Meme kanserinde difüzyon meme MR ile histopatolojik prognostik faktörler arasındaki ilişkinin değerlendirilmesi
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Tarih
2014
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Maltepe Üniversitesi, Tıp Fakültesi
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info:eu-repo/semantics/openAccess
Özet
Amaç: Meme kanserinde difüzyon MR, lezyonun morfolojisi yanında, metabolik aktivitesi hakkında da bilgi vermektedir. Patolojik prognostik faktörler meme kanserli olgularda tedavi protokolünü ve sağ kalımı etkilemektedir. Bu çalışmada amacımız, meme kanserli olgularda difüzyon MR özellikleri ile patolojik prognostik faktörler arasında ilişkinin değerlendirilmesidir. Gereç ve yöntem: Mart 2011 – Temmuz 2013 tarihleri arasında kliniğimizde, meme kanseri tanısı ile preoperatif olarak Meme MR tetkiki yapılan 33 olgu retrospektif olarak değerlendirildi. Tüm olguların post-operatif patoloji sonuçları elde edildi. Post-op histopatolojik spesmenlerde tümor çapı, aksiler lenf nodu durumu, histolojik grade klasik prognostik faktörler olarak ve östrojen reseptör durumu, progesteron reseptör durumu ve Ki67 moleküler prognostik faktörler olarak değerlendirilmiştir. Difüzyon meme MR özellikleri ile klasik ve moleküler histopatolojik prognostik faktörler arasındaki ilişki NCSS (Number Cruncher Statistical System) 2007&PASS (Power Analysis and Sample Size) 2008 Statistical Software (Utah, USA) istatistik programları kullanılarak değerlendirildi. Bulgular: ADC değerleri, aksiller lenf nodu tutulumu 3’den az olan olgularda (N1) aksiller lenf nodu tutulumu 4 ve/veya daha fazla olan olgulara (N2-N3) göre anlamlı düzeyde yüksek bulundu (p=0,011; p=0,010; p<0,05). Ki-67 ekspresyonu negatif olan olguların ADC 1500 değerleri, pozitif olan olgulara göre anlamlı düzeyde düşük bulundu.( (p=0,020; p<0,05) Sonuç: ADC değerleri, TNM evrelemesine göre N2 ve N3 olan olgularda N1 olgulara göre anlamlı düzeyde düşük bulundu. Düşük ADC değerleri lenf nodu tutulumuyla ilişkiliydi.
Objective: Diffusion MRI of the breast gives information about the metabolic activity of the lesions as well as the morphologies. Pathological prognostic factors in breast cancer affects the patient's treatment protocol and overall survival. Aim of this study is to evaluate the relationship between the diffusion MRI of the breast and histopathologic prognostic factors in breast cancer. Materials and method: The files of 33 patients who underwent pre-operative breast MRI between the March 2011 and July 2013 were reviewed retrospectively. Post-operative histopathologic results were obtained for all the patients. In post-operative histopathological specimens tumor diameter, axillary lymph node status and histological grade were evaluated as classical prognostic factors and estrogen receptor status, progesterone receptor status, C Erb B2 and Ki-67 were evaluated as molecular prognostic factors. In evaluation of the correlation between Diffusion MRI values and histo-pathological results were analysed by the NCSS (Number Cruncher Statistical System) 2007&PASS (Power Analysis and Sample Size) 2008 Statistical Software (Utah, USA) programs. Findings: Significantly high ADC values were observed in cases with axillary lymph node metastasis less than 3 (N1 patients) when compared to cases with 4 or more lymph node metastasis (N2 and N3 patients) (p=0,011; p=0,010; p<0,05). ADC 1500 values were significantly lower in cases with negative expression of Ki-67 when compared to cases with positive expression(p=0,020; p<0,05). Conclusion: ADC values were found significantly less in N2 and N3 patients when compared to N1 patients. Lower ADC values are correlated with lymph node metastasis.
Objective: Diffusion MRI of the breast gives information about the metabolic activity of the lesions as well as the morphologies. Pathological prognostic factors in breast cancer affects the patient's treatment protocol and overall survival. Aim of this study is to evaluate the relationship between the diffusion MRI of the breast and histopathologic prognostic factors in breast cancer. Materials and method: The files of 33 patients who underwent pre-operative breast MRI between the March 2011 and July 2013 were reviewed retrospectively. Post-operative histopathologic results were obtained for all the patients. In post-operative histopathological specimens tumor diameter, axillary lymph node status and histological grade were evaluated as classical prognostic factors and estrogen receptor status, progesterone receptor status, C Erb B2 and Ki-67 were evaluated as molecular prognostic factors. In evaluation of the correlation between Diffusion MRI values and histo-pathological results were analysed by the NCSS (Number Cruncher Statistical System) 2007&PASS (Power Analysis and Sample Size) 2008 Statistical Software (Utah, USA) programs. Findings: Significantly high ADC values were observed in cases with axillary lymph node metastasis less than 3 (N1 patients) when compared to cases with 4 or more lymph node metastasis (N2 and N3 patients) (p=0,011; p=0,010; p<0,05). ADC 1500 values were significantly lower in cases with negative expression of Ki-67 when compared to cases with positive expression(p=0,020; p<0,05). Conclusion: ADC values were found significantly less in N2 and N3 patients when compared to N1 patients. Lower ADC values are correlated with lymph node metastasis.
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Mermi, E. (2014). Meme kanserinde difüzyon meme MR ile histopatolojik prognostik faktörler arasındaki ilişkinin değerlendirilmesi. (Yayımlanmamış Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
