Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi

Kucukgoz Gulec, Umran; vardar, Mehmet

doi:doi:10.17827/aktd.855647

Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi

Ümran GÜLEÇ, (Çukurova Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Adana, Türkiye)

Mehmet VARDAR (Çukurova Üniversitesi, Tıp Fakültesi, Kadın Hastalıkları ve Doğum Anabilim Dalı, Adana, Türkiye)

Arşiv Kaynak Tarama Dergisi

59 4

Yıl: 2020 Cilt: 29 Sayı: 4 Sayfa Aralığı: 227 - 236 Metin Dili: Türkçe DOI: doi:10.17827/aktd.855647 İndeks Tarihi: 09-05-2021

Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi

Öz:

Günümüzde endometrial kanser tanısı ve sınıflaması esas olarak morfolojik özelliklerine ve gerektiği durumlarda immünohistokimyasal yöntemler ile değerlendirmeye dayanır. Hastaların yönetimlerine ise klinik ve patolojik özelliklerine göre değerlendirilen risk gruplarına göre karar verilir. Özellikle yüksek dereceli endometrial kanserli hastaların ve genç hastaların yönetiminde bazı sıkıntılı durumlar olabilmektedir. Bu hastaların bir kısmı gerektiğinden fazla veya az tedavi edilebilmektedir. 2013 yılında, Kanser Genom Atlas (TCGA) projesi endometrial kanser için moleküler 4 alt grup belirlemiştir: DNA polimeraz epsilon (POLE) (ultramutated), microsatellite instability (MSI) (hipermutated), Copy-number low (CNL) ve Copy-number high (CNH) olmak üzere. Moleküler sınıflamanın uygulanabilirliğini arttırmak üzere moleküler analizlerden ziyade immünohistokimyasal analizleri de kullanarak Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) sınıflaması geliştirildi. Önerilen moleküler sınıflamaların geçerlilikleri çeşitli çalışmalar ile doğrulandı. En önemlisi de moleküler sınıflamanın prognostik önemininin ortaya konulmasıdır. POLE-mutant grupta (ki bu grupta yüksek dereceli tümörler de bulunur) prognoz en iyi iken, CNH olan grupta en kötüdür. Son 5 yıl içerisinde endometrium kanseri alanındaki en ciddi gelişmenin moleküler sınıflama olduğunu söylersek abartmış olmayız. p53, MMR, L1CAM, CTNNB1, POLE analizi hastaların preoperatif değerlendirmede ve adjuvan tedavilerine karar vermede önemlidir. Histopatolojik özelliklerin moleküler özellikler ile beraber değerlendirilmeleri eksik ve fazla tedavileri engeller.

Anahtar Kelime:

Molecular Classification of Endometrial Cancer and It’s Clinical Significance

Öz:

Today, the diagnosis and classification of endometrial cancer is mainly based on morphological features and, whennecessary, evaluation by immunohistochemical methods. The management of patients is decided according to the riskgroups evaluated according to their clinical and pathological features. There may be some troubles, especially in themanagement of patients with high-grade endometrial cancer and young patients. Some of these patients can be treatedmore or less than necessary. In 2013, the Cancer Genome Atlas (TCGA) project identified 4 subgroups for endometrialcancer: DNA polymerase epsilon (POLE) (ultramutated), microsatellite instability (MSI) (hypermutated), Copy number low (CNL) and Copy-number high (CNH). To increase the applicability of molecular classification, ProactiveMolecular Risk Classifier for Endometrial Cancer (ProMisE) was developed using immunohistochemical analysisrather than molecular analysis. The validity of the proposed molecular classifications has been confirmed by severalstudies. The most important thing is to reveal the prognostic importance of molecular classification. In the POLE mutant group, this group also includes high-grade tumors, while the prognosis is the best, while in the group withCNH it is the worst. If we say that the most serious development in the field of endometrial cancer in the last 5 yearsis molecular classification, we will not be exaggerated. Analysis of p53, MMR, L1CAM, CTNNB1, POLE is importantin preoperative evaluation and decision making of adjuvant treatments. The evaluation and integration ofhistopathological features together with molecular features prevent overtreatment and undertreatment.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

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APA	Kucukgoz Gulec U, vardar M (2020). Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. , 227 - 236. doi:10.17827/aktd.855647
Chicago	Kucukgoz Gulec Umran,vardar Mehmet Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. (2020): 227 - 236. doi:10.17827/aktd.855647
MLA	Kucukgoz Gulec Umran,vardar Mehmet Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. , 2020, ss.227 - 236. doi:10.17827/aktd.855647
AMA	Kucukgoz Gulec U,vardar M Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. . 2020; 227 - 236. doi:10.17827/aktd.855647
Vancouver	Kucukgoz Gulec U,vardar M Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. . 2020; 227 - 236. doi:10.17827/aktd.855647
IEEE	Kucukgoz Gulec U,vardar M "Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi." , ss.227 - 236, 2020. doi:10.17827/aktd.855647
ISNAD	Kucukgoz Gulec, Umran - vardar, Mehmet. "Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi". (2020), 227-236. https://doi.org/doi:10.17827/aktd.855647

APA	Kucukgoz Gulec U, vardar M (2020). Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. Arşiv Kaynak Tarama Dergisi, 29(4), 227 - 236. doi:10.17827/aktd.855647
Chicago	Kucukgoz Gulec Umran,vardar Mehmet Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. Arşiv Kaynak Tarama Dergisi 29, no.4 (2020): 227 - 236. doi:10.17827/aktd.855647
MLA	Kucukgoz Gulec Umran,vardar Mehmet Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. Arşiv Kaynak Tarama Dergisi, vol.29, no.4, 2020, ss.227 - 236. doi:10.17827/aktd.855647
AMA	Kucukgoz Gulec U,vardar M Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. Arşiv Kaynak Tarama Dergisi. 2020; 29(4): 227 - 236. doi:10.17827/aktd.855647
Vancouver	Kucukgoz Gulec U,vardar M Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi. Arşiv Kaynak Tarama Dergisi. 2020; 29(4): 227 - 236. doi:10.17827/aktd.855647
IEEE	Kucukgoz Gulec U,vardar M "Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi." Arşiv Kaynak Tarama Dergisi, 29, ss.227 - 236, 2020. doi:10.17827/aktd.855647
ISNAD	Kucukgoz Gulec, Umran - vardar, Mehmet. "Endometrium Kanserinde Moleküler Sınıflama ve Klinik Önemi". Arşiv Kaynak Tarama Dergisi 29/4 (2020), 227-236. https://doi.org/doi:10.17827/aktd.855647