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Yavuz A, Simsek K, Alpsoy A, Altunay B, Gedik EO, Unal B, Bassorgun CI, Tatli AM, Elpek GO. Prognostic significance of tumor budding, desmoplastic reaction, and lymphocytic infiltration in patients with gastric adenocarcinoma. World J Gastrointest Pathophysiol 2024; 15:91237. [DOI: 10.4291/wjgp.v15.i1.91237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 03/08/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Recent studies have shown that the tumor microenvironment significantly influences the behavior of solid tumors. In this context, Accumulated data suggests that pathological evaluation of tumor budding (TB), desmoplastic reaction (DR), and tumor-infiltrating lymphocytes (TILs) may be crucial in determining tumor behavior in the gastrointestinal tract. Regarding gastric adenocarcinoma (GAC), although some results suggest that TB and TILs may be effective in determining the course of the disease, the data do not agree. Moreover, very few studies have investigated the relationship between DR and survival. At present, the associations between tumor TB, DR and TILs in GAC patients have not been determined.
AIM To establish the relationships between TB, DR, and TILs in patients with GAC and to assess their influence on prognosis.
METHODS Our study group comprised 130 patients diagnosed with GAC. The definition of TB was established based on the International TB Consensus Conference. The DR was categorized into three groups according to the level of tumor stroma maturation. The assessment of TILs was conducted using a semiquantitative approach, employing a cutoff value of 5%. The statistical analysis of the whole group and 100 patients with an intestinal subtype of GAC was performed using SPSS version 27.
RESULTS A significant correlation between peritumoral budding (PTB) and intratumoral budding (ITB) was noted (r = 0.943). Tumors with high PTBs and ITBs had a greater incidence of immature DRs and low TILs (P < 0.01). PTB and ITB were associated with histological subtype, lymph node metastasis (LNM), and stage (P < 0.01). ITB, PTB, LNM, DR, and stage were significant risk factors associated with poor prognosis. The multivariate Cox regression analysis identified ITB, PTB, and LNM as independent prognostic variables (P < 0.05). In intestinal-type adenocarcinomas, a positive correlation between PTB and ITB was noted (r = 0.972). While univariate analysis revealed that LNM, stage, PTB, ITB, and DR were strong parameters for predicting survival (P < 0.05), only PTB and ITB were found to be independent prognostic factors (P < 0.001).
CONCLUSION TB may be a potential prognostic marker in GAC. However, further studies are needed to delineate its role in pathology reporting protocols and the predictive effects of DR and TILs.
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Affiliation(s)
- Aysen Yavuz
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Kubra Simsek
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Anil Alpsoy
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Busra Altunay
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Elif Ocak Gedik
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Betul Unal
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | | | - Ali Murat Tatli
- Department of Medical Oncology, Akdeniz University Medical School, Antalya 07070, Türkiye
| | - Gulsum Ozlem Elpek
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Türkiye
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Cobankent Aytekin E, Unal B, Bassorgun CI, Ozkan O. Clinicopathologic Evaluation of CD80, CD86, and PD-L1 Expressions with Immunohistochemical Methods in Malignant Melanoma Patients. Turk Patoloji Derg 2024; 40:16-26. [PMID: 37614091 PMCID: PMC10823788 DOI: 10.5146/tjpath.2023.01608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2023] [Indexed: 08/25/2023] Open
Abstract
OBJECTIVE Diagnostic and prognostic biomarkers for malignant melanoma are crucial for treatment and for developing targeted therapies. Malignant melanoma is a highly immunogenic tumor, and its regression, treatment, and prognostic evaluation are directly related to escape from immune destruction. Therefore, we aimed to determine the expression levels of CD80, CD86, and PD -L1 in malignant melanoma tissue samples by immunohistochemistry and to investigate the possible relationship between these proteins and the clinicopathological features in this study. MATERIAL AND METHODS Hematoxylin and eosin staining and immunohistochemical staining for CD80, CD86, and PD-L1 were evaluated for clinical data, survival, prognosis, tumor location, malignant melanoma subtypes, tumor size, and prognostic findings. RESULTS Higher survival rates were observed in patients with lower PD-L1 staining scores in the tumor. The 5-year survival was higher in patients with CD80-positive and CD86-positive biopsies. Mortality was lower in superficial spreading melanoma and Lentigo maligna melanoma types, whereas staining positivity of CD80 and CD86 was higher. Furthermore, a relationship between clinical stage and Breslow thickness ( < 2mm/≥2mm), tumor ulceration, lymph node metastasis, and CD80 and CD86 expression was also identified. CONCLUSION Our findings suggest that PD-L1, CD80, and CD86 expression are essential in malignant melanoma and could be used as prognostic markers.
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Affiliation(s)
| | - Betul Unal
- Department of Pathology, Akdeniz University, Faculty of Medicine, Antalya, Turkey
| | | | - Ozlenen Ozkan
- Department of Plastic and Reconstructive Surgery, Akdeniz University, Faculty of Medicine, Antalya, Turkey
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Cigsar Kuzu EB, Tiryaki S, Guney N, Polatdemir K, Cakir Y, Karagozlu Akgul A, Toper MH, Karaguzel G, Ucar M, Bassorgun CI, Ozel SK, Ozkanli S, Salci G, Aydin Mungan S, Yilmaz MU, Aytac Vuruskan B, Yagmur I, Tarini EZ, Kaba M, Tanik C, Canbaz FA, Hurdogan O, User IR, Orhan D, Atici A, Gursoy D, Yagmurlu EA, Enneli D, Kilic SS, Erdogan S. Low-Grade Injury following Testicular Torsion: A Multicenter Study Confirming a Disturbing Possibility. Urol Int 2023; 107:971-976. [PMID: 37913756 DOI: 10.1159/000534454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023]
Abstract
INTRODUCTION There is an ongoing debate whether to perform orchiectomy or orchidopexy following testicular torsion (TT) in cases where the testis seems non-viable. The main problem is lack of objective criteria defining testicular viability. The aim of this study was to investigate the grade of injury in orchiectomy specimens obtained from cases of TT and its association with clinical findings. METHODS This multicenter retrospective study involved double-blinded reassessment of the patient files and the pathological specimens using Mikuz classification to analyze the relation between clinical and pathological findings. RESULTS A total of 289 patient charts from 14 centers were reviewed and 228 were included in this study. Twenty (8.8%) patients had grade 1 injury which refers to reversible injury. The clinical findings of these 20 patients were compared to 208 patients with higher grades of injury. As expected, there was statistically significant difference regarding duration of symptoms (p < 0.001); however, range was wide in both groups (as long as 96 h for grade 1 and as short as 7 h for higher grades). There was no statistically significant difference in any other variable including age (median 14 for both, p = 0.531), symptoms (pain: 19/20 vs. 189/202, p = 0.801; swelling: 13/19 vs. 168/197, p = 0.094), absence of blood flow in Doppler US (15/19 vs. 164/197, p = 0.635), or degree of torsion (median 720° for both, p = 0.172). CONCLUSION Our study revealed necessity for better criteria to define viability of testis following TT. Histopathological injury appeared to be reversible even in some patients with more severe perioperative findings, late admission, or high degree of twisting. Our findings support the tendency for testicular fixation instead of orchiectomy as none of the clinical or perioperative findings could be attributed to high-grade injury.
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Affiliation(s)
| | - Sibel Tiryaki
- Div. Pediatric Urology, Department Pediatric Surgery, Ege University, İzmir, Turkey
| | - Neslihan Guney
- Department Pathology, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Kamer Polatdemir
- Department Pediatric Surgery, Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Yasemin Cakir
- Department Pathology, Behcet Uz Pediatric Diseases and Surgery Training and Research Hospital, İzmir, Turkey
| | - Ahsen Karagozlu Akgul
- Div. Pediatric Urology, Department Pediatic Surgery, Marmara University Medical Faculty, İstanbul, Turkey
| | | | - Gungor Karaguzel
- Department Pediatric Surgery, Akdeniz University Medical Faculty, Antalya, Turkey
| | - Murat Ucar
- Department Urology, Akdeniz University Medical Faculty, Antalya, Turkey
| | | | - Seyhmus Kerem Ozel
- Div. Pediatric Urology, Department Pediatric Surgery, İstanbul Medeniyet University, İstanbul, Turkey
| | - Seyma Ozkanli
- Department Pathology, İstanbul Medeniyet University, İstanbul, Turkey
| | - Gul Salci
- Department Pediatric Surgery, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Sevdegul Aydin Mungan
- Department Pathology, Karadeniz Technical University Medical Faculty, Trabzon, Turkey
| | - Mehmet Ugur Yilmaz
- Div. Pediatric Urology, Department Pediatric Surgery, Bursa Uludağ University Medical Faculty, Bursa, Turkey
| | | | - Ismail Yagmur
- Div. Pediatric Urology, Department Urology, Harran University Medical Faculty, Şanlıurfa, Turkey
| | - Emine Zeynep Tarini
- Department Pathology, Şanlıurfa Mehmet Akif İnan Training and Research Hospital, Şanlıurfa, Turkey
| | - Meltem Kaba
- Department Pediatric Surgery, Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Canan Tanik
- Department Pathology, Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey
| | - Furkan Adem Canbaz
- Div. Pediatric Urology, Department Pediatric Surgery, İstanbul Medical Faculty, İstanbul, Turkey
| | - Ozge Hurdogan
- Department Pathology, İstanbul Medical Faculty, İstanbul, Turkey
| | - Idil Rana User
- Department Pediatric Surgery, Hacettepe Univesity Medical Faculty, Ankara, Turkey
| | - Diclehan Orhan
- Department Pathology, Hacettepe Univesity Medical Faculty, Ankara, Turkey
| | - Ahmet Atici
- Department Pediatric Surgery, Mustafa Kemal University Medical Faculty, Hatay, Turkey
| | - Didar Gursoy
- Department Pathology, Mustafa Kemal University Medical Faculty, Hatay, Turkey
| | - Emin Aydin Yagmurlu
- Department Pediatric Surgery, Ankara Univesity Medical Faculty, Ankara, Turkey
| | - Duygu Enneli
- Department Pathology, Ankara Univesity Medical Faculty, Ankara, Turkey
| | - Seref Selcuk Kilic
- Department Pediatric Surgery, Çukurova University Medical Faculty, Adana, Turkey
| | - Seyda Erdogan
- Department Pathology, Çukurova University Medical Faculty, Adana, Turkey
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Unal B, Celik MY, Gedik EO, Bassorgun CI, Elpek GO. Tumor budding as a potential prognostic marker in determining the behavior of primary liver cancers. World J Hepatol 2023; 15:775-785. [PMID: 37397937 PMCID: PMC10308291 DOI: 10.4254/wjh.v15.i6.775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/22/2023] [Accepted: 04/18/2023] [Indexed: 06/25/2023] Open
Abstract
Hepatocellular (HCC) and intrahepatic cholangiocarcinoma (ICC), the most common primary tumors of the liver, are among the most important causes of cancer deaths worldwide. Because patients with primary liver tumors are frequently diagnosed at an advanced stage and have high mortality, many efforts have been made to identify new markers to determine their behavior and treatment, similar to those in other solid organ tumors. Recently, morphological assessment of tumor budding (TB) has been revealed as a promising prognostic finding to predict tumor behavior and survival across several different tumor types. Currently, the TB score in colorectal cancer has been revealed as an important parameter in pathology report protocols to determine the course of the disease. Regarding the liver, despite enormous data showing that many mechanisms involved in TB are associated with tumor behavior in both HCC and ICC, studies focusing on the role of TB in predicting the behavior and prognosis of these tumors have started to be investigated very recently. The purpose of this review is to present data about TB in primary tumors of the liver, pointing out the potential role of this parameter in determining the course of the disease, and emphasize the need to increase the number of further studies focusing on the evaluation of this parameter with an overview of the mechanisms involved in TB.
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Affiliation(s)
- Betul Unal
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | | | - Elif Ocak Gedik
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | | | - Gulsum Ozlem Elpek
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
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Yavuz A, Alpsoy A, Gedik EO, Celik MY, Bassorgun CI, Unal B, Elpek GO. Artificial intelligence applications in predicting the behavior of gastrointestinal cancers in pathology. Artif Intell Gastroenterol 2022; 3:142-162. [DOI: 10.35712/aig.v3.i5.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/25/2022] [Accepted: 12/14/2022] [Indexed: 12/28/2022] Open
Abstract
Recent research has provided a wealth of data supporting the application of artificial intelligence (AI)-based applications in routine pathology practice. Indeed, it is clear that these methods can significantly support an accurate and rapid diagnosis by eliminating errors, increasing reliability, and improving workflow. In addition, the effectiveness of AI in the pathological evaluation of prognostic parameters associated with behavior, course, and treatment in many types of tumors has also been noted. Regarding gastrointestinal system (GIS) cancers, the contribution of AI methods to pathological diagnosis has been investigated in many studies. On the other hand, studies focusing on AI applications in evaluating parameters to determine tumor behavior are relatively few. For this purpose, the potential of AI models has been studied over a broad spectrum, from tumor subtyping to the identification of new digital biomarkers. The capacity of AI to infer genetic alterations of cancer tissues from digital slides has been demonstrated. Although current data suggest the merit of AI-based approaches in assessing tumor behavior in GIS cancers, a wide range of challenges still need to be solved, from laboratory infrastructure to improving the robustness of algorithms, before incorporating AI applications into real-life GIS pathology practice. This review aims to present data from AI applications in evaluating pathological parameters related to the behavior of GIS cancer with an overview of the opportunities and challenges encountered in implementing AI in pathology.
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Affiliation(s)
- Aysen Yavuz
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | - Anil Alpsoy
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | - Elif Ocak Gedik
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | | | | | - Betul Unal
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
| | - Gulsum Ozlem Elpek
- Department of Pathology, Akdeniz University Medical School, Antalya 07070, Turkey
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Sati L, Soygur B, Goksu E, Bassorgun CI, McGrath J. CTCFL expression is associated with cerebral vascular abnormalities. Tissue Cell 2021; 72:101528. [PMID: 33756271 DOI: 10.1016/j.tice.2021.101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 02/06/2021] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
CTCFL is expressed in testis, oocytes and embryonic stem cells, and is aberrantly expressed in malignant cells, and is classified as a cancer-testis gene. We have previously shown by using a tetracycline-inducible Ctcfl transgene that inappropriate expression of Ctcfl negatively impacts fetal development and causes early postnatal lethality in the mouse. The affected pups displayed severe vascular abnormalities and localized hemorrhages in the brain evocative of cerebral cavernous malformations (CCM) and arteriovenous malformations (AVM) in humans. Thus, we aim to analyze; a) the presence of CCM-related proteins CCM1/KRIT1, CCM2/malcavernin and CCM3/PDCD10 in Ctcfl transgenic animals and, b) whether there is CTCFL expression in human CCM and AVM tissues. Ctcfl transgenic animals exhibited increased CD31 expression in vascular areas of the dermis and periadnexal regions but no difference was observed for vWF and α-SMA expressions. CCM-related proteins CCM1/KRIT1, CCM2/malcavernin and CCM3/PDCD10 were aberrantly expressed in coronal sections of the head in transgenic animals. We also observed CTCFL expression in human CCMs and AVMs. The induced expression of CTCFL resulting in vascular brain malformations in mice combined with the presence of CTCFL in human vascular malformations provide new insights into the role of this gene in vascular development in humans.
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Affiliation(s)
- Leyla Sati
- Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey.
| | - Bikem Soygur
- Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey; Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California San Francisco, San Francisco, CA, USA
| | - Ethem Goksu
- Department of Neurosurgery, Akdeniz University School of Medicine, Antalya, Turkey
| | | | - James McGrath
- Departments of Genetics and Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA
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Abstract
Surfactant protein-A (SP-A) belongs to a family of collagen-containing C-type lectins called collectins. SP-A is expressed by renal tubule epithelial cells. We investigated the distribution of SP-A in renal cell carcinomas (RCC) using immunohistochemical techniques and western blotting. We used 35 formalin fixed, paraffin embedded (FFPE) RCC tissue samples. We compared results with clinico-pathological parameters of RCC including age, sex, Fuhrman grade, tumor volume, tumor node metastasis (TNM) and clinical stage. SP-A was localized in the glomerulus and renal tubule epithelium in nontumor tissue and strong SP-A immunoreactivity was observed in tumor tissue. SP-A was expressed in the RCC tumor cells (64%) and nontumor cells (34%) in males and RCC tumor cells (90%) and nontumor cells (30%) in females. There was a significant correlation between SP-A immunoreactivity in tumor cells and gender, age, tumor diameter, Fuhrman grade and tumor diameter. Western blot analysis supported the immunohistochemical findings. We present evidence for involvement of SP-A in RCC and suggest that increased SP-A expression in RCC is associated with favorable prognosis.
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Affiliation(s)
- C I Bassorgun
- a Departments of Pathology, Faculty of Medicine , University of Akdeniz , Antalya , Turkey
| | - E C Sayar
- a Departments of Pathology, Faculty of Medicine , University of Akdeniz , Antalya , Turkey
| | - M Baykara
- b Department of Urology, Faculty of Medicine , University of Akdeniz , Antalya , Turkey
| | - O Kankavi
- c Department of Biochemistry, Faculty of Veterinary Medicine , The University of Mehmet Akif Ersoy , Burdur , Turkey
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Bilgic Temel A, Ergün E, Poot AM, Bassorgun CI, Akman-Karakaş A, Uzun S, Alpsoy E, Pas HH, Jonkman MF. A rare case with prominent features of both discoid lupus erythematosus and pemphigus foliaceus. J Eur Acad Dermatol Venereol 2018; 33:e5-e7. [PMID: 29858874 DOI: 10.1111/jdv.15099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A Bilgic Temel
- Dermatology Department, UNSW, St. George Hospital, Sydney, NSW, Australia
| | - E Ergün
- Dermatology and Venereology Department, Cankırı State Hospital, Cankırı, Turkey
| | - A M Poot
- Department of Dermatology, Center for Blistering Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - C I Bassorgun
- Akdeniz University Faculty of Medicine, Pathology Department, Antalya, Turkey
| | - A Akman-Karakaş
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | - S Uzun
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | - E Alpsoy
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | - H H Pas
- Department of Dermatology, Center for Blistering Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M F Jonkman
- Department of Dermatology, Center for Blistering Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Temel AB, Bassorgun CI, Nur B, Alpsoy E. Mongolian spots combined with halo-like disappearance surrounding café au lait spots. Indian J Dermatol Venereol Leprol 2018; 84:474-477. [PMID: 29770784 DOI: 10.4103/ijdvl.ijdvl_383_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Aslı Bilgiç Temel
- Department of Dermatology and Venereology, Beysehir State Hospital, Konya, Turkey
| | | | - Banu Nur
- Department of Pediatric Genetics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Erkan Alpsoy
- Department of Dermatology and Venereology, Faculty of Medicine, Akdeniz University, Antalya, Turkey
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Özkesici B, Ünal B, Akman-Karakas A, Bassorgun CI, Uysal H, Alpsoy E. A case of late onset dermal melanocytosis in the C3 dermatome. Indian J Dermatol Venereol Leprol 2017; 82:705-707. [PMID: 27320763 DOI: 10.4103/0378-6323.184197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Birgül Özkesici
- Department of Dermatology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Betül Ünal
- Department of Pathology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Ayse Akman-Karakas
- Department of Dermatology, School of Medicine, Akdeniz University, Antalya, Turkey
| | | | - Hilmi Uysal
- Department of Neurology, School of Medicine, Akdeniz University, Antalya, Turkey
| | - Erkan Alpsoy
- Department of Dermatology, School of Medicine, Akdeniz University, Antalya, Turkey
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Bilgiç Temel A, Bassorgun CI, Akman-Karakaş A, Alpsoy E, Uzun S. Successful Treatment of a Bullous Pemphigoid Patient with Rituximab Who Was Refractory to Corticosteroid and Omalizumab Treatments. Case Rep Dermatol 2017; 9:38-44. [PMID: 28413387 PMCID: PMC5346946 DOI: 10.1159/000452828] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Accepted: 10/25/2016] [Indexed: 12/04/2022] Open
Abstract
Omalizumab is a humanized monoclonal antibody which is an FDA-approved treatment of severe allergic asthma and inhibits IgE binding to FcεRI. According to increasing evidence of IgE inhibition, omalizumab was suggested as a therapeutic approach for bullous pemphigoid (BP). Rituximab has been reported to be effective in various autoimmune diseases, including autoimmune bullous dermatoses. A specific protocol for the use of rituximab to treat BP patients is not yet available. There are only small case series and case reports about the efficacy and safety of rituximab in BP. Here we present a young BP patient who responded well to rituximab therapy and was refractory to conventional and omalizumab therapies although he had elevated IgE levels and eosinophilia. Our case supports the knowledge about the effectiveness and safety of rituximab not only in pemphigus but also in BP. On the other hand, although it did not work in our case, omalizumab may be a potentially effective agent in some carefully selected patients with certain subtypes of BP.
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Affiliation(s)
- Aslı Bilgiç Temel
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | | | - Ayşe Akman-Karakaş
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | - Erkan Alpsoy
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
| | - Soner Uzun
- Akdeniz University Faculty of Medicine, Dermatology and Venereology Department, Antalya, Turkey
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Koca T, Arslan D, Basaran H, Cerkesli AK, Tastekin D, Sezen D, Koca O, Binici DN, Bassorgun CI, Ozdogan M. Dietary and demographical risk factors for oesophageal squamous cell carcinoma in the Eastern Anatolian region of Turkey where upper gastrointestinal cancers are endemic. Asian Pac J Cancer Prev 2016; 16:1913-7. [PMID: 25773844 DOI: 10.7314/apjcp.2015.16.5.1913] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oesophageal squamous cell carcinoma (ESCC) is endemic in the Eastern Anatolian region of Turkey. The present study was performed to identify risk factors for ESCC that specifically reflect the demography and nutritional habits of individuals living in this region. MATERIALS AND METHODS The following parameters were compared in 208 ESCC patients and 200 control individuals in the Eastern Anatolian region: age, sex, place of living, socioeconomic level, education level, smoking, alcohol intake, nutritional habits, and food preservation methods. RESULTS The mean age of ESCC patients was 56.2 years, and 87 (41.8%) were 65 years-old or older. The ratio of women to men in the patient group was 1.39/1. ESCC patients consumed significantly less fruit and yellow or green vegetables and more hot black tea, 'boiled yellow butter', and mouldy cheese than did control individuals. Residence in rural areas, smoking, and cooking food by burning animal manure were also significantly associated with ESCC. CONCLUSIONS The consumption of boiled yellow butter and mouldy cheese, which are specific to the Eastern Anatolian region, and the use of animal manure for food preparation were identified as risk factors in this region. Further studies are required to potentially identify the carcinogenic substances that promote the development of ESCC in this region.
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Affiliation(s)
- Timur Koca
- Department of Radiation Oncology, Regional Training and Research Hospital, Erzurum, Turkey E-mail :
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Arslan D, Tural D, Koca T, Tastekin D, Kaymak Cerkesli A, Basaran H, Gunduz S, Murat Tatli A, Sezgin Goksu S, Uysal M, Kargi A, Kargi B, Koral L, Ibrahim Bassorgun C, Unal D, Mutlu H, Senol Coskun H, Ozdogan M, Bozcuk H. Prognostic factors in clinical stage T4N2 locally advanced non-small cell lung cancer. J BUON 2015; 20:573-579. [PMID: 26011352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE Relatively few studies have focused on T4N2 (stage IIIB) locally advanced non-small cell lung cancer (NSCLC). In this study, we tried to identify prognostic factors for patients with clinical stage T4N2 NSCLC. METHODS We retrospectively identified 223 patients, of which 168 met the inclusion criteria. Patients treated with curative intent using concurrent chemoradiotherapy (CRT) with or without adjuvant chemotherapy, or concurrent CRT after induction chemotherapy, were included in this study. Relevant patient, treatment, and disease factors were evaluated for their prognostic significance in both univariate and multivariate analyses using the Cox proportional hazards model. RESULTS The median progression-free survival (PFS) was 13 months (95% confidence interval [CI], 10.6-15.4). The median overall survival (OS) was 20 months (95% CI, 16.8-23.1), and 71, 40.3 and 28.2% of the patients survived for 1, 2 and 3 years after diagnosis, respectively. Multivariate analysis showed Eastern Cooperative Oncology Group (ECOG) performance status (PS) was independent predictor of PFS (hazard ratio [HR], 0.24; 95% CI, 0.13-0.43; p=0.001), and OS [HR, 0.48; 95% CI, 0.26-0.87; p=0.015). Absence of multifocal T4 tumors was also associated with a significantly longer OS (HR, 046; 95% CI, 0.31-0.7; p=0.001). There was no statistically significant difference in OS and PFS between treatment modalities. CONCLUSION PFS and OS were significantly shorter in patients with poor ECOG PS. OS was also significantly shorter in patients with multifocal T4 tumors. There were no differences between the two therapeutic approaches with respect to outcome.
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Affiliation(s)
- Deniz Arslan
- Erzurum Research and Education Hospital, Medical Oncology Department, Erzurum, Turkey
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Gamsizkan M, Yilmaz I, Buyukbabani N, Demirkesen C, Demiriz M, Cetin ED, Ince U, Akalin T, Demirkan NC, Lebe B, Erdem O, Gokoz O, Sakiz D, Demireli PT, Astarci HM, Adim SB, Zemheri IE, Acikalin A, Yaman B, Aydin O, Bassorgun CI. A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey. Asian Pac J Cancer Prev 2015; 15:10451-6. [DOI: 10.7314/apjcp.2014.15.23.10451] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Arslan D, Bozcuk H, Gunduz S, Tural D, Tattli AM, Uysal M, Goksu SS, Bassorgun CI, Koral L, Coskun HS, Ozdogan M, Savas B. Survival Results and Prognostic Factors in T4 N0-3 Non-small Cell Lung Cancer Patients According to the AJCC 7thEdition Staging System. Asian Pac J Cancer Prev 2014; 15:2465-72. [DOI: 10.7314/apjcp.2014.15.6.2465] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Kankavi O, Baykara M, Eren Karanis MI, Bassorgun CI, Ergin H, Ciftcioglu MA. Evidence of surfactant protein A and D expression decrement and their localizations in human prostate adenocarcinomas. Ren Fail 2013; 36:258-65. [PMID: 24168624 DOI: 10.3109/0886022x.2013.846831] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
AIM Surfactant proteins (SP-A and SP-D) were originally described in the lung; however, they are also present in the prostate. Purpose of this study, therefore, was to determine how surfactant proteins are altered in prostate adenocarcinomas (PCa) and find out any connection exists between their expressions and their staining patterns, prostate-specific antigen (PSA) values, Gleason score, age, tumor volume and tumor, node, metastases (TNM) clinical stage. METHODS Thirty-five tissue samples were obtained during radical prostatectomy. All specimens were classified to three groups based on the Gleason score <7, 7 and Gleason score >7. Surfactant proteins' expressions were tested by immunohistochemical and Western blotting methods. RESULTS Immunoreactivity was detected in the cytoplasm from both basal cells and secretory epithelial cells in malignant and non-malignant areas. About 80% of the malignant basal cells were characterized as either weak or strong while non-malignant epithelial cells demonstrated strong immunoreactivity for SP-A. Also malignant (81.8%) and non-malignant cells (90.6%) were characterized as either weak or strong for SP-D. Decrement of SP-A and SP-D immunostaining tended to associate with an increasing Gleason score (p > 0.05, p < 0.05), tumor volume (p < 0.05, p > 0.05) and age (p > 0.05, p > 0.05). There was a strong positive correlation between Gleason score and tumor volume (p < 0.01). Also, either none or weak SP-A and SP-D immunoreactivity was observed specimens with Gleason score 7 or higher. SP-A and SP-D reacted with 34 kDa (SP-A) and 43 kDa (SP-D) immunoreactive single bands were decreased in tumor tissues. CONCLUSIONS The development of prostate cancer may be related to decreased level of surfactant protein A and D.
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Affiliation(s)
- Orhan Kankavi
- Department of Biochemistry, Faculty of Veterinary Medicine, The University of Mehmet Akif Ersoy , Burdur , Turkey
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Sarigul M, Yazisiz V, Bassorgun CI, Ulker M, Avci AB, Erbasan F, Gelen T, Gorczynski RM, Terzioglu E. The numbers of Foxp3 + Treg cells are positively correlated with higher grade of infiltration at the salivary glands in primary Sjogren's syndrome. Lupus 2009; 19:138-45. [PMID: 19952070 DOI: 10.1177/0961203309348234] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study was designed to investigate whether Foxp3( +) regulatory T (Treg) cells play a role in the histopathologic changes of primary Sjögren's Syndrome (pSS) and to evaluate other factors possibly associated with Foxp3(+) Treg cells in pSS patients. The number of FoxP3-expressing T cells in peripheral blood (PB) of 39 patients with pSS, 40 patients with rheumatoid arthritis (RA), and 28 healthy controls was measured by flow-cytometer analysis. FoxP3-expressing CD4(+)CD25(+) Treg cells were analyzed in minor salivary gland (SG) tissues of 39 pSS patients. Histopathologic changes were examined by light microscopy according to Chisholm's classification. Immunohistochemistry and immunofluorescence were performed to assess the Foxp3(+) Treg in SG biopsy specim-ens. The numbers of CD4(+) T cells and FoxP3-expressing CD4(+) T cells in PB were similar in all groups. Expression of CD25 on CD4(+) T cells in PB of patients with pSS and RA was significantly higher than in healthy controls, especially for RA patients. Immunohistochemistry and immunofluorescence showed that FoxP3(+) Treg were enriched in the SGs of pSS patients, with a positive correlation between the increase in FoxP3(+) Treg in SG and the Chisholm score in pSS (p < 0.001, r = +0.605). The increase of FoxP3( +) Treg cells in the SGs of pSS patients, which is correlated with gland infiltration, suggests that natural regulatory T cells play an important role in the pathogenesis of pSS. Further studies are required to explore the mechanisms that mediate the relationship between Treg and the pathogenesis of pSS.
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Affiliation(s)
- M Sarigul
- Health Sciences Research Centre, Akdeniz University Faculty of Medicine, Antalya, Turkey
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Ozbudak IH, Dertsiz L, Bassorgun CI, Ozbilim G. Giant cystic chondroid hamartoma of the lung. J Pediatr Surg 2008; 43:1909-11. [PMID: 18926231 DOI: 10.1016/j.jpedsurg.2008.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 06/05/2008] [Accepted: 06/09/2008] [Indexed: 12/21/2022]
Abstract
Pulmonary hamartoma composed of an abnormal mixture of mesenchymal elements is the most common benign neoplasm in the lung. Pulmonary hamartoma larger than 10 cm and the cystic variant are also very rare. We describe an asymptomatic 11-year-old boy with a huge mass in the right hemithorax. Chest computed tomography revealed a heterogeneous mass filling the middle and the lower lobes of the right lung. The patient underwent thoracotomy and resection of the lesion. Gross examination of the surgical specimen showed a well-circumscribed, encapsulated, lobulated, and bluish-white mass, measuring 18 x 16 x 8 cm. Multilocular cystic spaces with intervening lobulated fragments of cartilaginous tissue and adipose tissue were seen. Microscopically, the solid component was composed of cartilage and adipose tissue. Cystic areas and cleft-like spaces were lined by ciliated columnar epithelium. We believe this is the first case of 'giant cystic chondroid hamartoma of the lung' described in childhood. We suggest that giant cystic pulmonary hamartoma should be included in the differential diagnosis of large intrathoracic masses in children.
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Affiliation(s)
- Irem Hicran Ozbudak
- Department of Pathology, Akdeniz University School of Medicine, Antalya 07059, Turkey.
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