Ćupurdija, Kristijan
(2011)
Izraženost survivina u karcinomu želuca i metastaskim limfnim čvorovima.
PhD thesis, Sveučilište u Zagrebu.
Abstract
Although the worldwide incidence is desreasing, gastric cancer is second cancer related cause
of death . Gastric cancer is supposed to appeare through several stages of carcinogenesis and
deviation of physiologic appopthosis is considered as a key moment in carconogenesis.
Survivin is a member of IAP (inhibitors of apoptosis) molecular family which have generaly
have a role in antiapoptotic mechanisms. Up to now, several researches concernig relationship
of survivin and gastric cancer have been published, however with adversely results, both
concernig the level of expression both possible relationship with clinical and pathological
features of the tumor. The expression of survivin in lymph nodes has not yet been explored.
Aim of this study is to determine the level of survivin expression, both in primary gastric
cancer tumor, both in metastatic lymph nodes and explore the relationship between the level
of expression with patohystology features of the tumor and clinical features of disease and
overall survival.
Results of this research have shown that there is high expression of survivin in primar and
metastatic lymph node cancer and the level of expression is in correlation with poor
clinicopathologic features of disease. Furthermore, we have shown that there is decreased
level of expression in metastatic lymph nodes comparing to primar cancer which can suggest
of possible role of survivin in changing the biology of metastatic tumor.The correlation of
survivin expression with clinical features of diseases and survival has shown the signifficane
of survivin as prognostic factor. The level of expression of this molecule could, on the end,
become an important factor that influence the modalities of treatment and also serve as follow
up marker.
Abstract in Croatian
Iako je svjetska incidencija u opadanju, karcinom želuca predstavlja drugi najveći uzrok smrti
povezan s karcinomima. Nastaje kroz nekoliko stupnjeva procesa karcinogeneze, a poremećaj
fiziološke apoptoze smatra se za ključni korak u njegovu nastanku.Survivin pripada IAP
porodici molekula (od eng. inhibitors of apoptosis) koje uglavnom imaju ulogu u
antiapoptotskim mehanizmima. Nekoliko objavljenih istraživanja o povezanosti survivina i
karcinoma želuca donosi oprečne rezultate bilo da se radi o razini izraženosti bilo da se radi o
eventualnoj povezanosti s kliničkopatološkim obilježjima tumora. Izraženost survivina u
metastatskim limfnim čvorovima do danas nije istraženo.
Cilj istraživanja bio je odrediti korištenjem imunohistomijskog obilježavanja razinu
izraženosti survivina u tkivu primarnog karcinoma želuca i metastatskim limfnim čvorovima
te istražiti povezanost izraženosti sa kliničkopatološkim obilježjima tumora i ukupnim
preživljenjem. Rezultati istraživanja pokazali su da u tkivu primarnog tumora te u
metastatskim limfnim čvorovima pacijenata oboljelih od karcinoma želuca postoji visoka
izraženost survivina te da je pojačana izraženost povezana s lošijom kliničkopatološkim
obilježjima tumora. Nadalje, pokazali smo da je izražavanje survivina u metastatskim
stanicama manje u odnosu na primarni tumor što govori o mogućoj ulozi survivina u
promjeni biologije metastatskog tumora. Povezanost izraženosti survivina s kliničkom slikom
i preživljenjem pokazala je vrijednost survivina kao prognostičkog čimbenika. Izraženost ove
molekule u konačnici bi mogao poslužiti kao dodatni pokazatelj određivanja prikladne
terapije, uspješnosti adjuvantnog liječenja karcinoma želuca odnosno kao dodatni marker
praćenja zdravstvenog stanja bolesnika.
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