Farklı plöredezis yöntemlerinin erken dönem radyolojik, histopatolojik ve moleküler sonuçlarının karşılaştırılması
Date
2022-06-28
Authors
Temiz, Elif Mekik
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Bu çalışmada, farklı plöredezis yöntemlerinin erken dönem radyolojik, histopatolojik ve moleküler bulgularının karşılaştırılması amaçlandı. Sıçanlar (n=18) 3 gruba (n=6) ayrıldı. Sıçanlara plöredezis amaçlı intraplevral olarak grup 1'de (GRI) otolog kan, grup 2'de (GRII) talk ve grup 3'te (GRIII) bleomisin uygulandı. Postoperatif 0, 7 ve 15. günlerde klinik, hematolojik, radyolojik muayeneleri ile kan plazmasında IL-8, D-Dimer ve VEGF analizleri yapıldı. Sıçanlar 15. günde sakrifiye edildikten sonra akciğer ve plevra doku histopatolojisi incelendi. Verilere istatistik uygulandı. Plöredezis sonrası SpO2 değerleri açısından gruplar arası değerlendirmede anlamlı fark belirlenmedi (p=0,290). Tüm hematolojik parametreler için 15. günde anlamlı fark saptanmadı (p>0,05). GRI'de pH (p=0,024), pCO2 (p=0,013), pO2 (p=0,027), K+ (p=0,018), Cl- (p=0,001) için ölçüm zamanları arasında fark anlamlıydı. Tüm kan gazı değerleri için 15. günde anlamlı fark yoktu (p>0,05). IL-8 için 7. günde tüm gruplarda değerlerin arttığı, 15. günde ise GRI'in ortalama değerlerinin arttığı ve GRII'nin azaldığı, GRIII'ün ise ortalama değerlerinin değişmediği saptandı. D-Dimer için 7. günde GRI ve GRII'nin ortalama değerleri azalmakta GRIII'ün ise ortalama değerleri artmaktaydı. Onbeşinci günde ise GRI ve GRII ortalama değerlerinin azalmaya devam ettiği, GRIII'te de ortalama değerin arttığı görüldü. VEGF için 7. günde GRI ve GRIII'nin ortalama değerlerinin azaldığı, GRII'nin ise ortalama değerinin arttığı görüldü. Onbeşinci günde ise GRI ve GRII ortalama değerlerinin azaldığı, GRIII'ün ortalama değerlerinin artış gösterdiği belirlendi. Biyobelirteç değerleri ölçüm zamanları yönünden grup içi karşılaştırıldığında ölçüm zamanları arasında fark saptanmadı (p>0,05). Radyolojik olarak postoperatif 0. günde gruplardaki tüm sıçanlarda radyopasite artışı görüldü. Radyolojik ve histopatolojik bulgular GRII'de daha şiddetliydi. Gruplar arasında fibrozis için anlamlı fark bulunurken (p=0,028) inflamasyon için herhangi bir anlamlı fark saptanmadı (p>0,05). Sonuç olarak; otolog kan, talk ve bleomisin'in farklı inflamatuvar özellikleri olsa da histopatolojik bulguları temelinde talk ile yapılacak plöredezisin klinik kullanım açısından daha etkin olduğu vurgulanabilir.
Comparison of Early Stage Radiological, Histopathological and Molecular Results of Different Pluerodesis Methods In this study, it was aimed to compare the early stage radiological, histopathological and molecular findings of different pleurodesis methods. The rats (n=18) were divided into 3 groups (n=6). Rats were administered intrapleural autologous blood in group 1 (GRI), talc in group 2 (GRII), and bleomycin in group 3 (GRIII) for pleurodesis. Clinical, hematological and radiological examinations and IL-8, D-Dimer and VEGF analyzes in blood plasma were performed on postoperative days 0, 7 and 15. After the rats were sacrificed on the 15th day, lung and pleural tissues were examined histopathology. Statistics were applied to the data. There was no significant difference between the groups in terms of SpO2 values after pleurodesis (p=0.290). No significant difference was found on the 15th day for all hematological parameters (p>0.05). In GRI, the difference between measurement times was significant for pH (p=0.024), pCO2 (p=0.013), pO2 (p=0.027), K+ (p=0.018), Cl- (p=0.001). There was no significant difference on the 15th day for all blood gas values (p>0.05). It was determined that the values for IL-8 increased in all groups on the 7th day, on the 15th day the mean values of GRI increased and GRII decreased, while the mean values of GRIII did not change. For D-Dimer, mean values of GRI and GRII were decreasing at day 7, while mean values of GRIII were increasing. On the 15th day, it was observed that the mean values of GRI and GRII continued to decrease, and the mean value in GRIII increased. For VEGF, it was determined that the mean values of GRI and GRIII decreased on the 7th day, while the mean value of GRII increased. On the 15th day, it was determined that the mean values of GRI and GRII decreased, and the mean values of GRIII increased. When the biomarker values were compared within the group in terms of measurement times, no difference was found between the measurement times (p>0.05). Radiologically, radiopacity increased in all rats in the groups on postoperative day 0. Radiological and histopathological findings were more severe in GRII. While there was a significant difference between the groups for fibrosis (p=0.028), no significant difference was found for inflammation (p>0.05). As a result; although autologous blood, talc and bleomycin have different inflammatory properties, it can be emphasized that pleurodesis with talc is more effective in terms of clinical use, based on histopathological findings.
Comparison of Early Stage Radiological, Histopathological and Molecular Results of Different Pluerodesis Methods In this study, it was aimed to compare the early stage radiological, histopathological and molecular findings of different pleurodesis methods. The rats (n=18) were divided into 3 groups (n=6). Rats were administered intrapleural autologous blood in group 1 (GRI), talc in group 2 (GRII), and bleomycin in group 3 (GRIII) for pleurodesis. Clinical, hematological and radiological examinations and IL-8, D-Dimer and VEGF analyzes in blood plasma were performed on postoperative days 0, 7 and 15. After the rats were sacrificed on the 15th day, lung and pleural tissues were examined histopathology. Statistics were applied to the data. There was no significant difference between the groups in terms of SpO2 values after pleurodesis (p=0.290). No significant difference was found on the 15th day for all hematological parameters (p>0.05). In GRI, the difference between measurement times was significant for pH (p=0.024), pCO2 (p=0.013), pO2 (p=0.027), K+ (p=0.018), Cl- (p=0.001). There was no significant difference on the 15th day for all blood gas values (p>0.05). It was determined that the values for IL-8 increased in all groups on the 7th day, on the 15th day the mean values of GRI increased and GRII decreased, while the mean values of GRIII did not change. For D-Dimer, mean values of GRI and GRII were decreasing at day 7, while mean values of GRIII were increasing. On the 15th day, it was observed that the mean values of GRI and GRII continued to decrease, and the mean value in GRIII increased. For VEGF, it was determined that the mean values of GRI and GRIII decreased on the 7th day, while the mean value of GRII increased. On the 15th day, it was determined that the mean values of GRI and GRII decreased, and the mean values of GRIII increased. When the biomarker values were compared within the group in terms of measurement times, no difference was found between the measurement times (p>0.05). Radiologically, radiopacity increased in all rats in the groups on postoperative day 0. Radiological and histopathological findings were more severe in GRII. While there was a significant difference between the groups for fibrosis (p=0.028), no significant difference was found for inflammation (p>0.05). As a result; although autologous blood, talc and bleomycin have different inflammatory properties, it can be emphasized that pleurodesis with talc is more effective in terms of clinical use, based on histopathological findings.
Description
Keywords
Histopatoloji, Moleküler sonuçlar, Plöredezis, Radyoloji, Sklerozan ilaç, Histopathology, Molecular results, Pleurodesis, Radiology, Sclerosing drug
Citation
Temiz, E. M. (2022). Farklı plöredezis yöntemlerinin erken dönem radyolojik, histopatolojik ve moleküler sonuçlarının karşılaştırılması. Yayınlanmamış doktora tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.