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Öğe Acute histopathological responses of testicular tissues after different fractionated abdominal irradiation in rats(Informa Healthcare, 2015) Akdere, Hakan; Caloglu, Vuslat Yurut; Tastekin, Ebru; Caloglu, Murat; Turkkan, Gorkem; Mericliler, Meric; Burgazli, Kamil MehmetPurpose: To compare the effects of different fractionated doses of abdominal radiation therapy on acute histopathological responses of testicular tissues in rats. Methods: Thirty-three 3-week-old Wistar albino rats were randomized into 6 groups: group 1 (n = 5), control; group 2 (n = 4), hypofractionated total abdominal irradiation (TAI) of 6 Gy/1 fraction/day for 2 days; group 3 (n = 6), hypofractionated TAI of 4 Gy/1 fraction/day for 3 days; group 4 (n = 6), hypofractionated TAI of 3 Gy/1 fraction/day for 4 days; group 5 (n = 6), conventionally fractionated TAI of 2 Gy/1 fraction/day for 6 days; group 6 (n = 6), conventionally fractionated TAI of 1.7 Gy/1 fraction/day for 7 days. Mean epithelial length and diameter of seminiferous tubules of testicular tissues were determined after euthanasia. Results: Initially, a highly significant decrease in both the mean tubular diameter and epithelial height of the seminiferous tubules was demonstrated in all irradiated rats compared with the control group. No significant differences regarding both damage parameters were found between different hypofractionated radiation therapies. Both conventional radiation therapies reduced the epithelial height and mean diameter of the seminiferous tubules to a lesser extent when compared with 6 Gy/1 fraction/day hypofractionated therapy. It was further shown that parameter values were comparable between rats that received 3 Gy/day hypofractionated therapy and rats that received either of the two conventional therapies. Furthermore, although 4 Gy/day hypofractionation decreased tubular diameter and epithelial length to a greater degree compared with the conventional therapy of 1.7 Gy/1 fraction/day, no statistically significant difference was found when compared with conventional therapy of 2 Gy/1 fraction/day. Additionally, no statistically significant difference was demonstrated between the two types of conventional radiotherapy application. Conclusion: The present study demonstrated that hypofractionated abdominal irradiation leads to more prominent tissue damage in the testes than conventional irradiation.Öğe Assessing the correlation between FDG PET findings of IDC breast carcinoma and histopathology of coexisting ductal carcinoma in-situ(Via Medica, 2022) Sarikaya, Ismet; Sarikaya, Ali; Albatineh, Ahmed N.; Tastekin, Ebru; Sezer, Yavuz AtakanBackground: Ductal carcinoma in-situ (DCIS) often coexists with invasive ductal carcinoma (IDC) of the breast. DCIS is consid-ered as a non-obligate precursor of IDC when both coexist. F-18-fluorodeoxyglucose positron emission tomography/computed tomography ([F-18]FDG PET/CT) imaging is commonly used in the staging and follow-up assessment of breast cancer. In this study, we aimed to assess if there is any correlation between primary tumor PET and histopathology findings and histopatho-logical features of the coexisting DCIS. Material and methods: FDG PET/CT images and histopathology results of the patients with newly diagnosed breast cancer (IDC) with coexisting DCIS were analyzed in this retrospective study. The grade and size of the primary tumor and histopathological features of the coexisting DCIS (nuclear grade and architectural pattern) were obtained from the postoperative histopathology results. Maximum standardized uptake values (SUV: SUVmax and SULmax) of the primary tumor normalized by weight and lean body mass were measured. Statistical analysis was performed to assess the correlation between various parameters of IDC and DCIS. Results: This study included sixty-two (62) patients with IDC-DCIS. Primary tumor grade was significantly correlated and associated with the nuclear grade of the coexisting DCIS (polychoric correlation r = 0.736, and Fisher exact test, PV < 0.001, respectively). Primary tumor SUV was not correlated with the nuclear grade and architectural pattern of the coexisting DCIS (polyserial correlation r = 0.172, PV = 0.155, and Point Bi-Serial correlation r = -0.009, PV = 0.955, respectively). Median primary tumor size was marginally significantly different among DCIS nuclear grades but it was not significantly different in comedo and non-comedo cases (Kruskal-Wallis test PV = 0.053, and Mann-Whitney U test PV = 0.890, respectively). Conclusions: Primary tumor grade is correlated with the nuclear grade of the coexisting DCIS. SUV of primary tumor does not seem to be correlated with the histopathological features of coexisting DCIS (nuclear grade and architectural pattern) but this may be further studied in a larger number of patients.Öğe Assessment of biological and clinical aggressiveness of invasive ductal breast cancer using baseline 18F-FDG PET/CT-derived volumetric parameters(Lippincott Williams & Wilkins, 2018) Aktas, Gul Ege; Tastekin, Ebru; Sarikaya, AliObjectiveThe aim of this study was to evaluate the relationship of baseline fluorine-18-fluorodeoxyglucose PET/computed tomography (CT)-derived volumetric parameters for the primary tumor with clinicopathological risk factors and molecular subtypes in patients with invasive ductal breast carcinoma (IDBC).Patients and methodsWe evaluated 65 patients who underwent fluorine-18-fluorodeoxyglucose PET/CT for initial breast cancer staging. The association of maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis (TLG) with clinicopathological risk factors and molecular subtypes was investigated and the discriminative power of significant features was assessed.ResultsAll volumetric parameters were significantly higher for tumors measuring more than 2cm and with a Ki-67 index of at least 20. Estrogen receptor (ER) and progesterone receptor (PR)-negative (ER-/PR-), human epidermal growth factor receptor 2-positive (HER2+), and triple-negative tumors showed increased SUVmax. SUVmax and SUVmean were higher for triple-negative and HER2+ IDBC than for ER+/HER2- IDBC. Metabolic tumor volume and TLG showed no differences among subtypes. All volumetric parameters correlated with the clinical tumor size and the Ki-67 index; these correlations differed among the different subtypes. Patients with systemic metastases showed significantly higher TLG. Receiver operating characteristic analysis showed that SUVmax had the highest discriminative power for the different subtypes, whereas TLG had a statistically significant discriminative power for systemic metastasis.ConclusionSUV(max) may appropriately reflect the immunohistochemical characteristics of IDBC, whereas TLG is associated with clinical risk factors and systemic metastasis. Our preliminary findings suggesting different relationships between volumetric parameters and the clinical tumor size and the Ki-67 index for different subtypes require further evaluation.Öğe BRAF V600 Mutation Profile of Metastatic Melanoma in the Thrace Region of Turkey(De Gruyter Poland Sp Zoo, 2018) Can, Nuray; Tastekin, Ebru; Deniz Yalta, Tulin; Sut, Necdet; Korkmaz, Selma; Usta, Ufuk; Oz Puyan, FulyaObjective: BRAF is the most common mutation in melanoma. The most common subtype is BRAF V600E, followed by V600K. Initially, the authors aimed to investigate whether clinicopathological features of melanoma are associated with BRAF mutations. We then aimed to present the relationships between the clinicopathological features and the mutated subtype (V600E vs V600K). Material and Method: 61 patients with metastatic malignant melanoma (affecting the lymph node or other distant sites) were selected. Patient data regarding age at the time of diagnosis, sex, metastatic site (lymph node, distant metastasis or both) and primary tumour site were obtained from the hospital's database. Tissue samples containing at least 30% tumour cells were isolated from the specimens of 61 patients (24 samples from primary tumours and 37 from metastatic foci) for BRAF analysis. Comparisons between the BRAF V600 mutation and clinicopathological and histopathological features were performed. Results: BRAF V600 mutation was detected in 34 (55.7%) patients. The subtype was BRAF V600E in 22 (64.7%) patients, BRAF V600K in 11(32.4%) patients and BRAF V600R in 1(2.9%) patient. The crucial results of the present study may be summarized as follows: i) BRAF V600 mutation was more common in older patients and tumors with BRAF V600 mutation revealed necrosis and LVI more commonly than wild-type tumors, ii) BRAF V600K mutation was more common in older patients and BRAF V600K mutated tumors exhibited ulceration more commonly than tumors with BRAF V600E mutation (close to significant). Conclusion: The BRAF V600 mutation may have interactions with prognostic clinicoptahological features of melanoma including necrosis and lymphovascular invasion. V600K mutation may be more common than expected and may have different associations with properties of the tumor such as tumor ulceration and patient age. Investigation of the mutated subtype of the BRAF gene may therefore reveal more detailed data about the management of melanoma and may also prevent missing of candidates for BRAF inhibitor therapies.Öğe BREAST CANCER IN A WOMAN WITH GUILLAIN-BARRE SYNDROE: A REMINDER TO CONSIDER PARANEOPLASTIC NEUROLOGICAL SYNDROME(Gunes Kitabevi Ltd Sti, 2016) Tuna, Filiz; Tastekin, Ebru; Ozdemir, Hande; Duzce, Ela; Tuna, Hakan72-year-old woman was referred to us for Guillain-Barre syndrome rehabilitation, during which her functional status improved (Hughes score 3-2, Functional Ambulation Classification Scale 2-4, Functional Independence Measure score 99-120). Despite her improvement, discharge was postponed because of a bloody discharge from her left nipple, which started 1 day before the last visit. The final diagnosis, after an excisional biopsy, was invasive ductal carcinoma with apocrine features. Guillain-Barre syndrome is an acute, rapidly progressing inflammatory polyneuropathy, with patients typically showing symmetrical, ascending weakness with a severe loss of reflexes. The current literature describes Guillain-Barre syndrome as a probable paraneoplastic neurological syndrome and cancer precursor. Guillain-Barre syndrome with this etiology, i.e., paraneoplastic neurological syndrome, may result from remote effects with immunological mechanisms that are not directly caused by the tumor or metastases infiltration. Guillain-Barre syndrome may develop as a paraneoplastic neurological syndrome, may be secondary to treatment, or may occur coincidentally with cancer. Because paraneoplastic neurological syndrome occurs at an early stage of cancer before metastasis, it is important to consider paraneoplastic neurological syndrome when evaluating Guillain-Barre syndrome patients.Öğe Breast Cancer Subtypes and Prognosis: Answers to Subgroup Classification Questions, Identifying the Worst Subgroup in Our Single-Center Series(Dove Medical Press Ltd, 2022) Cosar, Rusen; Sut, Necdet; Ozen, Alaattin; Tastekin, Ebru; Topaloglu, Sernaz; Cicin, Irfan; Nurlu, DilekPurpose: Many studies report the triple negative breast cancer (TNBC) as the worst subgroup, as such patients do not benefit from anti-hormonal therapy and human epidermal growth factor receptor 2 (HER2) antagonists. While HER2 overexpression was a poor prognostic factor in breast cancer before trastuzumab (Herceptin) was available, TNBC is often reported as the worst BC subgroup since targeted therapy is currently not possible. Since the patience-specific experiences and the current literature did not always align, we aimed to determine the BC subgroup with the shortest survival in our center.Methods: The records of patients with BC who were admitted to Trakya University Faculty of Medicine Department of Medical and Radiation Oncology between July 1999 and December 2019 were reviewed. Patients were divided into four main groups (Luminal A, Luminal B, TNBC, and HER2-enriched) according to the St Gallen International Consensus Panel and four subgroups in accordance with estrogen receptor, progestin receptor and HER2 positivity. Patient characteristics, treatment characteristics and clinical outcomes of the four main subgroups were evaluated. Survival curves were generated using the Kaplan-Meier method, and the significance of survival differences among the selected variables was compared by using the Log rank test. Factors affecting disease-free survival (DFS) and overall survival (OS) were analyzed by Cox regression analysis.Results: Statistical analysis was performed on 2017 patients, after excluding patients with phyllodes tumor, carcinoma-in-situ and missing information from a total of 2474 patients with BC. There were 952 (47.1%) patients in the Luminal A group, 236 (34.1%) in the Luminal B group, 236 (11.7%) in the TNBC group and 142 (7.1%) patients in the HER2 enriched group. HER2-enriched patients had the shortest survival (p < 0.001), with 113.70 +/- 7.17 months of DFS and 125.45 +/- 3.03 months of OS. For patients who received Herceptin, DFS was 101.50 +/- 6.4 months and OS was 118.14 +/- 6.16. Patients who did not receive Herceptin had 92.79 +/- 18 months of DFS and 94.44 +/- 15.23 months of OS.Conclusion: The HER2-enriched subgroup had the worst prognosis despite receiving targeted therapy. While the duration of DFS and OS had no significant difference between TNBC and Luminal A-B subgroups, HER2 enriched subgroup had significantly shorter survival when compared to any other subgroup. HER2-enriched subgroup had a 10-fold greater risk of death compared to the Luminal A subgroup.Öğe Cardiac metastasis of hepatocellular carcinoma in a young non-cirrhotic patient, to the left ventricle(Elsevier Espana, 2012) Tastekin, Ebru; Usta, Ufuk; Ege, Turan; Kazindir, Gokhan; Kutlu, Ali KemalHepatocellular carcinoma (HCC) is the most common primary tumor of the liver.(1,2) The most common extrahepatic metastatic sites are lung, abdominal lymph nodes and bone, while its cardiac metastasis is rare.(2,3) Metastasis of HCC into the cardiac cavity is mostly caused by direct tumor invasion of vena cava inferior with continuous extension into the right cardiac cavity.(4,5) Right heart metastasis without invasion of inferior vena cava, which may be caused by hematogenous spread of cancer cells, is rarely reported.(6,7) This paper announces an unusual case of isolated involvement of left ventricle (LV) together with myocardial invasion of HCC. Our patient is known to be the first case with isolated HCC metastasis to the left ventricle. Strikingly, the patient was young and non-cirrhotic with negative serum HBsAg, and anti-HCV results.Öğe CD56, CD57, HBME1, CK19, GALECTIN-3 AND P63 IMMUNOHISTOCHEMICAL STAINS IN DIFFERENTIATING DIAGNOSIS OF THYROID BENIGN/MALIGN LESIONS AND NIFTP(Vesalius Univ Medical Publ, 2019) Tastekin, Ebru; Keskin, Elif Usturali; Can, Nuray; Canberk, Sule; Mut, Ayse Nur Usturali; Erdogan, Ezgi Genc; Asa, NurtacDetection of thyroid carcinoma has been steadily increased in the past few decades. After the recognition of NIFTP, also gain importance to differentiate benign tumors (follicular adenoma) from follicular patterned variants of papillary thyroid carcinoma (invasive and infiltrative follicular variant papillary thyroid carcinoma), and low-risk lesions of thyroid (NIFTP). Follicular patterned proliferations of thyroid still persists as a battle for pathologists. In this study, we aimed to analyze the most commonly used immunohistochemical stains HBME1, CK19, Galectin-3, adding the new ones CD56, CD57, and p63. Study groups were; nodular hyperplasia, follicular adenoma, NIFTP, infiltrative follicular variant PTC, classical variant PTC (CVPTC) and follicular carcinoma. Each group consisted of twenty cases. The sections were stained with CD56, CD57, p63, CK19, HBME1 (Mesotel cell), Galectin-3 antibody. Although the expression of CD56 was high in benign follicular lesions, FC could not be excluded in this group. CD57 was high in malignant follicular group and NIFTP. Interestingly, p63 was found highly expressed in FVPTC, which might be promising to predict invasiveness in follicular group of lesions. CK19, Galectin-3 and HBME1 were found quietly prominent in CVPTC in concordance with the previous reports.Öğe Classifying invasive lobular carcinoma as special type breast cancer may be reducing its treatment success: A comparison of survival among invasive lobular carcinoma, invasive ductal carcinoma, and no-lobular special type breast cancer(Public Library Science, 2023) Cosar, Rusen; Sut, Necdet; Topaloglu, Sernaz; Tastekin, Ebru; Nurlu, Dilek; Ozler, Talar; Senodeyici, EylulPurposeThe literature contains different information about the prognosis of invasive lobular carcinoma of breast cancer (BC). We aimed to address the inconsistency by comparatively examining the clinical features and prognosis of invasive lobular carcinoma patients in our university and to report our experience by dividing our patients into various subgroups. Patients and methodsRecords of patients with BC admitted to Trakya University School of Medicine Department of Oncology between July 1999 and December 2021 were reviewed. The patients were divided into three groups (No-Special Type BC, Invasive Lobular Special Type BC, No-Lobular Special Type BC). Patient characteristics, treatment methods and oncological results are presented. Survival curves were generated using the Kaplan-Meier method. Statistical significance of survival among the selected variables was compared by using the log-rank test. ResultsThe patients in our study consisted of 2142 female and 15 male BC patients. There were 1814 patients with No-Special Type BC, 193 patients with Invasive Lobular Special Type BC, and 150 patients with No-Lobular Special Type BC. The duration of disease-free survival (DFS) was 226.5 months for the No-Special Type BC group, 216.7 months for the No-Lobular Special Type BC group, and 197.2 months for the Invasive Lobular Special Type BC group, whereas the duration of overall survival (OS) was 233.2 months for the No-Special Type BC group, 227.9 for the No-Lobular Special Type BC group, and 209.8 for the Invasive Lobular Special Type BC group. The duration of both DFS and OS was the lowest in the Invasive Lobular Special Type BC group. Multivariate factors that were significant risk factors for OS were Invasive Lobular Special Type BC histopathology (p = .045), T stage, N stage, stage, skin infiltration, positive surgical margins, high histological grade, and mitotic index. Modified radical mastectomy, chemotherapy, radiotherapy and use of tamoxifen and aromatase inhibitors for more than 5 years were significant protective factors for overall survival. ConclusionThe histopathological subgroup with the worst prognosis in our study was Invasive Lobular Special Type BC. Duration of DFS and OS were significantly shorter in Invasive Lobular Special Type BC than No-Lobular Special Type BC group. The classification of Invasive Lobular BC under the title of Special Type BC should be reconsidered and a more accurate treatment and follow-up process may be required.Öğe Clinical correlation of biopsy results in patients with temporal arteritis(Assoc Medica Brasileira, 2017) Yuksel, Olkan; Guclu, Orkut; Tastekin, Ebru; Halici, Umit; Huseyin, Serhat; Inal, Volkan; Canbaz, SuatObjective: Temporal arteritis is systemic vasculitis of medium and large sized vessels. The lowest incidence rates were reported in Turkey, Japan and Israel. We aimed to investigate the results of patients with biopsy-proven temporal arteritis and those classified according to the American College of Rheumatology criteria from a low-incidence region for temporal arteritis. The results of our study are noteworthy, since there is limited data on pathologic diagnosis of temporal arteritis in Turkey. Method: We studied the medical records, laboratory findings such as erythrocyte sedimentation rate and C-reactive protein levels, biopsy results, and postoperative complications of all the patients operated for temporal artery biopsy at our clinic. We used the computerized laboratory registry that keeps all records of 42 consecutive temporal artery biopsy results from January 2011 to December 2016. Results: The mean age was 66 +/- 12.5 years. The most common manifestations on admission were temporal headache, optic neuritis and jaw claudication, respectively. Temporal artery biopsy results confirmed tempoal arteritis in eight out of 42 (19%) patients. There was no statistically significant difference between biopsy-positive and biopsy-negative groups in terms of sex, age, erythrocyte sedimentation rate, C-reactive protein and biopsy length. Conclusion: We were not able to find a correlation between the analysis of biopsy results and clinical evaluation of patients with temporal arteritis. We suggest that diagnosis of temporal arteritis depends on clinical suspicion. Laboratory examination results may not be helpful in accurate diagnosis of tempoal arteritis.Öğe The Clinical Significance of Incidental Parotid Uptake in a PET/CT Study: A Diagnostic Algorithm(Bentham Science Publ Ltd, 2019) Ustun, Funda; Tastekin, Ebru; Tas, Abdullah; Altun, Gulay DurmusBackground: Patients diagnosed with cancer do not have sufficient clinical data for the management of incidental parotid lesions. We aimed to reveal the importance of randomized parotid lesions encountered during oncologic F-18 fluorodeoxyglucose positron emission tomography (FDG PET/CT) imaging in our clinical practice and the diagnostic algorithm of such lesions. Methods: We performed a database search of PET/CT records generated from 2009 to 2015 for parotid in reports of patients who underwent PET/CT examination for a known malignancy elsewhere, or cancer screening. Results: Incidental parotid FDG uptake on PET/CT had a prevalence of 1.1%. The incidence of parotid metastasis in our series was 36.4%, and 75% of them had malign melanoma metastasis. Of the 11 cases, 5 were of Warthin tumours, and Warthin tumours showed stronger GLUT1 expression than metastatic parotid lesions. Conclusion: In patients with malignancy elsewhere, focal involvement of FDG by the parotid gland, especially if malignant melanoma or SCC is absent, should not be considered a metastatic disease without histopathologic confirmation. If parotid disease would change the patient's treatment plan and disease stage, the parotid lesion should be evaluated by additional methods, such as fine needle aspiration biopsy.Öğe Clinicopathological and molecular analyses of uterine carcinosarcomas using next-generation sequencing: A single-center experience(Wolters Kluwer Medknow Publications, 2023) Erdogan, Ezgi Genc; Yalta, Tuelin D.; Can, Nuray; Sut, Necdet; Tastekin, Ebru; Usta, Ufuk; Puyan, Fulya OzBackground: Uterine carcinosarcomas (UCS) constitute 3-4% of all uterine malignancies and 16% of deaths caused due to uterine neoplasms. Aim: In this study, we aimed to perform DNA-based mutation analysis in 12 genes (KRAS, NRAS, EGFR, C-KIT, BRAF, PDGFRA, ALK, ERBB2, ERBB3, ESR1, RAF1, PIK3CA) to determine the molecular subtypes of UCS using next-generation sequencing (NGS) in patients with aggressive UCS and poor prognosis. We aimed to compare the results of our analysis with clinicopathological data to contribute to the development of targeted therapy approaches related to the molecular changes of UCS. Materials and Methods: In this study, we included 12 cases diagnosed with uterine carcinosarcomas and examined the changes in oncogenes that play a role in UCS pathogenesis. For the analysis of mutation, the clinicopathological data were compared with the variations in the DNA-based gene panel consisting of 12 genes and 1237 variants in the UCS using the NGS method. Results: EGFR mutation was found in 91.7% of the cases, mutation in 41.7%, PDGFRA mutation in 25%, KRAS and PIK3CA mutation in 16.7%, and C-KIT mutation in 8.3% of the cases. Although no statistical significance was found between the detected mutation and clinicopathological data, it was concluded that PDGFRA mutation might be associated with advanced-stage disease development. Conclusion: This study's findings regarding different molecular types of UCS and information on oncogenesis of UCS can provide inferences for targeted therapies in the future by identifying targetable mutations representing early oncogenic events and thereby contribute toward further studies on this subject.Öğe Combination of Docetaxel and Gemcitabine Ineffective in Metastatic Eccrine Porocarcinoma: A Case Report(Kare Publ, 2017) Kodaz, Hilmi; Hacioglu, Muhammet Bekir; Kostek, Osman; Erdogan, Bulent; Tastekin, Ebru; Kodaz, Cagnur Elpen; Cicin, IrfanMalignant eccrine porocarcinoma is a very rare tumor and the etiology is not known. Treatment is surgical removal of the tumor. The benefit of chemotherapy and radiotherapy is unclear. A 49-year-old male patient presented with the complaint of left inguinal swelling. Ultrasonography examination revealed 5x4 cm inguinal lymphadenopathy. The inguinal lymph nodes were excised. Pathology report indicated eccrine porocarcinoma. The patient was treated with cisplatin 40 mg/m(2) week as well as concurrent radiotherapy for 5 weeks. After 6 weeks of dual therapy, liver metastases were detected. KRAS, NRAS, and BRAF tests were negative. Gemcitabine was administered at a dose of 1000 mg/m(2) on days 1 and 8 every 21 days, and docetaxel was administered at a dose of 75 mg/m(2) on day 8, every 21 days. There was progression after 2 cycles of chemotherapy. The patient lived 7 months. In this case, use of synchronous cisplatin and radiotherapy as adjuvant treatment could not prevent tumor metastasis. The combination chemotherapy of docetaxel and gemcitabine applied after metastatic disease development was ineffective.Öğe COMPARISON OF CLINICO PATHOLOGICAL FEATURES IN INCIDENTAL AND NONINCIDENTAL PAPILLARY THYROID CARCINOMAS IN 308 PATIENTS(Vesalius Univ Medical Publ, 2017) Can, Nuray; Ozyilmaz, Filiz; Celik, Mehmet; Sezer, Atakan Y.; Sut, Necdet; Tastekin, Ebru; Ayturk, SemraIncidental papillary thyroid carcinomas (IPTCs) consist of a significant portion of increasing incidence in papillary thyroid carcinomas. This study investigated the clinicopathological features of IPTCs from different perspectives and by comparing nonincidental PTCs (NIPTCs) in patients who underwent total thyroidectomy and lymph node dissection. Basic results were as follows. IPTC was present in 27.9% of 308 patients. IPTCs were significantly accompanied by lymphocytic thyroiditis (LT), particularly, multinodular hyperplasia (MNH). IPTCs were more common in older patients (51.3 years vs. 47.2 years) and in female patients. IPTCs significantly differed from NIPTCs in terms of smaller tumour size, lymphatic vessel invasion (2.6% vs. 97.4%), extrathyroidal extension (4.3% vs. 95.7%), lymph node metastasis (3.6% vs. 96.4%), multifocality (21.2% vs. 78.8%), bilaterality (5.3% vs. 94.7%), and BRAFV600 mutation (6.7% vs. 93.3%). Older age, bilaterality, encapsulation, and radioactive iodine (RAI) were significantly more common in IPTCs > 5 mm than in those <= 5 mm. In conclusion, IPTCs are more commonly associated with LT and MNH. IPTCs may have a more favourable prognosis than NIPTCs, and tumour size > 5 mm may predict bilaterality and need for RAI. Nevertheless, the patient-based clinical approach in IPTCs may have benefits in the management of IPTCs.Öğe Comparison of clinicopathological features in patients with noninvasive follicular thyroid neoplasm with papillary-like nuclear features and follicular variant papillary thyroid cancer(Medycyna Praktyczna Sp K Sp Zoo, 2020) Celik, Mehmet; Bulbul, Buket Y.; Can, Nuray; Ayturk, Semra; Tastekin, Ebru; Sezer, Atakan; Ustun, FundaINTRODUCTION Noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) is a newly defined entity accepted as a tumor precursor. OBJECTIVE We aimed to examine the features of patients diagnosed with follicular variant papillary thyroid carcinoma (FVPTC), which are classified as NIFTP in the recent classification. This study compares clinical, radiological, histopathological, and molecular features of NIFTP and FVPTC. PATIENTS AND METHODS A total of 247 patients with FVPTC were retrospectively examined and pathology specimens were reviewed. RESULTS Patients were divided into 2 groups (NIFTP group: 107 patients; FVPTC group: 140 patients). There was a difference in terms of the percentage of pathologic nodules with irregular borders detected on preoperative neck ultrasonography (NIFTP group: 6.5%, FVPTC group: 15.7%; P = 0.02). Central lymph node dissection specimens of 50 patients in the NIFTP group were normal, while 4 of 70 patients (5.7%) in the FVPTC group had lymph node metastasis (P = 0.14). In addition, multivariable analysis (binary logistic regression) showed that FVPTC was positively associated only with irregular borders and extrathyroidal extensions (P = 0.02 and P <0.001, respectively). CONCLUSIONS We suggest that patients diagnosed with NIFTP according to the new classification are considered low risk, and margin characteristics of the nodule detected on preoperative ultrasonography may be helpful in the differential diagnosis.Öğe Comparison of real-life data from patients with NGS panel negative and KRAS mutation positive metastatic lung adenocarcinoma(Sage Publications Ltd, 2022) Gokyer, Ali; Kucukarda, Ahmet; Kostek, Osman; Gokmen, Ivo; Ozcan, Erkan; Sayin, Sezin; Tastekin, EbruObjective: To evaluate clinical and demographic characteristics and the results of cytotoxic treatments of KRAS(G12C), KRAS(other), and next-generation sequencing (NGS) panel negative patients. Methods: NGS data of 1264 patients with non-small cell lung cancer were retrospectively evaluated. Among these patients, the mutation distributions of 1081 patients with metastatic lung adenocarcinoma were analyzed. A total of 150 patients with negative NGS panel or mutant KRAS followed up in our clinic were included. Clinical features, overall survival, first-line chemotherapy responses, and progression-free survival of NGS panel negative, KRAS(G12C), and KRAS(other) groups were compared. Results: In 1081 patients who underwent NGS from tumor tissue with the diagnosis of metastatic lung adenocarcinoma, 296 (27%) NGS panel negative and 276 (26%) KRAS mutant patients were detected. Among these patients, 150 patients whose data were available were 71 (47.3%) NGS panel negative, 54 (36%) KRAS(other), and 25 (16.7%) KRAS(G12C). Clinical features, brain metastasis, and first-line chemotherapy response were similar among groups. Bone metastases were detected more often in the NGS panel negative group (p = 0.03). The median follow-up was 8.4 months. Overall, 107 deaths had occurred at the time of analysis. There was no difference in overall survival (p = 0.56) or progression-free survival (p = 0.71) among NGS panel negative, KRAS(other), and KRAS(G12C) patients. Conclusion: There is no difference in overall survival, first-line chemotherapy response, or progression-free survival among patients with NGS panel negative, KRAS(G12C), or KRAS(other) metastatic lung adenocarcinoma. Bone metastases were observed more frequently in the NGS panel negative group.Öğe Comparison of the protective roles of L-carnitine and amifostine against radiation-induced acute ovarian damage by histopathological and biochemical methods(Medknow Publications & Media Pvt Ltd, 2015) Yurut-Caloglu, Vuslat; Caloglu, Murat; Eskiocak, Sevgi; Tastekin, Ebru; Ozen, Alaattin; Kurkcu, Nukhet; Oz-Puyan, FulyaPurpose: The aim of this study was to compare the radioprotective efficacies of L-carnitine (LC) and amifostine against radiation-induced acute ovarian damage. Materials and Methods: Forty-five, 3-month-old Wistar albino rats were randomly assigned to six groups. Control (CONT, n = 7); irradiation alone RT: radiation therapy (RT, n = 8); amifostine plus irradiation (AMI + RT, n = 8); LC plus irradiation (LC + RT, n = 8); LC and sham irradiation (LC, n = 7); and amifostine and sham irradiation (AMI, n = 7). The rats in the AMI + RT, LC + RT and RT groups were irradiated with a single dose of 20 Gy to the whole abdomen. LC (300 mg/kg) and amifostine (200 mg/kg) was given intraperitoneally 30 min before irradiation. Five days after irradiation, both antral follicles and corpus luteum in the right ovaries were counted, and tissue levels of malondialdehyde (MDA) and advanced oxidation protein product (AOPP) were measured. Results: Irradiation significantly decreased antral follicles and corpus luteum (P:0.005 and P < 0.0001). LC increased the median number of antral follicles and corpus luteum (P:0.009 and P < 0.0001, respectively). Amifostine improved median corpus luteum numbers but not antral follicle (P < 0.000, P > 0.05). The level of MDA and AOPP significantly increased after irradiation (P = 0.001 and P < 0.0001, respectively). MDA and AOPP levels were significantly reduced by LC (P:0.003, P < 0.0001) and amifostine (P < 0.0001, P:0.018). When comparing CONT group with AMI + RT and LC + RT groups, MDA and AOPP levels were similar (P > 0.005). The levels of both MDA and AOPP were also similar when LC + RT is compared with AMI + RT group (P > 0.005). Conclusions: L-carnitine and amifostine have a noteworthy and similar radioprotective effect against radiation-induced acute ovarian toxicity.Öğe A Comprehensive Approach to the Thyroid Bethesda Category III (AUS) in the Transition Zone Between 2nd Edition and 3rd Edition of The Bethesda System for Reporting Thyroid Cytopathology: Subcategorization, Nuclear Scoring, and More(Humana Press Inc, 2024) Bagis, Merve; Can, Nuray; Sut, Necdet; Tastekin, Ebru; Erdogan, Ezgi Genc; Bulbul, Buket Yilmaz; Sezer, Yavuz AtakanSignificant interobserver variabilities exist for Bethesda category III: atypia of undetermined significance (AUS) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC). Thus, subcategorization of AUS including AUS nuclear and AUS other is proposed in the recent 3rd edition of TBSRTC. This study investigated the impact of the nuclear features/architectural features/nuclear score (NS) (3-tiered)/subcategories and subgroups on risk of malignancy (ROM) in thyroid fine-needle aspirations (FNA). 6940 FNAs were evaluated. 1224 (17.6%) cases diagnosed as AUS were reviewed, and 240 patients (initial FNAs of 260 nodules and 240 thyroidectomies) were included. Subcategories and subgroups were defined according to TBSRTC 2nd and 3rd editions. Histological diagnostic groups included nonneoplastic disease, benign neoplasm, low-risk neoplasm, and malignant neoplasm. Overall, ROM was 30.7%. ROM was significantly higher in FNAs with nuclear overlapping (35.5%), nuclear molding (56.9%), irregular contours (42.1%), nuclear grooves (74.1%), chromatin clearing (49.4%), and chromatin margination (57.7%), and these features were independent significant predictors for malignancy. FNAs with NS3 had significantly higher ROM (64.2%). Three-dimensional groups were significantly more frequent in malignant neoplasms (35.7%). ROM was significantly higher in AUS-nuclear subcategory (48.2%) and in AUS-nuclear and architectural subcategory (38.3%). The highest ROM was detected in AUS-nuclear1 subgroup (65.2%). ROM was significantly higher in the group including AUS-nuclear and AUS-nuclear and architectural subcategories, namely high-risk group than the group including other subcategories, namely low-risk group (42.0%vs 13.9%). In conclusion, subcategorization may not be the end point, and nuclear scoring and evaluation of architectural patterns according to strict criteria may provide data for remodeling of TBSRTC categories.Öğe Congenital Pulmonary Airway Malformation Type 2: A Case Report with Review of the Literature(De Gruyter Open Ltd, 2016) Tastekin, Ebru; Usta, Ufuk; Kaynar, Aysegul; Ozdemir, Cigdem; Yalcin, Omer; Ozyilmaz, Filiz; Kutlu, Ali KemalA congenital pulmonary airway malformation is a rare disorder of the pulmonary airway and a hamartomatous mass of disorganized lung tissues with various degrees of cystic change. A 20-year-old pregnant woman who did not have previous clinical follow-up during her pregnancy visited the gynecology department for her first check on the 19th week of gestation. The sonogram, showed severe hydrops fetalis. Laboratory findings were consistent with non-immune hydrops fetalis. Medical abortion was performed and the fetus was sent to our department for a complete fetal autopsy. Macroscopically, whole parts of the fetus had striking oedema. Massive pleural and peritoneal effusions were seen on dissection. The left lung filled the whole thoracic cavity. The heart was displaced to the right and the right lung was compressed. Microscopically, the left lung mass showed dilated bronchiole-like structures (1-20 mm) that were lined with ciliated columnar cells without any intervening mucinous cells. The subepithelial stroma contained thin, interrupted smooth muscle fibers and elastic connective tissue without cartilage plates. Our case is a very good example of non-immune hydrops fetalis associated with congenital pulmonary airway malformation type 2. Prenatal clinical and ultrasonographic follow-ups during pregnancy are very important for early diagnosis of congenital malformations.Öğe Conventional Tools for Predicting Satisfactory Response to Neoadjuvant Chemotherapy in HR+/HER2-Breast Cancer Patients(Karger, 2023) Oprea, Adela Luciana; Gulluoglu, Bahadir; Aytin, Yusuf Emre; Eren, Ozgur Can; Aral, Canan; Szekely, Tiberiu-Bogdan; Tastekin, EbruAim: The aim of the study was to assess the role of Magee Equation 3 (MagEq3), IHC4 score, and HER2-low status in predicting satisfactory response (SR) to neoadjuvant chemotherapy (NAC) in HR+/HER2- breast cancer (BC) patients. Methods: In a retrospective study, female patients of any age with T1-4, N0-2, M-0 HR+/HER2- BC who received NAC and underwent adequate locoregional surgical treatment were included. Patients were grouped according to 2 outcomes: (a) overall response to NAC in breast and axilla by using residual cancer burden (RCB) criteria and (b) axillary downstaging after NAC by using N staging. 2 cohorts for overall response were overall SR (RCB 0-1) and no SR (RCB 2-3). On the other hand, for axillary downstaging, 2 cohorts constituted from axillary SR (ypN(0) and ypN(0i+)) and no SR (ypN(mic-N3)). MagEq3 and IHC4 scores were calculated from their pathological tumor slides in each patient. HER2 status was categorized as either no or low. In addition, patient age, family history, tumor histology, stage at admission, and Ki-67 status were compared between cohorts according to predefined outcomes. Results: In a total of 230 BC patients, 228 patients were included to compare according to their RCB levels. The mean age of patients with overall SR was significantly lower than those without. Patients with high Ki-67 expression, high (>30) MagEq3 score, high ICH4 quartile, and HER2-low status had significantly more overall SR. On the other hand, only patients with high Ki-67 expression had significantly more axillary SR. MagEq3 score levels, ICH4 quartiles, and HER2 status were similar between patients with axillary SR and not. Conclusion: MagEq3 and IHC4 tools seemed to be useful to predict those HR+/HER2- BC patients who are most likely to get benefit from NAC. But, only high Ki-67 expression level significantly predicted satisfactory axillary downstaging in HR+/HER2- BC patients.
