Influenţa diabetului zaharat de tip 2 asupra activităţii proliferative a carcinomului mamar

Abstract

Introducere. Afecţiunile oncologice şi endocrine asociate, reprezintă o provocare pentru medicina contemporană. Diabetul zaharat de tip 2 (DZ2] asociat cancerului mamar (CM) poate influenţa evoluţia tumorală. Scopul lucrării: evaluarea influenţei nivelului seric de glucoză asupra activităţii proliferative a carcinomului mamar. Material şi metode. Au fost investigate imunohistochimic (buffer citrat, microundă 900W, 95°C, 20 minute, anticorp primar Ki67/ K2, Leica Biosystem/15 min/RTU, Dako Autostainer Link 48, Zeiss Axiolmager 2.0 cu AxioCam Mrc5) 72 de cazuri de carcinoame mamare ductal invazive de tip NST (Institutul Oncologic, 2021-2022). în 29 de cazuri, tumora a fost asociată cu DZ2. Toţi pacienţii au fost supuşi mastectomiei radicale, fără chimio- şi radioterapie prealabilă. Eseurile statistice (X±SD, mediana (Me), t-Student, corelaţie după Spearman (rs)) au fost efectuate cu WINSTAT 2012.1. Studiul a fost aprobat (nr.7, 12.11.2021) de comitetul de etică al USMF "Nicolae Testemiţanu". Rezultate. Nivelul seric de glucoză la pacienţii cu carcinom mamar asociat cu DZ2 a fost semnificativ mai mare (9.9±3.1 mmol/L vs 4.7±0.5 mmol/L, p = 0.04). Expresia Ki67 în CM a fost mai pronunţată (36.2±18.4, Me = 40) comparativ cu cazurile asociate cu DZ2 (30.6±18.2, Me = 25, p = 0.01). în CM asociat cu DZ2 nivelul seric de glucoză a corelat negativ, statistic semnificativ cu activitatea proliferativă (rs = -0.29, p = 0.05 vs rs = 0.15, p = 0.22). Concluzii. Diabetul zaharat poate influenţa caracteristicile tisulare, inclusiv ale tumorii. Creşterea nivelului seric de glucoză diminuează activitatea proliferativă a carcinomului mamar.

Introduction. Associated oncological and endocrine diseases represent a challenge for contemporary medicine. Type 2 diabetes mellitus (T2DM) associated with breast cancer (CM) may influence tumor progression. The aim of the paper is evaluation of the influence of serum glucose level on the proliferative activity of breast carcinoma. Material and methods. 72 cases of ductal invasive NST type breast carcinomas (Oncological Institute, 2021-2022,) were investigated immunohistochemically (citrate buffer, microwave 900W, 95°C, 20 minutes, primary antibody Ki67/K2/Leica Biosystem/15 min/RTU, Dako Autostainer Link 48, Zeiss Axiolmager 2.0 with AxioCam Mrc5). In 29 cases, the tumor was associated with T2DM. All patients underwent radical mastectomy, without prior chemotherapy and radiotherapy. Statistical tests (X±SD, median (Me), t-Student, Spearman correlation (rj) were performed with WINSTAT 2012.1. The study was approved (no. 7, 12.11.2021) by the ethics committee of Nicolae Testemiţanu SUMPh. Results. The serum glucose level in patients with breast carcinoma associated with T2DM was significantly higher (9.9±3.1 mmol/L vs 4.7±0.5 mmol/L, p = 0.04). Ki67 expression in CM was more pronounced (36.2±18.4, Me = 40) compared to cases associated with T2DM (30.6±18.2, Me = 25, p = 0.01). In CM associated with DM2, the serum glucose level correlated negatively, statistically significantly with the proliferative activity (rs = -0.29, p = 0.05 vs rs = 0.15, p = 0.22). Conclusions. Diabetes mellitus can influence tissue characteristics, including tumor. Increasing serum glucose level decreases the proliferative activity of breast carcinoma.