Publication: Derece II oligodendrogliomların anjiyojenik niteliklerinin nüks zamanı ile ilişkisinin araştırılması
Abstract
Bu çalışmada düşük dereceli oligodendrogliomların anjiyojenik potansiyelleri fare kornea anjiyojenez modeli (KAM) ile çalışılmış ve radyolojik kontrast tutulumu, 1 p/ 19q heterozigosite kaybı (LOH) ve tümör nüksü süresi ile karşılaştırılmıştır. Marmara Üniversitesi Tıp Fakültesi Nöroşirürji ABD ve Marmara Üniversitesi Nörolojik Bilimler Enstitüsünde Ocak 1986-Ekim 2006 tarihleri arasında yeni belirlenen supratentoryal tümör tanısı ile öpere olan ve oligodendrogliom derece 2 (WHO sınıflaması) tanısı alan toplam 102 hasta arasından, cerrahi sonrası 24 saatlik manyetik rezonans görüntüleme (MRG) ile teyit edilmiş total rezeke, doku örnekleri tümör bankasında saklanmış ve izlemi esnasında radyolojik nüksü tespit edilmiş olan hastalar örneklem grubunu oluşturmuştur. Yarısı cerrahi öncesi MRG'de kontrast tutan, diğer yarısı ise kontrast tutmayan ve hiçbiri cerrahi sonrasında, nükse kadar ek tedavi almayan toplam 20 oligodendrogliom derece 2 olgusu seçildi. Yirmi olgunun tümör dokusu fare korneasına ekildi ve 4., 8., 12. ve 16. günlerde gözlenerek korneada gelişen anjiyojenez derecelenmesi yapıldı. Aynı zamanda tümörlerde floresan in-situ hibridizasyon tekniği ile 1p36, 19q 13 LOH araştırıldı. KAM ile gösterilen anjiyojenik potansiyeller, 60 ay sonrası nüks edenlerle, daha kısa zamanda nüks edenler arasında anlamlı olarak farklıydı. MRG'deki kontrast tutulumu anjiyojenik aktivite ile ilişkiliyken, 1 p/ 19q LOH'nin ise anjiyojenik potansiyelde önemli bir belirleyici olmadığı görüldü. Olguların nüks süreleri, kontrast tutulumu ve kornea anjiyojenez dereceleri ile bağlantılı iken, 1 p/ 19q LOH ile arada bir bağlantı tespit edilmedi. Bu çalışma oligodendrogliomlarda anjiyojenezi araştıran ilk laboratuvar çalışmasıdır. Tüm olgular oligodendrogliom derece 2 olmasına rağmen, anjiyojenik potansiyellerinin değişkenlik gösterdiği ve anjiyojenik potansiyel ile nüks arasında anlamlı bağlantı olduğu saptanmıştır. Anjiyojenez inhibitörlerinin tedavide, radyolojik anjiyojenez işaretleyicilerinin ise klinik belirteç olarak kullanılması, çalışmamızın kliniğe ilk uygulama alanları olacaktır.
In this study, the angiogenetic potential of oligodendroglioma WHO grade 2 tumors were studied by rat cornea angiogenesis model and compared the relationships between radiologic contrast enhancement, 1 p/ 19q loss of heterozygosity (LOH), and time to radiologic tumor recurrence. From a total of 102 cases that had been operated in Marmara University Department of Neurosurgery and Marmara University Institute of Neurologic Sciences between January 1986-October 2006 and had oligodendroglioma grade 2 diagnosis, 20 cases have been chosen; 10 of those were enhancing with contrast in preoperative MRI, while 10 were not. All of those 20 had total excision verified by postoperative 24 hour MRI, and none had an adjuvant treatment unless a recurrence was noted. The time to radiologic tumor recurrence of all were noted. The tumor samples of those 20 kept in tumor bank were embedded into rat corneas and observed on day 4, 8, 12 and 16 and visual grading was done. At the same time 1 p/ 19q LOH study was performed on those tumors by fluorescent in-situ hybridization (FISH). While the time to tumor recurrence of those cases were correlated with contrast enhancement and cornea angiogenesis grades either on day 4, 8, 12 or 16, but 1 p/ 19q LOH; and the angiogenetic potentials of tumors verified by cornea angiogenesis model were significantly different between those having a time to tumor recurrence >60 months and those having <60 months, and according to contrast enhancement status in preoperative MRI; 1 p/ 19q LOH was not a significant determinant of angiogenetic potential. This is the first experimental study about the angiogenetic potential of oligodendroglioma grade 2. Though all tumors were oligodendroglioma grade 2, their angiogenetic potentials were much heterogeneous and angiogenetic potential seems to have an important role on time to tumor recurrence. Use of angiogenesis inhibitors in treatment, and radiologic angiogenesis markers in grading and predicting time to tumor recurrence may be the first clinical applications of our study. godendroglioma, glial, glioma, angiogenesis, 1 p/ 19q
In this study, the angiogenetic potential of oligodendroglioma WHO grade 2 tumors were studied by rat cornea angiogenesis model and compared the relationships between radiologic contrast enhancement, 1 p/ 19q loss of heterozygosity (LOH), and time to radiologic tumor recurrence. From a total of 102 cases that had been operated in Marmara University Department of Neurosurgery and Marmara University Institute of Neurologic Sciences between January 1986-October 2006 and had oligodendroglioma grade 2 diagnosis, 20 cases have been chosen; 10 of those were enhancing with contrast in preoperative MRI, while 10 were not. All of those 20 had total excision verified by postoperative 24 hour MRI, and none had an adjuvant treatment unless a recurrence was noted. The time to radiologic tumor recurrence of all were noted. The tumor samples of those 20 kept in tumor bank were embedded into rat corneas and observed on day 4, 8, 12 and 16 and visual grading was done. At the same time 1 p/ 19q LOH study was performed on those tumors by fluorescent in-situ hybridization (FISH). While the time to tumor recurrence of those cases were correlated with contrast enhancement and cornea angiogenesis grades either on day 4, 8, 12 or 16, but 1 p/ 19q LOH; and the angiogenetic potentials of tumors verified by cornea angiogenesis model were significantly different between those having a time to tumor recurrence >60 months and those having <60 months, and according to contrast enhancement status in preoperative MRI; 1 p/ 19q LOH was not a significant determinant of angiogenetic potential. This is the first experimental study about the angiogenetic potential of oligodendroglioma grade 2. Though all tumors were oligodendroglioma grade 2, their angiogenetic potentials were much heterogeneous and angiogenetic potential seems to have an important role on time to tumor recurrence. Use of angiogenesis inhibitors in treatment, and radiologic angiogenesis markers in grading and predicting time to tumor recurrence may be the first clinical applications of our study. godendroglioma, glial, glioma, angiogenesis, 1 p/ 19q