Kolorektal Kanserlerde Postoperatif İzlemde Nüks Metastaz Gelisimine Etkiyen Cerrahi, Histopatolojik ve Immünogenetik (Killer Immünoglobulin Like Reseptör ve Ligand Tiplendirilmesi) Özelliklerin Tanımlanması

Abstract

To analyze the frequency of Killer Immunoglobulin Like Receptor (KIR) gene and their ligands (HLA Class I), 87 patients diagnosed with colorectal cancer and operated between 2005 and 2008 were enrolled into this study. 29 patients progressing within a median of five year follow-up period were compared with 58 cases that did not. Age, gender, clinical stage, tumor location, adjuvant therapy and recurrence location were similar between the groups. Among the cases without recurrence 2DL1, which is an inhibitory KIR, is observed significantly less frequent while activatory KIRs, 2DS2 and 2DS3, significantly more frequent. Therefore, a decrease in inhibition and an increase in activation, may lead to an antitumor immune response. Among the KIR ligands only A-Bw4 is observed significantly less frequently among non-recurrent patients. When KIR and KIR ligand association is examined, two KIR's who share the same ligand (group C1), 2DL2 (inhibitor) and 2DS2 (activator), frequently coexisted. Similarly inhibitory KIR-ligand combinations 2DL1-C2 and 2DL3-C1 are seen less frequnetly in the non-recurrent group while the activatory combination 2DS2-C1 and inhibitory combination 2DL2-C1 are shown to be more frequent in the non-recurrent group. Even though 2DS2 is seen less frequently in recurrent group, if recurrence occurs despite 2DS2, distant metastasis is more frequent than local recurrence. Our findings show for the first time in literature that in colorectal cancers, recurrence is association with the presence of activating KIR's and absence of inhibitory KIR's in the setting of their appropriate ligands.