Fakülteler / Faculties
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Item The Overexpression of Programmed Death-Ligand 2 in Uterine Adenosarcoma: Correlation with High-Grade Morphology, Mutant Type TP53 Expression and Clinical Outcomes(2023) Atilgan, Alev Ok; Akcay, Eda Yilmaz; Ozen, Ozlem; Haberal Reyhan, A. Nihan; Ayhan, Ali; 35466759Immunotherapy involving the programmed death-1 (PD-1)/the programmed death-ligand (PD-1/PD-L) blockade is an understudied tumor therapy approach in cases of adenosarcoma. PD-L1 and PD-L2, and tumor protein p53 (p53) were examined in 20 uterine adenosarcoma cases, and tumor-infiltrating lymphocytes and tumor-associated macrophages were counted in tumor tissue using immunohistochemistry. While CPS PD-L1 positivity with 1% and 10% cut-off values was observed in 40% and 10% of tumors, respectively, CPS PD-L2 positivity with 1%, 10% and 50% cut-off values was observed in 100%, 85% and 50% of the tumors, respectively. The CPS PD-L2 positivity with a 50% cut-off value was positively correlated with tumor grade and the presence of sarcomatous overgrowth and lymphovascular invasion (LVI) (p = 0.025, p = 0.025, and p = 0.025, respectively). Nine of 11 high-grade adenosarcomas and none of the low-grade adenosarcomas showed mutant type p53 expression (p = 0.000). However, PD-L1 expression and tumor-infiltrating immune cells did not correlate with clinicopathological parameters. The CPS PD-L2 positivity with a 50% cut-off value was also positively correlated with mutant type p53 expression (p = 0.024) and tumor-associated macrophages density (p = 0.024). The CPS PD-L2 positivity with a 50% cut-off value and mutant type p53 expression were associated with shorter disease-free survival and shorter overall survival. The high density of tumor-associated macrophages and low density of tumor-infiltrating lymphocytes were also associated with shorter disease-free survival and overall survival (p < 0.05).These results suggested that the CPS PD-L2 positivity with a 50% cut-off value, p53 mutation and tumor microenvironment played an essential role in the progression of uterine adenosarcomas.Item Analysis of Bcl-2, PTEN, p53, and Ki-67 expressions in endometrial cancer arising from endometrial polyp(2019) Karakas, L. A.; Tohma, Y. A.; Kuscu, E.; Ozen, O.; Ayhan, A.Objective: To compare the expression of the proliferation marker Ki-67, the antiapoptotic protein Bcl-2, and the tumor suppressor genes p53 and PTEN between endometrial cancer arising from endometrial polyp and benign endometrial polyps. Materials and Methods: The study was performed retrospectively in 40 patients treated at the present institution between 2006-2011. A total of 20 cases that had endometrial cancer arising from endometrial polyp that met study criteria were included consecutively in the study. For each malign case, one case that had a benign endometrial polyp diagnosed at hysterectomy specimen was included in the study. Results: The Ki-67 score was significantly higher in endometrial cancer arising from endometrial polyp group in comparison to the benign polyps (p < 0.05). However, the Bcl-2 expression was significantly lower in the endometrial cancer arising from endometrial polyp when compared to the benign polyps (p < 0.05). PTEN and p53 expressions were not different between groups (p > 0.05). in patients with endometrial cancer, Ki-67, Bcl-2, PTEN, and p53 expressions were not different among histological type, stage, grade, myometrial invasion, polyp size, and lymphovascular space invasion, with an exception of p53. p53 expression was significantly increased in higher grade tumors (p < 0.05). Conclusion: The results of the present study indicate that there is an inhibition of apoptosis and a decrease in proliferation in benign endometrial polyps. Possibly, at carcinogenesis step of endometrial cancer developed from benign polyp, other additional mutations cause a reverse effect and they increase proliferation and prevent the apoptosis inhibition.Item Expression of maspin in testis tumors with germ cells and its relation with angiogenesis factors(2016) Celik, Huseyin; Turunc, Tahsin; Bal, Nebil; Hasirci, Eray; Akay, Alaaddin; Pekircioglu, Cetin Levent; 27513425Background/aim: We aimed to evaluate the importance of maspin expression in testicular tumors with germ cells, its effect on prognosis, and the relation with angiogenesis factors. Materials and methods: The paraffin blocks of the orchiectomy materials of 32 patients who had undergone orchiectomy due to testicular tumors were taken within the scope of the study. The specimens of the cases included in the study group were reexamined under light microscope. Results: While just one maspin-positive sample was found in the seminoma cases, maspin stained positively in 6 of the nonseminoma germ cell tumors (NSGCTs). No statistical difference was found between maspin and tumor stage, size, alpha fetoprotein values, vascular endothelial growth factor, Ki-67, and CD31. A statistically positive correlation was only determined between maspin and p53 (P < 0.001). Conclusion: Maspin protein, whose expression in some tumors is accepted as a poor prognostic factor, is also expressed in testicular tumors with germ cells. However, according to our study, it is difficult to say whether this protein is a favorable or poor prognostic factor in testicular tumors and to understand how the effect mechanism works. The positive correlation between maspin and p53 in the NSGCTs makes us think that maspin might have displayed an effect on the p53 pathway.Item Endometriyal polip zemininde gelişen endometriyum kanserlerinde BCL-2, PTEN,p53 ve Ki-67 ekspresyonlarının değerlendirilmesi(Başkent Üniversitesi Tıp Fakültesi, 2011) Atasoy, Latife; Kuşcu, EsraAmaç: Endometriyal polip zemininde gelişen endometriyum kanserleri ve benign endometriyal polipler arasında, proliferasyon belirteci olan Ki-67 ve antiapoptotik protein bcl-2 ile tümor supresor genler olan p53 ve PTEN ekspresyonlarının karşılaştırılması. Gereç ve Yöntem: Çalışma Başkent Üniversitesi Hastanesinde 2006-2011 yılları arasında tedavi edilmiş 40 olguda retrospektif olarak yapıldı. Çalışmaya en az bir yıldır menopozda olan hastalar dahil edildi. Hormon replasman tedavisi alan, tamoksifen kullanan, meme kanseri öyküsü olan ve premenopozal hastalar ile yeterli doku bloğu bulunmayan ve evrelenmesi tam yapılmamış polip zemininde gelişmiş endometriyum kanseri olgular çalışma dışı bırakıldılar. Endometriyum kanseri olgularının %8’inde (26/323) endometriyal polipten köken alan kanser saptandı. Çalışma kriterlerini sağlayan endometriyal polip zemininde gelişmiş toplam 20 endometriyum kanseri olgusu ardışık olarak çalışmaya dahil edildi. Herbir kanser olgusu için histerektomi örneklerinde saptanmış bir benign polip olgusu rastgele çalışmaya dahil edildi. Bulgular: Ki-67 ekspresyonu polip zemininde gelişen endometriyum kanseri grubunda benign endometriyal polip grubuna göre anlamlı şekilde yüksekti ( p < 0,05). Fakat bcl-2 ekspresyonunun polip zemininde gelişen endometriyum kanserlerinde benign endometriyal poliplere göre anlamlı şekilde azaldığını tespit ettik (p< 0,05). PTEN kaybı ve p53 ekspresyonu ile iki grup arasında anlamlı bir ilişki izlenmedi (p>0,05). Endometriyal polip zemininde gelişen endometriyum kanserlerinde Ki-67, Bcl-2, PTEN ve p53 ekspresyonu ve histolojik tip, evre, grade, myometriyal invazyon, polip büyüklüğü ve lenfovasküler invazyon arasında bir istisna hariç alamlı bir ilişki izlenmedi. p53 ekspresyonu yüksek gradeli tümorlerde belirgin şekilde artmaktaydı (p< 0,05). Sonuç: Çalışmamızın sonuçları benign poliplerde apoptozis inhibe olurken proliferasyonun arttığını düşündürmektedir. Polip zeminde gelişen endometriyum kanserlerinde karsinogenez aşamasında benign poliplerdekinin tersine apoptozis inhibisyonunun engellenmesinden ve proliferasyonun artmasından ek mutasyonların sorumlu olduğunu düşünmekteyiz.