Udruženost ekspresije vaskularnog endotelnog faktora rasta sa patohistološkim parametrima kožnih melanoma

  • Milomir Gačević Clinic for Plastic Surgery and Burns Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Milena Jović Institute of Pathology and Forensic Medicine, §Institute for Medical Research, Military Medical Academy, Belgrade, Serbia
  • Lidija Zolotarevska Institute of Pathology and Forensic Medicine, §Institute for Medical Research, Military Medical Academy, Belgrade, Serbia Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Ivan Stanojević Institute for Medical Research Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Marijan Novaković Clinic for Plastic Surgery and Burns Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Karolina Miller Dorset County Hospital Foundation Trust, Dorchester, UK
  • Vesna Šuljagić Department of Hospital Infection Control Military Medical Academy, Belgrade, Serbia; †Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Željko Mijušković Clinic for Dermatovenerology, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
  • Danilo Vojvodić Institute for Medical Research, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia;
DOI: https://doi.org/10.2298/VSP140804027G
Ključne reči: melanoma||, ||melanom, skin||, ||koža, vascular endothelial growth factors||, ||vaskularni endotelni faktori rasta, histology||, ||histologija, immunohistochemistry||, ||immunohistohemija, sensitivity and specificity||, ||osetljivost i specifičnost,

Sažetak


Uvod/Cilj. Melanom je najagresivniji maligni tumor kože. Do sada su objavljeni kontradiktorni podaci o vaskularnom endotelnom faktoru rasta (VGEF) prisutnom u uzorcima tumora, kao i njegovoj ulozi u progresiji i prognozi melanoma kože. Cilj ove studije bio je da se ispita značaj ekspresije VEGF kao prognostičkog parametra kod melanoma. Metode. Eksperimentalna grupa sastojala se od 81 bolesnika sa primarnim melanomom kože lečenih na Vojnomedicinskoj akademiji, Beograd, od 2009. do 2013. godine. Kontrolna grupa sastojala se od 20 bolesnika sa displastičnim i 20 sa benignim nevusima. Stratifikacija je izvršena prema polu, starosti, kliničkom i histološkom stadijumu, lokalizaciji, histološkom tipu, Clark-u, Breslovu, broju mitoza, regresiji i ulceraciji, prisustvu tumorinfiltrišućih limfocita i načinu širenja. Imunohistohemijsko bojenje izvedeno je na biopsijama kože uz upotrebu DAKO anti-VEGF antitela, LSABTM + HRP, Liquid DAB i mikrotalasnog demaskiranja u DAKO pH 9.0 rastvoru. Za statističku obradu korišćeni su testovi ANOVA, Bonferroni post-test, Mann-Whitney i Wilcoxon test. Rezultati. Prosečan intenzitet VEGF bojenja bio je značajno veći u melanomima nego u benignim ili displastičnin nevusima, a u melanomima bio je najveći u Ia i IV kliničkom stadijumu. Većina melanoma u pT1a patološkom stadijumu imala je najveće prosečne vrednosti VEGF. Melanomi sa najvećim brojem mitoza (> 6) imali su značajno veći intenzitet VEGF bojenja nego oni sa < 2 mitoze. Melanomi bez limfocitne infiltracije imali su najveće vrednosti VEGF, dok su oni sa najintenzivnijom infiltracijom imali najniže vrednosti. Ova razlika je bila statistički visokoznačajna. Melanomi sa limfnim i hematogenim načinom širenja imali su najveće prosečne vrednosti VEGF. Nije bilo statistički značajne korelacije između intenziteta VEGF bojenja i bilo kog drugog parametra. Zaključak. U primarnim melanomima kože povećana ekspresija VEGF značajna je za tumorsku progresiju, a povezana je kako sa odsustvom limfocitne infiltracije, tako i sa prisustvom limfovaskularne invazije. Potrebna su detaljnija prospektivna istraživanja ekspresije VEGF kao prognostičkog parametra kod melanoma na većem broju bolesnika.


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Objavljeno
2017/03/07
Broj časopisa
Vol. 73 Br. 5 (2016)
Rubrika
Originalni članak