Analiza tumorskog markera CA 15-3 i hormonskog statusa u ondosu na metastatsku zahvaćenost interpektoralnih (Rotterovih) limfnih čvorova

Autor: Vrdoljak, Danko Velimir, Ramljak, Vesna, Mužina, Dubravka, Lesar, Miroslav, Banović, Miroslav, Roth, Andrej, Brozović, Gordana
Jazyk: angličtina
Rok vydání: 2003
Předmět:
Zdroj: Libri Oncologici : Croatian Journal of Oncology
Volume 31
Issue 1-3
ISSN: 2584-3826
0300-8142
Popis: The study was aimed at analyzing metastatic involvement in interpectoral (Rotter's) lymph nodes related to tumor marker CA 15-3 and hormone receptor status. The study includes 172 female patients undergoing surgery for breast cancer at the University Hospital for Tumors, Zagreb, Croatia from November 2001 to August 2003. In addition to the standard surgical procedure, interpectoral (Rotter's) lymph nodes were removed in all of the patients. Levels of the serum tumor marker CA 15-3 was determined prior to surgery and hormone receptors status were determined after the surgery. Rotter's lymph nodes were identified in 67% of the patients, with metastatic involvement revealed in 20% of the Rotter's nodes. Metastatic involvement of Rotter's nodes in patients with negative and positive axillary lymph nodes was 4% and 35%, respectively. Of 35 Rotter's node-positive patients, 31.4% had elevated serum levels of tumor marker CA 15-3, with the level statistically significantly higher in Rotter's positive patients compared to those with negative (or absent) Rotter's nodes ( 2=8.22, p= 0.0004). Hormone receptor status showed statistically significant difference in the expression of estrogen receptors and no statistically significant difference in progesteron receptors between patients with and those without positive Rotter's nodes (2=3.68; p=0.05 and 2=0.07;p=0.79). The results show that one-fifth of breast cancer patients, or even one-third of them with positive axillary lymph nodes, are discharged with positive interpectoral lymph nodes that remain undiagnosed and non-extirpated. Tumor marker CA 15-3 is more frequently elevated in patients with positive Rotter's lymph nodes. Estrogen receptors are as well more frequently negative in such patients. Progesteron receptors show no difference in patients with positive or negative Rotter's lymph nodes. As the nodes can be surgically removed without additional mutilation, the exploration of Rotter's lymph nodes should be introduced into routine clinical practice and the elevated values of tumor marker CA 15-3 could be warning for possible positive interpectoral nodes.
U radu je analizirana zahvaćenost interpektoralnih (Rotterovih) limfnih čvorova metastazama u odnosu na vrijednosti tumorskog markera CA 15-3 i hormonski status. Analizirane su 172 bolesnice s rakom dojke operirane u Klinici za tumore, Zagreb od studenog 2001. do kolovoza 2003. U svih su bolesnica, uz standardnu operaciju, uklonjeni i interpektoralni (Rotterovi) limfni čvorov. Prije operacije su izmjerene vrijednosti tumorskog markera CA15- 3, a nakon operacije vrijednosti hormonskih receptora. Rotterovi limfni čvorovi otkriveni su u 67% bolesnica, od kojih je 20% bilo zahvaćeno metastazama. U bolesnica s negativnim aksilarnim limfnim čvorovima metastatska zahvaćenost Rotterovih limfnih čvorova iznosila je 4%, a u bolesnica s pozitivnim aksilarnim limfnim čvorovima 35 %. Od 35 bolesnica s pozitivnim Rotterovim limfnim čvorovima u njih 31, 4% bio je i povišen tumorski marker CA 15- 3 što je statistički znakovito viša vrijednost u odnosu na žene s rakom dojke s negativnim (ili neprisutnim) Rotterovim limfnim čvorovima (_2=8,22, p= 0,0004). Hormonski status pokazuje statistički znakovitu razliku u ekspresiji estrogenskih receptora, a u ekspresiji progesteronskih receptora takva razlika između bolesnica sa ili bez pozitivnih Rotterovih čvorova nije uočena (_2=3,68; p=0,05 and _2=0.07;p=0,79). Rezultati pokazuju da je jedna petina bolesnica s rakom dojke, ili čak jedna trećina s pozitivnim aksilarnim limfnimčvorovima otpuštena iz bolnice s pozitivnim interpektoralnim limfnim čvorovima koji nisu dijagnosticirani, pa tako ni uklonjeni. Vrijednosti tumorskog markera češće su povišene u bolesnica s pozitivnim Rotterovim čvorovima. Estrogenski su receptori u tih bolesnica tako|er bili češće negativni, a progesteronski receptori ne pokazuju razlike između bolesnica s pozitivnim i onima s negativnim Rotterovim čvorovima. Kako se ti čvorovi mogu ukloniti bez dodatne mutilacije, otkrivanje Rotterovih limfnih čvorova treba postati redovitom kliničkom praksom, a pritom povišene vrijednosti tumorskog markera CA 15-3 mogu upozoravati na eventualno pozitivne interpektoralne limfne čvorove.
Databáze: OpenAIRE
Externí odkaz: