العلاقة بين تعبير المعلمات المناعية ل (P53) وعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. الخلاصة الخلفية: يحدث سرطان المعدة الغدي بسبب عدم استقرار الكروموسومات، وطفرات TP53، واختلال الصيغة الصبغية، والانتقالات، والجينات الورمية الأولية، والتغيرات الجينية المثبطة للورم.عدم استقرار الساتل الميكروي(MSI) يسبب فشل إصلاح عدم تطابق الحمض النووي، مما يؤثر على دقة تكرار الحمض النووي. يم الكشف عن أخطاء النسخ المتماثل المبكرة بواسطة مجمع البروتين المتغاير (hMSH2/hMSH6) ، الذي يقوم بتفعيل hMLH1) و(hPMS2 لإعادة تكوين الحمض النووي. يحدث عدم استقرار الساتل الميكروي في حالات سرطان المعدة المتفرق ومتلازمة لينش. الهدف من الدراسة: دراسة العلاقة بين تعبيرالمعلم P53 وتعبير المعلمات المناعية لـعدم استقرار الساتل الميكروي (MSI) مع العوامل السريرية المرضية لسرطان المعدة الغدي باستخدام الكيمياء النسيجية المناعية. المواد والطرق: تم فحص 40 كتلة من نسيج سرطان المعدة الغدي المثبت بالفورمالين والمطمور بالشمع في بغداد، العراق. تناولت الدراسة حالات سرطان المعدة الأولية، مع البيانات السريرية المرضية المتاحة، والأنسجة الجراحية. التعبير المناعي الكيميائي الذي تم تقييمه بواسطة نظام تسجيل النقاط. تم استخدام برنامج SPSS لتحليل البيانات، كما تم استخدام اختبارات Chi-square واختبارات Fisher الدقيقة لتقييم الارتباطات. تم اعتبار مستوى الثقة 95٪ والقيمة الاحتمالية P 0.05 أو أقل مهمًا. النتائج : كان التصبيغ المناعي النسيجي الكيميائي لـ P53 إيجابيًا في 65٪ من الحالات، بينما كانت نتائج MSI إيجابية في 97.5٪ من الحالات. حصل الزوجان المتغايران MLH1/PMS2 على نتائج إيجابية بنسبة 32.5% ونتائج سلبية 67.5%، في حين حصل الزوجان المتغايران MSH2/MSH6 على نتائج إيجابية بنسبة 87.5% ونتائج سلبية 12.5%. ارتبطت صبغة P53 بشكل كبير بانتشار العقدة الليمفاوية ودرجة الورم ، ولكن لم يكن هنالك ارتباط مع العوامل الأخرى. لم يتم العثور على ارتباط كبير بين معلمات MSI والعوامل المدروسة,لم يكن هناك ارتباط كبير بين معلمات MSI غير المتجانسة (MLH1 / PMS2) والمعلمات المرضية السريرية، ولكن كان هناك ارتباط كبير بين علامات MSI الزوجين غير المتجانسة (MSH2 / MSH6) والنقائل فقط . الاستنتاج: : يعد P53 معلما حيويا مهما لتقييم انتشار العقدة الليمفاوية وعدوانيتها في التصنيف النسيجي، مما يشير إلى التشخيص، وتحديد مرضى السرطان الأكثر عرضة لخطر الإصابة بالورم النقيلي. على الرغم من أن MSH2/MSH6 اظهر ارتباطا مهمًا مع النقائل الورمية ، إلا أن معلمات MSI كان لها أقل قيمة إنذارية في دراستنا. هناك حاجة إلى مزيد من البحث لإثبات فعاليتها في علاج سرطان المعدة.
Receipt date: 12/28/2020 accepted date: 20/1/2021 Publication date: 12/31/2021
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