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Eren T, Tigrel LZ, Gapbarov A, Aydemir MA, Seneldir H, Ekinci O, Alimoglu O. Prognostic value of the lymph node ratio in surgically treated stage III colorectal cancer patients with high numbers of harvested lymph nodes. Acta Chir Belg 2023; 123:535-543. [PMID: 35849005 DOI: 10.1080/00015458.2022.2103247] [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: 11/11/2021] [Accepted: 07/14/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The lymph node ratio (LNR), defined as the number of positive lymph nodes (LN) divided by the total number of harvested LN, has been demonstrated to be an independent factor in the prognosis of surgically treated colorectal cancer (CRC) patients. This study aims to establish the prognostic value of LNR in stage III CRC patients with high numbers of LN removed. METHODS Stage III CRC patients who underwent curative resections over an 8-year period were included to the study. Demographics, clinicopathological features, surgical as well as recurrence and survival outcomes were recorded and statistically analyzed. Calculations for LNR were carried out as a function of percentage rates and Cox proportional hazards regression analyses were performed to determine its effect on disease-free and overall survival. RESULTS Among a total of 493 surgically treated CRC cases, 104 patients were included to the study consisting of 68 (65.4%) men and 36 (34.6%) women with a median age of 64 (inter-quartile range: 55-74) years. The mean number of harvested LN was 31.6 ± 21.0 (range: 12-103). Multivariate Cox regression analyses proved LNR to be a significant factor in both disease-free and overall survival (p = 0.007 and p = 0.003, respectively). Forward elimination analyses showed that a 1% increase in LNR resulted with a 2% increase in both the risks of recurrence and mortality. CONCLUSIONS The LNR may be assessed as an adjunct to the current staging systems for the prediction of oncological outcomes and survival of surgically treated stage III CRC patients.
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Affiliation(s)
- Tunc Eren
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Leyla Zeynep Tigrel
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Aman Gapbarov
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Muhammet Ali Aydemir
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Ozgur Ekinci
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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Kir G, Gunel H, Cicek T, Seneldir H. Immediate histopathologic correlation in Turkish population with negative cytology and high-risk human papillomavirus positivity: A retrospective analysis of high-risk human papillomavirus genotype and stratified by age. Diagn Cytopathol 2023; 51:605-611. [PMID: 37318782 DOI: 10.1002/dc.25182] [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: 03/26/2023] [Revised: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 06/16/2023]
Abstract
INTRODUCTION According to the American Society of Colposcopy and Cervical Pathology (ASCCP) recommendations, regardless of age, women with high-risk infections other than human papillomavirus 16/18 positivity (other hrHPV) and negative cytology should not be referred directly to colposcopy. Several studies compared detection rates of ≥high-grade squamous intraepithelial lesion (HSIL) between HPV 16/18 ± 45, and other hrHPV types on colposcopic biopsy. METHODS We designed a retrospective study to determine the presence of ≥HSIL in colposcopic biopsy in women with negative cytology and hrHPV positivity during the years 2016-2022. RESULTS HPV 16/18/45 had a PPV of 43.8%, while other hrHPV types had a PPV of 29.1% for a tissue diagnosis of ≥HSIL. For a tissue diagnosis of ≥HSIL detection, there was no statistically significant difference between the PPV of other hrHPV and HPV 16/18/45 in patients ≥30. There were only two cases with a tissue diagnosis of ≥HSIL in the other hrHPV group of women under 30 years of age. CONCLUSION We suggested that the follow-up recommendations of ASCCP for patients above the age of 30 with negative cytology and other hrHPV positivity may not be fully applicable to countries like Turkey with a different healthcare environment. Referring to patients ≥30 who had other hrHPV positivity and negative cytology to direct colposcopy may be clinically beneficial, particularly in populations where a colposcopic examination is easy and inexpensive.
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Affiliation(s)
- Gozde Kir
- Department of Pathology, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalçın City Hospital, Istanbul, Turkey
| | - Humeyra Gunel
- Department of Pathology, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalçın City Hospital, Istanbul, Turkey
| | - Tuba Cicek
- Department of Pathology, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalçın City Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalçın City Hospital, Istanbul, Turkey
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Kir G, Dokmeci Guney D, Seneldir H. Comparison of the clinical performance of Aptima HPV assay and the Cobas 4800 platform in women with normal cytology and positive high-risk HPV. Acta Cytol 2023:000530347. [PMID: 36977394 DOI: 10.1159/000530347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/10/2023] [Indexed: 03/30/2023]
Abstract
INTRODUCTION According to current the American Society for Colposcopy and Cervical Pathology (ASCCP) guidelines, patients with normal cytology results may be referred for colposcopy according to their high-risk human papillomavirus (hrHPV) test results. A higher positive predictive value (PPV) of hrHPV has significance for preventing unnecessary colposcopic examinations. Several studies have compared the performance of the Aptima assay and the Cobas 4800 platform among patients who had minor cytologic abnormality. However, in our English literature search, we found no other study that had been conducted to compare these two methods in patients with normal cytology. We thus aimed to compare the PPV of the Aptima assay and Cobas 4800 platform among women with normal cytology. METHODS Between September 2017 and October 2022, we retrospectively identified 2,919 patients who had normal cytology and hrHPV positivity who had been referred for a colposcopy. Among them, 882 agreed to undergo a colposcopy; on examination, 134 had target lesions revealed and underwent a colposcopic punch biopsy. RESULTS Among the patients who underwent a colposcopic punch biopsy, 49 (38.9%) were tested with Aptima, and 77 (61.1%) were tested with Cobas. In the Aptima group, 29 (59.2%) patients showed benign histology, 2 (4.1%) patients had an low-grade squamous intraepithelial lesions (LSIL), and 18 (36.7%) patients had ≥ high-grade squamous intraepithelial lesion (HSIL) biopsy results. The false positivity rate and PPV of Aptima were 63.3% (31/49) and 36.7% (95% CI:0.232-0.502), respectively, for a histopathologic diagnosis of ≥ HSIL. In the Cobas group, 48 (62.3%) biopsies were benign, 11 (14.3%) reported an LSIL, and 18 (23.4%) biopsies were ≥HSIL. The false positivity rate and PPV of Cobas were 76.6% (59/77) and 23.4% (95% CI:0.139-0.328), respectively, concerning a ≥HSIL tissue diagnosis. The false positivity rate of Aptima HPV 16 positivity was 40% (4/10). The false positivity rate of Cobas HPV 16 positivity was 61.1% (11/18). The PPVs of HPV 16 positivity for Aptima and Cobas were 60% (95% CI:0.296-0.903), and 38.9% (95% CI:0.163-0.614), respectively, concerning ≥HSIL tissue diagnosis. DISCUSSION/CONCLUSION We recommend analyzing the performances of hrHPV platforms in future larger studies in patients with normal cytology, rather than only cases with abnormal cytology.
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Durakbaşa ÇU, Ugurlu D, Bozbeyoglu SG, Aydoner S, Seneldir H, Candir MO, Candan C, Gemici A. Bilateral Native Kidney Papillary Renal Cell Carcinomas in a 11-Year-Old Renal Transplant Patient. European J Pediatr Surg Rep 2022; 10:e160-e163. [PMCID: PMC9719804 DOI: 10.1055/s-0042-1759546] [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: 05/22/2022] [Accepted: 10/04/2022] [Indexed: 12/07/2022] Open
Abstract
Renal cell carcinomas (RCCs) are the most common renal tumors in adults and are usually sporadic and unilateral. Renal transplant recipients have an increased risk of developing RCC. RCC development after kidney transplantation is very rarely reported in children. We present a 11-year-old boy who had cadaveric kidney transplantation for kidney failure 2 years ago. He was under immunosuppressive therapy and presented with microscopic hematuria. An ultrasound (US) revealed bilateral solid renal masses. Further cross-sectional imaging showed a 60 × 70 × 60-mm right renal mass with claw sign and a 5 × 6 × 6-mm mass in the left renal lower pole. A bilateral radical nephroureterectomy of native kidneys was performed. The pathology revealed bilateral papillary RCC without TFE3 upregulation. The patient was kept on low-dose immunosuppressive therapy in the perioperative period. He received no chemotherapy but a close radiological surveillance was undertaken. He is tumor-free 2 years after the operation. RCC is a rare tumor for children and bilateralism is even rarer. The child had a history of chronic kidney disease, peritoneal dialysis, and immunosuppressive therapy. As there are no standardized protocols regarding imaging in transplanted kidneys routine surveillance, US follow-up should also focus on detecting malignancy.
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Affiliation(s)
- Çiğdem Ulukaya Durakbaşa
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey,Department of Pediatric Surgery, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey,Address for correspondence Prof. Çiğdem Ulukaya Durakbaşa, MD Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of MedicineKadikoy, Istanbul 34000Turkey
| | - Deniz Ugurlu
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | | | - Sinem Aydoner
- Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Istanbul Medeniyet University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Onur Candir
- Department of Pediatric Oncology, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey
| | - Cengiz Candan
- Department of Pediatric Nephrology, Istanbul Medeniyet University Faculty of Medicine, Uskudar, Istanbul, Turkey
| | - Atilla Gemici
- Department of Pediatric Nephrology, Baskent University Istanbul Hospital, Istanbul, Turkey
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Torun C, Yavuz A, Akan K, Seneldir H, Toksoz AN, Ulasoglu HC, Tuncer I. Comparison of the diagnostic accuracy of the updated Sydney system and single biopsy. Saudi J Gastroenterol 2022; 28:441-447. [PMID: 35899924 PMCID: PMC9843512 DOI: 10.4103/sjg.sjg_146_22] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Updated Sydney system (USS) recommends taking biopsies from certain areas of the stomach for the diagnosis of precancerous lesions associated with Helicobacter pylori. Our aim was to evaluate the contribution of each of the biopsy sites to the diagnosis. METHODS This prospective study included 97 patients aged 40 and over with dyspeptic complaints. Biopsies were taken from five regions: the lesser curvature of the antrum (LCA), the lesser curvature of the corpus (LCC), incisura angularis (IA), the greater curvature of the antrum (GCA), and the greater curvature of the corpus (GCC). Biopsy specimens were stained with hematoxylin-eosin stain, periodic acid Schiff-alcian blue, and Giemsa histochemical stain and evaluated according to the Sydney classification. RESULTS Thirty-seven (38%) patients were positive for H. pylori in at least one biopsy site. Atrophic gastritis without intestinal metaplasia (IM) was found in 17 (17.5%) of the patients (6.2% in IA, 5.2% in each of LCA, GCA, and LCC, and 2% in GCC). The prevalence of atrophic gastritis with IM was 42.3% (21.6% in LCA, 20.6% in GCA, 20.6% in IA, 14.4% in LCC, and 5.2% in GCC). Endoscopic follow-up was planned in 21 (22%) patients due to the presence of extensive atrophy or incomplete IM. If a single biopsy of the LCA or a biopsy of both LCA and GCA was taken, endoscopic follow-up would have been missed in 12 (57%) or 6 (29%) patients, respectively. CONCLUSION Taking biopsies in accordance with the USS had higher sensitivity in detecting atrophic gastritis with or without IM compared to single biopsy. One or two biopsies is not sufficient to identify patients for whom endoscopic follow-up is recommended.
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Affiliation(s)
- Cundullah Torun
- Department of Internal Medicine, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey,Address for correspondence: Dr. Cundullah Torun, Goztepe Training and Research Hospital, Province of Istanbul, District of Kadıköy, Neighbourhood of Eğitim – 34722, Turkey. E-mail:
| | - Arda Yavuz
- Department of Gastroenterology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey
| | - Kubra Akan
- Department of Gastroenterology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey
| | - Hatice Seneldir
- Department of Medical Pathology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey
| | - Ayse Nur Toksoz
- Department of Medical Pathology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey
| | - Hak Celal Ulasoglu
- Department of Gastroenterology, Istanbul Okan University, Tuzla/Istanbul, Turkey
| | - Ilyas Tuncer
- Department of Gastroenterology, Goztepe Training and Research Hospital, Istanbul Medeniyet University, Kadikoy/Istanbul, Turkey
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Gündüz N, Buyuker F, Seneldir H, Durukan G, Alimoglu O, Kabaalioglu A. Computed Tomography-based Morphological Differences between Histologic Subtypes of Periampullary Ductal Adenocarcinoma. J Coll Physicians Surg Pak 2021; 31:959-964. [PMID: 34320715 DOI: 10.29271/jcpsp.2021.08.959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 01/06/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the computed tomography (CT)-based differences between pancreaticobiliary (PBST) and intestinal (IST) subtypes of periampullary pancreatic ductal adenocarcinomas (PDAC). STUDY DESIGN Analytical study. PLACE AND DURATION OF STUDY Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey between 2015 and 2018. METHODOLOGY Overall 24 periampullary PDAC cases, in whom histomorphologic evaluation and CDx2 expression were used to discriminate between PBST and IST, were included. The lesion morphology (infiltrative versus nodular), common bile and main pancreatic ducts' dilation, tumor grade, enhancement pattern, pancreaticoduodenal groove, pancreaticoduodenal artery and lymphatic involvement were evaluated by CT. RESULTS Overall 24 PDAC cases [median age 67.5 (60.5-76.5) years] were enrolled. Histopathology revealed 9 (25%) IST and 18 (75%) PBST. The age [72.5 (69-81) versus 63 (57.75-75.5) years, respectively, p=0.204] and gender [3 (50%) versus 12 (66.7%) males, respectively, p=0.635] and the prevalence of all CT characteristics were similar between groups (p>0.05 for all) except for lesion morphology. Infiltrative morphology was more frequent in PBST than IST [14 (77.8%) versus 1 (16.7%), respectively, p=0.015]. Multiple variable logistic regression analysis revealed infiltrative morphology as the only independent CT predictor of PBST [OR: 14.9, 95% CI: 1.2-186), p=0.036]. The interrater reproducibility for lesion morphology was moderate (Cohen's Kappa: 0.55, p<0.007). CONCLUSION Infiltrative appearance is associated with PBST; whereas, nodular appearance more likely predicts IST. The potential role of CT lesion morphology on guiding appropriate chemotherapy in cases with no chance for surgery or biopsy requires addressing. Key Words: Intestinal differentiation, Pancreatobiliary differentiation, Periampullary adenocarcinoma.
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Affiliation(s)
- Nesrin Gündüz
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Fatih Buyuker
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Hatice Seneldir
- Department of Pathology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Gulcin Durukan
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
| | - Adnan Kabaalioglu
- Department of Radiology, Faculty of Medicine, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Turkey
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Tercan M, Yılmaz İnal F, Seneldir H, Kocoglu H. Nephroprotective Efficacy of Sugammadex in Ischemia-Reperfusion Injury: An Experimental Study in a Rat Model. Cureus 2021; 13:e15726. [PMID: 34285839 PMCID: PMC8286175 DOI: 10.7759/cureus.15726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2021] [Indexed: 12/03/2022] Open
Abstract
Background: It is known that ischemia-reperfusion damage in the kidney is one of the most common causes of acute kidney failure. It is also known that reduced renal damage has a nephroprotective effect by reducing the release of inflammatory and vasoactive peptides that cause tissue damage. Therefore, we think that reperfusion caused by ischemia in kidney damage may be an important focus for clinical research. Methods: A total of 21 healthy 230-250 g female rats were used in our experimental study. During the experiment, animals were randomly divided into three groups, each containing seven rats. Group 1: The group that underwent left nephrectomy with a sham operation. Group 2: Left renal ischemia for 60 minutes, then left nephrectomy followed by 45 minutes of reperfusion. Group 3: Left renal ischemia for 60 minutes, then reperfusion for 45 minutes, followed by left nephrectomy. In this group, sugammadex was given intravenously at a dose of 100 mg/kg at the beginning of reperfusion. In the histomorphological examination, damage findings of tubules atrophy, dilation and cast formation, tubular epithelial brush border loss and vacuolization, presence of fibrosis as interstitial structural change, capillary vasodilatation/congestion and neutrophilic cell infiltrates in interstitial spaces, and morphological changes in glomeruli were evaluated. Results: When evaluated based on tubular brush border, there were no significant differences between Group 2 and Group 1 (P = 0.454), while the damage in Group 3 was less significant than Group 2 (P = 0.017). When evaluated in terms of tubular vacuolization, there was no significant difference between Group 2 and Group 1 (P = 0.902), while the damage in Group 3 was less significant than Group 2 (P = 0.017). Conclusion: We believe that 100 mg/kg sugammadex given at the beginning of reperfusion after one hour of ischemic condition on rats has a histochemically detectable nephroprotective effect.
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Affiliation(s)
- Mehmet Tercan
- Department of Anesthesiology and Reanimation, University of Health Sciences, Mehmet Akif Inan Research and Training Hospital, Sanliurfa, TUR
| | - Ferda Yılmaz İnal
- Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, TUR
| | - Hatice Seneldir
- Department of Medical Pathology, Istanbul Medeniyet University, Istanbul, TUR
| | - Hasan Kocoglu
- Department of Anesthesiology and Reanimation, Istanbul Medeniyet University, Istanbul, TUR
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Ozkanli S, Soylemez T, Keskin H, Seneldir H, Sahin FM, Çetinkaya A, Gokturk A, Aycicek N, Duz K, Cobanoglu Simsek B. A Five-Year Retrospective Analysis of Basal Cell Carcinoma: A Monocentric Study. Medeni Med J 2020; 35:219-225. [PMID: 33110674 PMCID: PMC7584263 DOI: 10.5222/mmj.2020.92332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/29/2020] [Indexed: 12/05/2022] Open
Abstract
Objective Our aim in this study is to define the histopathological subtypes, body site distribution, and incidence rates of single or multiple of BCCs. The study is conducted on patients from a single institution in Istanbul which has a migrant-receiving population reflecting that of the country overall. Method We retrospectively analyzed data concerning 896 cases of BCC seen between 2014 and 2018. Data about patient demographics (age and sex), tumor diameter,its anatomic localization, histological type, presence of ulceration, lymphovascular/perineural invasion, and single or multiple tumor formations were retrieved from both the hospital’s automated system and archived records of the pathology clinic. Results Our univariate analysis showed that the patients’ age, tumor size, and tumor multicentricity were all significantly related to their gender (p=0.011, p=0.001, and p=0.021, respectively). Further, age, male gender, and tumor size were all significantly related to tumor multicentricity (p=0.003, p=0.021, and p=0.001, respectively). BCC was most commonly found in male, and the diameters of the BCC tumors were also larger in male patients. Multiple BCC was more frequently seen in older and male patients, and the tumors had larger diameters in these groups. The nodular type of BCC was the most frequently seen type in all age groups. Conclusion As our study is the first BCC study that has the greatest number of cases in Turkey and as Istanbul reflects the population of Turkey, it is important for the data of BCC cases in Turkey.
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Affiliation(s)
- Seyma Ozkanli
- Istanbul Medeniyet University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Tuce Soylemez
- Istanbul Medeniyet University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | - Havva Keskin
- Istanbul Medeniyet University, Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey
| | - Hatice Seneldir
- Istanbul Medeniyet University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
| | | | - Aysenur Çetinkaya
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Andac Gokturk
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Nagihan Aycicek
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Kubra Duz
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Bengu Cobanoglu Simsek
- Istanbul Medeniyet University, Faculty of Medicine, Department of Pathology, Istanbul, Turkey
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Ulukaya Durakbasa C, Kiyan G, Aydoner S, Pirim A, Seneldir H, Ozkok S, Caymaz I. Epiphrenic Diverticulum in an Infant with Congenital Esophageal Stenosis Associated with Esophageal Atresia. Medeni Med J 2020; 35:261-265. [PMID: 33110679 PMCID: PMC7584271 DOI: 10.5222/mmj.2020.22220] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/15/2020] [Indexed: 11/20/2022] Open
Abstract
Congenital esophageal stenosis (CES) is a rare congenital disorder which may be isolated or associated with esophageal atresia (EA). It courses with esophageal outflow tract obstruction. Esophageal epiphrenic diverticulae are esophageal outpouchings above diaphragm which develop because of an underlying esophageal motor disorder. We present an infant who had CES associated with EA detected during the course of routine follow-up. She underwent several sessions of esophageal balloon dilatations for CES with some symptomatic improvement. However, an epiphrenic diverticulum (ED) developed during the course of treatment which was detected by further investigations. A surgical excision was performed with a successful outcome. An ED developed secondary to CES has not been previously reported. We have highlighted the diagnostic modalities employed, treatment options, and clinical follow-up for these two rare conditions in children.
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Affiliation(s)
- Cigdem Ulukaya Durakbasa
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey
| | - Gursu Kiyan
- Marmara University Faculty of Medicine, Pendik Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey
| | - Sinem Aydoner
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey
| | - Ahmet Pirim
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Pediatric Surgery, Istanbul, Turkey
| | - Hatice Seneldir
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Pathology, Istanbul, Turkey
| | - Sercin Ozkok
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Radiology, Istanbul, Turkey
| | - Ismail Caymaz
- Istanbul Medeniyet University Faculty of Medicine, Goztepe Training and Research Hospital, Department of Radiology, Istanbul, Turkey
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Seneldir H, Kir G, Soylemez T, Girgin RB, Ozbay N, Ozen F, Ankarali H, Bas G, Alimoglu O. Diagnostic accuracy of molecular testing with three molecular markers on thyroid fine-needle aspiration cytology with abnormal category. Diagn Cytopathol 2020; 48:507-515. [PMID: 32031330 DOI: 10.1002/dc.24394] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 11/08/2019] [Revised: 01/12/2020] [Accepted: 01/30/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND Cases with abnormal category, determined by thyroid fine-needle aspiration (FNA), frequently undergo surgical resection, despite the majority of cases being identified as benign after resection. Additional diagnostic markers are needed to guide the management of patients with abnormal thyroid nodules. MATERIALS AND METHODS The retrospective study enrolled 150 cases diagnosed abnormal by FNA cytology that had undergone molecular testing with three markers (BRAF V600E, NRAS, and KRAS) on the cell block. Seventy-one cases had a surgical follow-up. RESULTS When NIFTP is not considered as malignant, positive predictive values (PPVs) of cytology and combined cytology and molecular testing (CC-MT) were 67.6% (95% CI: 0.555-0.782) and 89.2% (95% CI: 0.746-0.970) (P = .004), respectively. The sensitivity of the CC-MT was 68.8%, specificity was 82.5%, and the false-positive rate was 17.4%. When NIFTP is considered as malignant, PPVs of cytology and CC-MT were 83.1% (95% CI: 0.743-0.918) and 94.6% (95% CI: 0.873-1.018) (P = .047), respectively. The sensitivity of the CC-MT was 59.3%, specificity was 83.3%, and the false-positive rate was 16.7%. CONCLUSION The addition of molecular testing with a small panel to FNA cytology may increase the PPV of cytology in abnormal categories. Small panel (BRAF V600E, KRAS, and NRAS) with high specificity and high PPVs may be used particularly for the detection of thyroid malignancy. Cell blocks can be an especially useful and straightforward method for molecular diagnostic studies.
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Affiliation(s)
- Hatice Seneldir
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gozde Kir
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Tuce Soylemez
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Rabia B Girgin
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Nurver Ozbay
- Department of Pathology, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Filiz Ozen
- Department of Medical Genetics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Handan Ankarali
- Department of Biostatistics and Medical Informatics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Gurhan Bas
- Department of General Surgery, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
| | - Orhan Alimoglu
- Department of General Surgery, Goztepe Research and Training Hospital, Istanbul Medeniyet University, Istanbul, Turkey
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Kir G, Arikan EA, Seneldir H, Ankarali H, Oznergiz S, Olgun ZC, Yildirim A. Determining the cut-off values of tumor diameter, degree of extraprostatic extension, and extent of surgical margin positivity with regard to biochemical recurrence of prostate cancer after radical prostatectomy. Ann Diagn Pathol 2019; 44:151431. [PMID: 31837592 DOI: 10.1016/j.anndiagpath.2019.151431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 07/23/2019] [Revised: 09/02/2019] [Accepted: 09/17/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND The pre-biopsy (bx) prostate-specific antigen (PSA) level, tumor volume/diameter, degree of extraprostatic extension (EPE), and extent of surgical margin positivity have been shown to be significant prognostic parameters of biochemical recurrence (BCR) after radical prostatectomy. The present study assessed the cut-off values of the pre-bx PSA level, maximum tumor diameter, radial and circumferential distances of EPE, and circumferential length of surgical margin (SM) positivity with regard to BCR. MATERIAL AND METHODS The study included 445 radical prostatectomy specimens, and the cut-off values of all parameters were determined using receiver operating characteristic curve analysis. RESULTS An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm were identified as independent predictors of BCR after radical prostatectomy. The parameters that showed statistical significance in univariate analysis, such as pre-bx PSA level ≥ 7.20 ng/mL, tumor diameter ≥ 19.5 mm, presence of seminal vesicle invasion, and circumferential distance of EPE >3 mm, did not have independent prognostic values for BCR. CONCLUSIONS An ISUP grade group ≥ 3, radial distance of EPE >1 mm, and circumferential length of SM positivity ≥2 mm are predictors of BCR. Our findings might have significance in risk classification and adjuvant therapy consideration among patients with localized prostate cancer.
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Affiliation(s)
- Gozde Kir
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey.
| | - Evsen Apaydin Arikan
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Handan Ankarali
- Department of Biostatistics, Istanbul Medeniyet University, Istanbul, Turkey
| | - Seca Oznergiz
- Istanbul Medeniyet University, Faculty of Medicine, Istanbul, Turkey
| | - Zeynep Cagla Olgun
- Department of Pathology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Asif Yildirim
- Department of Urology, Istanbul Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
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Seneldir H, Kir G. Prevalence of high-risk human papilloma virus in liquid-based cervical samples from Turkish women with normal and abnormal cytology. Diagn Cytopathol 2018; 47:100-104. [DOI: 10.1002/dc.24022] [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] [Received: 02/07/2018] [Revised: 05/29/2018] [Accepted: 06/18/2018] [Indexed: 11/08/2022]
Affiliation(s)
- Hatice Seneldir
- Istanbul Medeniyet University, Göztepe Research and Training Hospital, Istanbul Medeniyet University; Istanbul Turkey
| | - Gozde Kir
- Istanbul Medeniyet University, Göztepe Research and Training Hospital, Istanbul Medeniyet University; Istanbul Turkey
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13
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Buz A, Aslan A, Gunduz N, Seneldir H, Buyuker F. Pancreatic hydatid cyst as an incidental finding. Acta Gastroenterol Belg 2018; 81:336-337. [PMID: 30024709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Aysenur Buz
- Department of Radiology, Medical School of Istanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Ahmet Aslan
- Department of Radiology, Medical School of Istanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Nesrin Gunduz
- Department of Radiology, Medical School of Istanbul Medeniyet University, Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Hatice Seneldir
- Department of Pathology, Medical School of Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbul, Turkey
| | - Fatih Buyuker
- Department of General Surgery, Medical School of Istanbul Medeniyet University Goztepe Training and Research Hospital, İstanbul, Turkey
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14
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Kir G, Seneldir H, Cosan Sarbay B. The clinical performance of computer-assisted liquid-based cytology, primary hrHPV screening, and cotesting at a Turkish Tertiary Care Hospital. Diagn Cytopathol 2017; 46:3-8. [PMID: 29024512 DOI: 10.1002/dc.23836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 05/12/2017] [Revised: 08/25/2017] [Accepted: 09/27/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND We aimed to compare the performance of computer-assisted liquid-based cytology, primary high-risk human papillomavirus (hrHPV) screening, and cytology-hrHPV cotesting with regards to the detection rate of cervical cancer precursor lesions. METHODS A total of 22,653 computer-assisted liquid-based cytology specimens interpreted between 2013 and 2015 were included in the study. We compared the false-negative rates and sensitivities for computer-assisted liquid-based cytology, primary hrHPV screening and cytology-hrHPV cotesting among women with normal and abnormal cytologies. Among 1,748 women who had undergone cotesting, 249 underwent follow-up biopsies. RESULTS For detecting biopsy-confirmed high-grade lesions, the sensitivities of using hrHPV, Pap tests, and cytology-hrHPV cotesting were 90.67%, 88%, and 98.67%, respectively, while the false-negative rates for hrHPV and Pap tests were 9.3% and 12%, respectively. The false negative rate for cotesting was only 1.3%. CONCLUSION Based on the significantly high sensitivity and lower false-negative rates achieved, we conclude that the combination of cytologic screening with hrHPV testing is the best preferred strategy for detection of cervical precursor lesions in our country's conditions.
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Affiliation(s)
- Gozde Kir
- Pathology Department, İstanbul Medeniyet University Göztepe Research and Training Hospital, Istanbul, Turkey
| | - Hatice Seneldir
- Pathology Department, İstanbul Medeniyet University Göztepe Research and Training Hospital, Istanbul, Turkey
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15
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Kir G, Sarbay BC, Seneldir H. The significance of parakeratosis alone in cervicovaginal cytology of turkish women. Diagn Cytopathol 2017; 45:297-302. [PMID: 28160449 DOI: 10.1002/dc.23674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/22/2016] [Revised: 11/15/2016] [Accepted: 01/17/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND We aimed to analyze the significance of parakeratosis on an otherwise negative Papanicalaou (Pap) smear, in the absence of any characteristic human papilloma virus (HPV) findings. METHODS A total of 22,076 Papanicalaou smears that were diagnosed as negative for intraepithelial lesions or malignancy between 2013 and 2015 were included in this study. Samples were separated into two groups, according to the presence of parakeratosis. We investigated the association between parakeratosis in the cytology results and a high-risk HPV status and high-grade squamous intraepithelial lesion (HSIL) in the colposcopic biopsy specimens. RESULTS A positive HPV result was more frequently identified in cases with parakeratosis than in cases without parakeratosis (P < 0.001). A histological diagnosis of HSIL was more frequently observed in HPV-positive cases with a diagnosis of parakeratosis on cytology than in cases without parakeratosis (P = 0.8). CONCLUSION Our results demonstrate that a finding of parakeratosis on an otherwise negative Pap smear supports a follow-up HPV DNA test. Also we should consider whether the presence of parakeratosis should be included in standard cytology reports. Additionally parakeratosis trended toward increased frequency of HSIL in follow-up biopsy specimens. But it did not reach statistical significance. That is why larger studies are necessary to evaluate the association of parakeratosis and HSIL in colposcopic biopsy specimens. Diagn. Cytopathol. 2017;45:297-302. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Gozde Kir
- İstanbul Medeniyet University Göztepe Research and Training Hospital, Istanbul, Turkey
| | | | - Hatice Seneldir
- İstanbul Medeniyet University Göztepe Research and Training Hospital, Istanbul, Turkey
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Kır G, Seneldir H, Kıran G. A case of mesonephric adenocarcinoma of the uterine cervix mimicking an endometrial clear cell carcinoma in the curettage specimen. J OBSTET GYNAECOL 2016; 36:827-829. [PMID: 27147080 DOI: 10.3109/01443615.2016.1157155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Gozde Kır
- a Pathology Department , Umraniye Education & Research Hospital , Istanbul , Turkey and
| | - Hatice Seneldir
- a Pathology Department , Umraniye Education & Research Hospital , Istanbul , Turkey and
| | - Gurkan Kıran
- b Obstetrics & Gynecology Department , Umraniye Education & Research Hospital , Istanbul , Turkey
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Kır G, Seneldir H, Gumus E. Outcomes of Gleason score 3 + 4 = 7 prostate cancer with minimal amounts (<6%) vs ≥6% of Gleason pattern 4 tissue in needle biopsy specimens. Ann Diagn Pathol 2015; 20:48-51. [PMID: 26750655 DOI: 10.1016/j.anndiagpath.2015.10.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [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: 09/01/2015] [Revised: 10/28/2015] [Accepted: 10/29/2015] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The International Society of Urological Pathology Gleason grading system was modified in 2005. Since the modified system was introduced, many cancers that previously would have been categorized as Gleason score (GS) 6 are now categorized as GS 7 based on biopsy specimens that only contain minimal amounts (<6%) of Gleason pattern (GP) 4 tissue. However, the clinical significance of observing <6% of GP 4 tissue in biopsies of GS 7 prostate cancer has not been studied. MATERIAL AND METHODS This study was based on needle biopsy specimens that were categorized as GS 6 or GS 7 and were obtained from patients who underwent radical prostatectomy (RP) with available follow-up data. We assessed the quantity of GP 4 tissue in biopsy specimens of GS 7 prostate cancer. Further, we evaluated the correlation between the quantity of GP 4 tissue and disease progression after RP. RESULTS GP 4 comprising 26-49% of the specimen, GS 4+3 and percentage of total core tissue scored as positive were significant and independent predictors of prostate-specific antigen (PSA) failure after RP, as assessed using a multivariate Cox regression model that included the quantity of GP 4 in the prostate biopsy specimen, preoperative PSA, perineural invasion, clinical stage, number of positive cores, and percentage of core tissue scored as positive. Cases with GS 3+3 and cases in which the observed GP 4 area was <6% did not differ significantly in terms of biochemical PSA recurrence (BPR) status. In contrast, cases with 6-25% GP 4 tissue, 26-49% GP 4 tissue, and GS 4+3 showed more frequent BPR than cases with GS 3+3. CONCLUSIONS Our data suggest that the quantity of GP 4 tissue in GS 7 cancer has clinical significance. However, there is a need for larger studies of the clinical significance of biopsy specimens that include <6% GP 4 tissue. We should reconsider whether the amount of GP 4 should be included in standart pathology reports.
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Affiliation(s)
- Gozde Kır
- Umraniye Education & Research Hospital, Istanbul, Turkey.
| | | | - Eyup Gumus
- Umraniye Education & Research Hospital, Istanbul, Turkey.
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