"GIPOFIZ BEZINING NOFAOL MAKRO VA GIGANT ADENOMALARIDA INVAZIYA VA PROLIFERACIYA MARKERLARINING PROGNOSTIK AHAMIYATI"
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NFPA, giant pituitary adenomas##article.abstract##
Dolzarbligi. Ki-67 va p53 ni immunohistokimyo bilan baholash, odatda MIB1 bilan, gipofiz bezining transnazal adenomektomiyasidan o'tgan bemorlarda proliferatsiyani baholash uchun majburiydir.
Maqsad. Makro va gigant faol bo'lmagan gipofiz o'smalari bo'lgan bemorlarda invaziya va proliferatsiya belgilarining prognostik ahamiyatini o'rganish.
Materiallar va uslublar. Hammasi bo'lib, makro va ulkan nag bilan kasallangan 272 bemor tekshirildi. Nag bilan kasallangan 272 bemordan 151 bemor (erkak va ayol)tadqiqotda istiqbolli ishtirok etdi
Tadqiqot usullari quyidagilarni o'z ichiga oladi: 1) umumiy klinik (endokrin, nevrologik holatlarni o'rganish), 2) instrumental (barcha ranglar, fundus, ko'rish keskinligi uchun perimetriya, 3) EKG, turk egarlari va buyrak usti bezlarining KT/MRI, 4) ichki va jinsiy organlarning ultratovush tekshiruvi va boshqalar), 5) gormonal qon tadqiqotlari (STH, IFR-1, LH, FSH, BPD, TSH, ACTH, prolaktin, testosteron, estradiol, progesteron, kortizol va immunohistokimyoviy tadqiqotlar.
Natijalar. Proliferatsiya belgilarining immunoekspressiyasining kuzatilgan darajasi p53 uchun 40%/50% ni tashkil etdi(≥3+), 50%/60% Ki - 67 uchun (≥2+). Kogortaning 54 foizida kamida 2 ta yuqori proliferatsiya indeksiga ega bo'lgan immunoekspressiyali o'smalar kuzatilgan va proliferativ adenomalar sifatida qabul qilingan.
Xulosa. Gigant faol bo'lmagan gipofiz adenomalari ko'pincha atrofdagi anatomik tuzilmalarga invaziv o'sish bilan birga keladi (holatlarning 80% dan ortig'i), bu jarrohlikning radikalligini cheklaydigan va relapslar sonini ko'paytiradigan asosiy omil.
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