Purpose: This study aims at investigating the relation between papillary, follicular, medullar and anaplastic types of thyroid carcinomas and immunohistochemical markers such as bcl-2, bax, p53, p21, Ki-67, and c-erbB2. Material and Methods: A total of forty thyroid carcinoma cases, 10 of which were papillary, follicular anaplastic and medullar were applied bcl-2, bax, p53, p21, Ki-67, and c-erbB2 using immunohistochemistry. Results: Of these, positive staining was observed in all thyroid

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... oma types except for medullar carcinoma for bax, Bcl-2 showed 60% positive staining in papillary type, 80% in follicular type, 90% in medullar type and 60% in anaplastic type. The relation was that as tumor differentiation decreased positive staining increased both for p21 and p53. None of the medullar carcinoma cases had positive staining with these markers. While Ki-67 index was found to be low in the papillary and follicular carcinomas it was found to be significantly high in the medullary and anaplastic carcinomas.The positivity, which was 60% in the papillary carcinomas, reached 80% in anaplastic and 90% in the medullary carcinomas, with cerbB2. Conclusion: It was established that the relation between thyroid carcinomas and bax, bcl-2 and c-erbB-2 was not significant, while their relation to p21,p53 and Ki67 showed a significant difference between well-differentiated and poor-differentiated tumors. Özet Amaç: Bu çalýþmada tüm kanserler içinde %1.5 oranýnda görülen papiller, folliküler, medüller ve anaplastik tipteki tiroid karsinomlarýnýn bcl-2, bax, p53, p21, Ki-67, ve c-erbB2 gibi immunhistokimyasal belirleyicilerle iliþkisini araþtýrmayý amaçladýk. Gereç ve Yöntemler: 10 papiller 10 folliküler,10 medüller ve 10 adet anaplastik karsinomdan oluþan 40 tiroid karsinomu olgusuna immunhistokimyasal metodla bcl-2, bax, p53, p21, Ki-67, ve c-erbB2 uygulandý. Bulgular: Medüller karsinom hariç tüm tiroid karsinomlarýnda bax için pozitiflik saptandý. Bcl-2 papiller tipte %60, folliküler tipte %80, medüller tipte %90 ve anaplastik tipte %60 pozitif bulundu. p53 ve p21'in kendi aralarýnda ve tümör diferansiyasyonu ile aralarýnda bir iliþki bulundu.Tümör diferansiyasyonu azaldýkça p53 ve p21 pozitifliði artmaktaydý.Ancak medüller karsinomlar bu antikorlar için negatifti.Proliferatif indeks olarak Ki-67 Papiller (1.71) ve folliküler karsinomlarda (2.56) düþük bulunurken medüller (12.00) ve anaplastik karsinomlarda (13.29) belirgin derecede yüksekti. CerbB2 için papiller karsinomlarda %60 pozitiflik saptanýrken anaplastik karsinomlarda %80, medüller karsinomlarda %90 pozitiflik bulundu. Sonuç: Sonuç olarak tiroid karsinom tipleri ile bax, bcl-2 ve C-erb-B2 arasýnda anlamlý bir farklýlýk saptanmazken, iyi diferansiye tümörlerle az diferansiye tümörler arasýnda p53,p21 ve ki-67 açýsýndan belirgin farklýlýklar saptandý. Anahtar Kelimeler: Apoptosis; Tiroid karsinom. Erciyes Týp Dergisi (Erciyes Medical Journal) 2007;29(3):201-209 202 Introduction Thyroid carcinomas making up 1.5% of all cancers have four major histological subtypes. These are papillary (75-85%), follicular (10-20%), medullar (5%) and anaplastic (less than 5%) carcinomas in order of frequency. They are generally more common among women (1).