçlamaktadır. Çalışmaya 2020-2021 yılları arasında Kafkas Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Anabilim Dalı’nda çeşitli nedenlerle endometriyal örnekleme yapılan 68 hasta dahil edildi. Seçilen vakalar dört gruba ayrıldı: proliferatif endometriyum, atipisiz endometrial hiperplazi, atipik endometrial hiperplazi/endometrioid intraepitelyal neoplazi ve endometrial polip. Çalışmamızda endometrial tümör tanısı alan olguya rastlanmadı. Tüm hastaların patoloji örnekleri yeniden değerlendirildi ve doku örneklerine P16 immünohistokimyası uygulandı. Atipik endometriyal hiperplazi tanısı alan hastaların %72,7’sinde orta derecede P16 protein ekspresyonu, %18,2’sinde düşük ekspresyon ve %9,1’inde yüksek protein ekspresyonu gösterdi. Atipik endometrial hiperplazi tanısı alan hasta sayısı çalışma popülasyonunda çok düşük bir sıklığa sahipti. Endometriyal polip tanısı alan hastaların %50,0’ı orta derecede P16 protein ekspresyonu gösterdi, %20,0’ı düşük protein ekspresyonu gösterdi ve %30,0’ı yüksek protein ekspresyonu gösterdi. Literatürde yüksek P16 ekspresyonunun endometrium kanseri ile anlamlı derecede ilişkili olduğu bildirilmektedir. P16 ekspresyonu kanser öncesi lezyonlarda ve kanser gelişiminin aşamalarında önemlidir. Bu konuda daha büyük ölçekli, daha fazla olgu içeren çalışmalara ihtiyaç vardır.

Keywords

endometriyum kanseri, Ekspresyon, Endometriyal örnekleme, Endometriyal hiperplazi, Endometriyal polip, P16

Immunohistochemical Investigation of P16 Expression in Curettage Biopsies

Abstract

Our study aims to investigate the immunohistochemical expression of the P16 molecule, which is involved in the cell cycle and plays a role in developing endometrial cancer in normal epithelium, endometrial polyp, and precursor lesions. A total of 68 patients underwent endometrial sampling for various reasons at the Department of Obstetrics and Gynecology, Faculty of Medicine, Kafkas University, between 2020 and 2021 were included in the study. The selected cases were categorized into four groups: proliferative endometrium, endometrial hyperplasia without atypia, atypical hyperplasia / endometrioid intraepithelial neoplasia (AH / EIN) and endometrial polyp. There were no cases with a diagnosis of endometrial tumors in our study. All patients’ pathology samples were re-evaluated, and P16 immunohistochemistry was applied to tissue samples. Among patients diagnosed with atypical endometrial hyperplasia, 72.7% exhibited moderate P16 protein expression, 18.2% had low expression, and 9.1% had high protein expression. The number of patients diagnosed with AH / EIN had a very low frequency in the study population. Among patients diagnosed with endometrial polyps, 50.0% showed moderate P16 protein expression, 20.0% exhibited low protein expression, and 30.0% had high protein expression. High P16 expression has been reported to be significantly associated with endometrial cancer in the literature. P16 expression is significant in precancerous lesions and stages of cancer development. Larger-scale studies with more cases are needed in this regard.

Keywords

Expression, Endometrial biopsies, Endometrial cancer, Endometrial hyperplasia, Endometrial polyp, P16

Ethical Statement

The study was received ethical approval from the Faculty of Medicine Ethics Committee, Kafkas University, with reference number 80576354-050-99/231, on November 23, 2021.

Thanks

We would like to express our gratitude to Dr. Yalçın Polat for his supervision in the evaluation of pathological data and to Barış Yıldız for his contributions to the statistical analysis of the data in our study.

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