Browsing by Author "Aldemir, Mehmet Naci"

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Abnormal Liver Function Test in Hydatidiform Moles: a Retrospective Study Comparing the Hyperthyroid State and the Euthyroid State
(informa Healthcare, 2014) Kucukoglu, Mehmet Emin; Dulger, Ahmet Cumhur; Aslan, Mehmet; Olmez, Sehmus; Guler, Ayse; Aldemir, Mehmet Naci; Demirkiran, Davut
Introduction: The effect of a hyperthyroid or euthyroid state on liver function tests in patients with hydatidiform moles (HM) is not known. The aim of this study was to determine the effect of hyperthyroidism on liver transaminases in HM. Patients and methods: We retrospectively reviewed aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels in 80 patients with HM (23 complete moles and 57 partial moles). Results: Of the 80 HM patients, 52 (65%) were euthyroid and 28 (35%) were hyperthyroid. The number of gravida and the levels of serum beta-human chorionic gonadotropin (beta-HCG), AST, and ALT were significantly higher in the hyperthyroid state than in the euthyroid state (p = 0.033, p = 0.001, p = 0.001 and p = 0.001; respectively). Number of gravida, serum TSH and total T4 were significantly higher in complete HM than partial HM (p < 0.05, p < 0.001, p < 0.05; respectively). Conclusions: Our results demonstrated that HM-related beta-HCG may activate thyroid cells via TSH-related signalling, resulting in the release of high levels of FT4, FT3, TT3 and TT4, and a subsequent decrease in TSH.
Comparison of the Automated Cell Counter and Manual Method for the Assessment of Dialysis Fluids in Peritoneal Dialysis Patients
(Drunpp-sarajevo, 2011) Soyoral, Yasemin Usul; Begenik, Huseyin; Aldemir, Mehmet Naci; Baran, Ali Irfan; Emre, Habib; Karahocagil, Mustafa Kasum; Erkoc, Reha
Objective: To compare the accuracy of automated cell counter and the manual methods for the peritoneal fluid assessments in peritoneal dialysis patients. Material and Method: We analyzed 72 peritoneal fluid samples collected under sterile conditions from 27 patients with peritonitis (15 female; 12 male) following by the peritoneal dialysis unit of Yuzuncu Yil University Medical Faculty. The white blood cell counts of these peritoneal fluid samples were assessed by the both manual method and the automated cell counter. Results: The white blood cells were usually higher in the automated cell count method than the manual method (p<0,01). In 5 subjects, white cell counts were less than 100 cell/mu L in the manual method, but were more than 100 cell/mu L in the automated counter. There was a significant correlation between the manual and automated methods in terms of cell counts (p<0.01, r = 0.79). We also found good correlation between the two methods when WBC counts were greater than 300 cell/mu L (r = 0.87). Conclusions: There is a good correlation between the automated method and the manual methods for the assessment of peritoneal fluid samples in CAPD patients. However, in the assessment of fluids with less than 300 cell/mu L, the manual method should be preferred for critical clinical decisions.
Correlation of 24-Hour Urine Sodium, Potassium and Calcium Measurements With Spot Urine
(Modestum Ltd, 2013) Kara, Pinar Sonat; Erkoc, Reha; Soyoral, Yasemin Usul; Begenik, Huseyin; Aldemir, Mehmet Naci
In this study, we analyzed the correlation of sodium(Na), potassium(K) and calcium(Ca) amounts with spot urine(SU) and 24-hour urine(24-HU) collected as 8-hour portions. 21 hypertensive patients and 21 normotensive individuals were enrolled in the study. Na, K and Ca were studied in three sequential 8-hour urine samples and with the sum of three, 24-HU samples of the cases. Sodium/creatinine, potassium/creatinine, and calcium/creatinine were studied in fasting SU and serum Na, K and creatinine were studied. A significant correlation was found between the SU sodium/creatinine ratio and the Na amount in each 8-hour urine collections, and the Na amount in the 24-hour urine in hypertensive patients, the control group, and when all patients were evaluated together. When all group were evaluated together for Ca, a significant correlation was determined between the SU calcium/creatinine ratio and the Ca amount in all three 8-hour urine collections. The Na amount in the 24-HU may be estimated both with the SU Na/creatinine ratio and the 8-hour urine collection; SU does not have clinical significance for potassium. However, it may be estimated with 8-hour urine collections; SU may help roughly for calcium, and the collected urine gives higher correlation coefficients.
The Course of Hypercalciuria and Related Markers of Bone Metabolism Parameters Associated With Corticosteroid Treatment
(Taylor & Francis Ltd, 2012) Duzen, Omer; Erkoc, Reha; Begenik, Huseyin; Soyoral, Yasemin Usul; Aldemir, Mehmet Naci
Background and objective: Prolonged corticosteroid (CS) use induces osteoporosis; the pathogenesis of this condition is multifactorial and includes CS-induced hypercalciuria. We investigated the course of hypercalciuria and related markers of bone metabolism parameters during and after the CS treatment. Materials and Methods: We recruited 42 patients who were taking at least 10 mg/day of methylprednisolone or an equivalent dose of CSs for at least 30 days. The 24-h urinary calcium and sodium, a spot urinary calcium/creatinine ratio, and urinary deoxypyridinoline were measured prior to the treatment, at day 7, at days 30-60, and after the cessation of the treatment. Additionally, the serum levels of phosphorus, calcium, alkaline phosphatase (ALP), albumin, creatinine, osteocalcin, and parathyroid hormone (PTH) were analyzed. Results: The 24-h urinary calcium excretion was significantly increased at day 7 (182.2 +/- 158.6 mg/day; p < 0.001) and at days 30-60 (196.9 +/- 167.8 mg/day; p < 0.001) compared with baseline (98.7 +/- 88.1 mg/day) and returned to basal level after the cessation of the CSs (118.9 +/- 90.2 mg/day; p = 0.725). The urinary deoxypyridinoline level was significantly higher at days 30-60 compared with basal level. The serum osteocalcin level was decreased at days 30-60 when compared with day 7. No significant changes were detected in the PTH, phosphorus, creatinine, and ALP levels. Conclusions: CS treatment induces hypercalciuria just after starting the treatment until the end of it. CS-induced hypercalciuria promptly improved after cessation of the treatment. By days 30-60, the excretion of urinary deoxypyridinoline was accompanied by hypercalciuria. The serum osteocalcin level was decreased at days 30-60 when compared with day 7.
Definitive Chemoradiotherapy Versus Upfront Surgery in Locoregional Esophageal Squamous Cell Cancer
(2024) Kalkan, Nurhan Önal; Mert, Aslihan Guven; Çakıroğlu, Umut; Aldemir, Mehmet Naci; Kotan, Çetin
Aim: Previous studies have indicated that definitive chemoradiotherapy and upfront surgery have comparable survival rates, and definitive chemoradiotherapy is a more applicable treatment option in resectable locally advanced esophageal squamous cell cancer (ESCC). We compared definitive chemoradiotherapy to upfront surgery for survival in locally advanced ESCC patients who denied the standard treatment approach, receiving definitive chemoradiotherapy or upfront surgery. Materials and Methods: One hundred eighty eight locoregional ESCC patients with thoracic and distal involvement who had upfront surgery were compared with those who received chemoradiotherapy but declined surgery, although their tumor was resectable at presentation. Patients who underwent upfront surgery with negative surgical margins were included. The upfront surgery group received no adjuvant treatment (chemotherapy or radiotherapy). The definitive chemoradiotherapy group received standard therapy with 50.4 Gray/28 fractions/6 weeks concomitantly with weekly Paclitaxel 50 mg/m2 and Carboplatin AUC 2 combination regimen. Results: A total of 102 patients (54.3%) underwent surgery up front, whereas 86 patients (45.7%) had definitive chemoradiotherapy. The median follow-up of the study was 31 months. Definitive chemoradiotherapy had a median disease-free survival (DFS) of 39 months compared to 16 months for upfront surgery (p:0.005). Median overall survival (OS) was 29 months in upfront surgery and 47 months in definitive chemoradiotherapy (p=0.01). Although the multivariate Cox regression analysis found no difference in DFS between upfront surgery and definitive chemoradiotherapy groups, OS was greater with the latter (HR, 0.69; 95% CI, 0.47 to 1.00; p=0.05). Conclusion: In this non-randomized retrospective analysis, definitive chemoradiotherapy improved overall survival compared to upfront surgery in locally advanced ESCC patients.
Determination of Oxidative Stress Levels (malondialdehyde), and Some Antioxidant Activities (superoxide Dismutase, Glutathione Peroxidase and Reduced Glutathione) in Unoperated Breast Cancer Patients
(2022) Amar, Safa Alı Ahmed; Demir, Halit; Aldemir, Mehmet Naci
Bu çalışmada, opera olmamış meme kanserli hastalarında malondialdehit (MDA) düzeyi ile süperoksit dismutaz (SOD), indirgenmiş glutatyon (GSH) ve glutatyon peroksidaz (GPx) gibi bazı antioksidan aktivitelerin belirlenmesi amaçlandı. SOD, GSH ve GPx aktiviteleri opera olmamış meme kanserli hasta grubu sağlıklı kontrol grubuna göre anlamlı olarak düşük bulundu (p<0.05). Opera olmamış meme kanserli hasta grubu, MDA düzeyleri sağlıklı kontrol grubuna göre anlamlı olarak yüksek bulundu (p<0.05). Sonuç olarak, opera olmamış meme kanserli hastalarda oksidatif stres artışı hücresel hasarı meydana getirebilir. Bunun sonucunda lipid peroksidasyon düzeyi (MDA) artarken, buna karşılık antioksidant aktiviter ise azalmıştır.
Determination of Total Sulfhydryl, Dynamic Thiol, Disulphide, Total Thiol and Ischemia Modified Albumin Levels in Newly Diagnosed Gastric Cancer Patients
(2023) Adsaz, Turgut; Aldemir, Mehmet Naci
Mide kanseri dünyada en sık görülen beşinci kanserdir ve kansere bağlı ölümlerin ise en sık üçüncü nedenidir. Kendine özgü semptomları olmaması ve geç bulgu vermesi sebebiyle sinsi bir hastalık olarak değerlendirilir. Erken tanı konulduğu zaman sağkalım oranları belirgin şekilde yükselmektedir. Erken evrede tanı koymanın önemi düşünüldüğünde biyokimyasal tetkikler ve tarama programları hastalığın sürveyansı için oldukça değerlidir. Bu çalışmada, mide kanseri tanısını hızlandırmaya ve patogenezini açıklamaya katkı sağlamak için total sülfhidril (TSH), dinamik tiyol (-SH), disülfit (-S-S), total tiyol (TT) ve iskemi modifiye albümin (İMA) düzeylerini belirlemek amaçlanmaktadır. Gereç ve Yöntem: Bu prospektif yapılan tez çalışması, Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi Hastanesi Tıbbı Onkoloji Polikliniği'ne başvuran yeni tanı mide kanseri olan 49 hasta üzerinde yapıldı. Kontrol grubu olarak 55 sağlıklı birey dahil edildi. Her iki çalışma grubu bireylerden EDTA içeren tüplere 1 ml periferik kan alındı. Kan örneklerinin çalışma grubu bireylerden alındığı gün santrifüj edilerek -80°C'ye kaldırılarak saklandı. Saklanan kan örnekleri 49 sayısına ulaşınca biyokimya çalışma sürecine geçildi. Erel ve Neselioğlu tarafından geliştirilen yeni bir spektrofotometrik yöntemle kan örnekleri analiz edildi. Elde edilen tüm bilgiler bilgisayar ortamına taşındı. Verilerin analizinde tanımlayıcı istatistikler kullanıldı. Tanımlayıcı istatistiklere bakıldığında; ortalama, standart sapma, minimum, maksimum, sayı (n) ve yüzde (%) olarak ifade edildi. Bütün analizlerde SPSS (IBM SPSS for Windows, ver.25) istatistik paket programı kullanıldı ve anlamlılık düzeyi için p <0.05 değeri anlamlı kabul edildi. Bulgular: Çalışmamızda oksidatif stres markerı olarak belirlediğimiz TSH, -SH, -S-S, TT ve IMA düzeyleri kontrol grubu ile karşılaştırıldığında, hasta grubunda–S-S ve IMA değerleri anlamlı olarak yüksek bulunurken; TSH, -SH, TT düzeyi anlamlı olarak düşük bulundu (sırasıyla TSH: 0.149-0.2940, p<0.001; –SH: 366.05-589.24, p<0.001; –S-S: 19.13-9.57, p<0.001; TT: 374.15-625.34, p<0.001; IMA: 0.244-0.114, p<0.001). Hasta ve kontrol grubunda onkolojik takiplerde kullandığımız hematolojik ve biyokimyasal parametereleri kıyasladığımızda; CEA, WBC, NEU, ÜRE, LDH değerleri mide CA hastalarında kontrol grubuna göre anlamlı olarak yüksek bulunurken; LYM, HGB, NA, AST ve ALBÜMİN değerleri ise anlamlı olarak düşük bulundu (tüm gruplarda p<0.05). Sonuç: Oksidatif stres belirteci olarak çalıştığımız parametreler yeni tanı alan mide kanseri hastalarında istatistiksel olarak anlamlı bulundu. Bu belirteçlerin kullanılması mide kanserinin erken tanında yol gösterici olabilir.
Evaluation of Demographic and Clinical Data of Patients With Diagnosis of Lung Cancer: One Center Experience
(2021) Kayran, Mehmet Maruf; Aldemir, Mehmet Naci
Amaç: Çalışmamızda, kliniğimizde son 10 yılda akciğer kanseri tanısı almış olan hastalarımızın demografik, epidemiyolojik ve klinik özelliklerinin geriye dönük olarak belirlenmesini amaçladık. Gereç ve Yöntemler: Van Yüzüncü Yıl Üniversitesi Dursun Odabaş Tıp Fakültesi Medikal Onkoloji Kliniğine Ocak 2011-Haziran 2020 tarihleri arasında tanı ve tedavi için başvuran akciğer kanseri hastaları çalışmaya alındı. Bu çalışmada hastalara ait bilgiler hastanemiz elektronik dosya sisteminden ve arşiv dosyalarından retrospektif olarak elde edildi. Bulgular: Tanı ve tedavi amacıyla başvuran 331 akciğer kanseri hastası alındı. Hastaların yaş ortalaması 62,7±10,3'dir. Hastaların %83,4'ü erkek, %16,6'sı kadındır. Erkek/Kadın oranı 5/1 idi. Hastaların ensık başvuru şikâyetleri öksürük, nefes darlığı, göğüs ağrısıydı. Hastaların %10,5'inin sigara içim öyküsü yok iken %66,5'inin sigara içme öyküsü mevcuttu. %23'ünün ise sigara içme hikâyesi bilinmiyordu. Hastaların %15,3'ünde tandır öyküsü mevcuttu. Radyolojik olarak tümöral lezyonların en sık lokalizasyonu %38 hasta ile sağ üst lobdu. Diğer yerleşimler sırası ile sol üst lob (%28,4), sağ alt lob (%15,8), sol alt lob (%12,2) ve sağ orta lob (%5,6) idi. En sık görülen histopatolojik tipler ise yassı hücreli karsinom (%39,3), adenokarsinom (%26,8) ve küçük hücreli karsinomdu (%20,1). Hastaların tanı esnasındaki evreleri sıklık sırasına göre; evre 4(%48,9), evre 2(%39), evre 2(10,9) ve evre 1(%1,3) dir. Tüm hastalarda median genel sağkalım süresi (mGSK) 14±1,4 (11,2-16,8) ay olarak bulundu. ECOG ve evre yüksekliğinin sağkalımı olumsuz etkilediği görüldü. Cinsiyete göre mGSK, kadınlarda 31 ay bulunurken, erkeklerde 13 ay bulundu. Sonuç: Çalışmamızda elde ettiğimiz verilerin daha önce yapılan diğer çalışmalarla uyumlu olduğu görüldü. Hastaların çoğunluğunun ileri evrede tanı almasında sigara içiminin yaygın olduğu ülkemizde, hastaların semptomlarını sigara içimine bağlamaları ve asemptomatik olmaları nedeniyle sağlık kuruluşlarına geç başvurmalarının etkili olduğu düşünüldü. Buna ek olarak yapılan diğer çalışmalara göre tanı alan kadın hasta oranının yüksek olması bölgemizde yaygın tandır kullanımına bağlı olduğu düşünüldü.
Factors Affecting Recurrence in Operated Breast Cancer Patients Receiving Adjuvant Chemotherapy
(2021) Aydemir, Ozan; Aldemir, Mehmet Naci
Meme kanseri kadınlarda cilt kanserleri hariç tutulduğunda en sık görülen kanserdir. Kadınlarda kanserden ölümlerin ikinci en sık nedenidir. Bu çalışmada adjuvan kemoterapi alan opere meme kanserli hastalarda nüksü etkileyen faktörlerin incelenmesi amaçlandı. Materyal ve Metod: Çalışmaya 2007-2020 yılları arasında Van Yüzüncü Yıl Üniversitesi Tıp Fakültesi Dursun Odabaş Tıp Merkezine takip ve tedavi amacıyla başvuran meme kanserli hastalar alındı. Çalışamaya meme kanseri nedeniyle opere olan ve adjuvan tedavi alan 18 yaşın üzerindeki hastalar alındı. Bulgular: Çalışmaya tümü kadın olan 285 hasta alındı. Hastaların ortanca yaşı 52 (24-92) idi. Hastalardan 50 (%17.54) tanesinde nüks gözlendi. Hastalarda 10 yıllık genel sağkalım %89 iken, 10 yıllık hastalıksız sağkalım oranı %70.3 idi. Hastalardan tümör evresi arttıkça hastalıksız sağkalım istatistiksel olarak anlamlı kısaydı (log rank p=0.013). Hastalıksız sağkalım için yapılan tek değişkenli analizde tümörün invaziv duktal karsinom (İDC) ve invaziv lobüler karsinom (İLC) dışında kalan diğer histolojik alt tipte olması (p=0.025), çıkarılan lenf nodu sayısı (p<0.001), pozitif lenf nodu sayısı (p<0.001), tümör evresinin artması (p=0.006) sağkalımı olumsuz etkiliyordu. Çok değişkenli analizde yine tümörün İDC ve İLC dışında kalan diğer histolojik alt tipte olması (p=0.006) ve tümörün ileri evrede olması (p=0.004) sağkalımı olumsuz etkiliyordu. Tartışma: Çalışmamızda adjuvan tedavi alan opere meme kanserli hastalarda tümörün İDC ve İLC dışında kalan diğer histolojik alt tiplerden biri olması ve tümörün ileri evrede olması sağkalımı anlamlı olarak kısaltıyordu. Sonuç: Bu bulgular eşliğinde meme kanserinde erken evrede tanı konulmasının ve bu doğrultuda 40 yaş üstü kadınlarda meme kanseri tarama programlarının son derece önemli olduğu kanaatindeyiz. Bu çalışmamızın prospektif klinik çalışmalar ile desteklenmesi gerekmektedir.
Factors Affecting Recurrence-Free Survival in Gastric Gastrointestinal Stromal Tumors: a Single Center Experience
(Galenos Yayincilik, 2020) Sakin, Aysegul; Aldemir, Mehmet Naci
Aim: Gastrointestinal stromal tumors (GISTs) are extremely rare. In this study, we aimed to analyze the factors affecting disease-free survival (DFS) in patients operated for non-metastatic gastric GIST (gGIST). Methods: This was a retrospective analysis of 34 patients with resectable gGIST who were followed up and treated at the oncology clinic between 2008 and 2019. Patients with metastatic disease and non-gastric disease and those aged <18 years were excluded. Results: Seventeen (50%) patients were male. The median age was 64 years. According to Miettinen Risk Scores, seven patients were (20.6%) in very low-risk group, five (14.7%) in low-risk group, 17 (50%) in moderate-risk group, and five (14.7%) patients were in high-risk group. Adjuvant therapy was given in 11 (32.4%) patients. The 5- and 10-year DFS rates were same as 79.2%. The 5- and 10-year overall survival rates were 90.9% and 85.6%, respectively. In multivariate analysis, presence of necrosis [Hazard rate (HR)=9.5], being in high-risk group (HR=27.2), Ki-67 (HR=1.03), and receiving adjuvant therapy (HR=0.51) were factors affecting DFS. Conclusion: We assume that adjuvant therapy should be given in high-risk patients operated for gGIST in the presence of necrosis and high Ki-67.
Factors Affecting Survival in Operated Esophageal Squamous Cell Carcinoma
(Springer, 2022) Akgul, Nida; Sakin, Abdullah; Sahin, Suleyman; Aldemir, Mehmet Naci; Aytekin, Aydin; Alay, Murat; Kotan, Mehmet Cetin
Purpose Esophageal squamous cell carcinoma (ESCC) is an extremely fatal and relatively rare gastrointestinal system malignancy. This study aimed to investigate the factors affecting survival in operated patients with ESCC. Materials and Methods We included 110 patients (38 [34.5%] male; 72 [65.5%] female) aged >= 18 (median age, 54 [26-77]) years who were operated without any signs of metastases and followed up at Van Yuzuncu Yil University Dursun Odabasi Medical Center between 2004 and 2019. Results Initially, 39 (35.5%) patients were clinical lymph node-positive and 71 (64.5%) patients were negative. Thirty-five (31.8%) patients underwent surgery after neoadjuvant chemoradiotherapy (nCRT), and 75 (%68.2) patients underwent direct surgery without nCRT. Five-year overall survival (OS) was 84.4% and 59.2% in patients who underwent surgery after nCRT and in those who underwent direct surgery, respectively. Median OS was significantly longer in patients who underwent surgery after nCRT (p = 0.003). There was a statistically significant difference in OS in patients who underwent surgery after nCRT depending on tumor response (p = 0.04). In multivariate analysis, advanced pathologic stage (p = 0.002) adversely affected survival, whereas nCRT administration (p = 0.031) positively affected OS. Conclusion We suggest that nCRT should be administrated before surgery, especially in locally advanced ESCCs. In addition, we believe that nCRT response can be used as a good parameter for survival. These results, however, should be supported by prospective studies.
Factors Affecting Survival in Operated Gastric Cancer
(Elsevier Sci Ltd, 2023) Sakin, Aysegul; Sahin, Suleyman; Sakin, Abdullah; Aldemir, Mehmet Naci; Sakoglu, Nevin; Bayram, Irfan; Kotan, Mehmet Cetin
In this study, our aim was to determine the possible effects of Helicobacter pylori (HP), chronic atrophic gastritis (CAG), and gastrointestinal metaplasia (GIM) on survival in operated bowel type gastric cancer patients (INTGC). Among 548 patients, 347(63.3%) were male. The median age was 57 years. Disease-free survival (DFS) and overall survival (OS) were significantly shorter in patients with GIM than those in patients without GIM (log rank, P = 0.003 and log rank P = 0.003, respectively). Multivariate analysis showed that presence of GIM (HR, 2.1) was found to be an independent factor of worse DFS. In our study, stage pIII patients with GIM had significantly shorter DFS and OS than those without GIM (log rank p = 0.008 and log rank p = 0.001, respectively). However, in subgroup analysis of patients with GIM, there was no significant DFS and OS difference between patients with stage pI and pII disease (log rank p = 0.999, log rank p = 0.184 vs. log rank p = 0.409, log rank p = 0.281, respectively).
Investigation of Some Interleukins, Trace Elements and Oxidative Stress Levels in Patients With Colon Cancer
(2024) Sulaıman, Seerwan Hamadameen Sulaıman; Demir, Halit; Aldemir, Mehmet Naci
Kolorektal kanser dünya çapında en yaygın ve tehlikeli kanser türlerinden biridir. Bu araştırmanın amacı, kolon kanserli hastalarda bazı interlökinler, iz elementler ve oksidatif stres düzeylerini belirlemektir. IL-6, IL-10 ve IL-35 gibi parametreler kolon kanseri hastalarında kontrol grubuna kıyasla önemli bir artış gösterdi. Vit E, SOD ve GST parametrelerinde kolon kanseri hastalarında artarken sağlıklı kontrol grubunda ise GPx anlamlı bir azalma gösterdi. VIT D, GSH, CAT ve GR parametreleri kolon kanseri hastaları ve kontrol grubu arasında anlamlı bir fark bulunmadı. Kolon kanseri hastalarında IMA, MDA ve PCO düzeyleri sağlıklı kontrol grubuna kıyasla önemli bir artış gösterdi. Kolon kanseri hastalarında Cu ve K'de anlamlı bir artış bulunurken Zn, Al, Na, Ca ve Mn'de ise kontrol grubuna kıyasla anlamlı bir azalma gösterdi. Fe, Mg, Cr ve Pb sonuçları kolon kanseri hastaları ve kontrol grubu arasında anlamlı bir fark bulunmadı. Sonuç olarak, kolon kanseri hastalarda antioksidan aktiviteler, vitaminler, interlökinler ve eser elementler hastalığın etiyopatogenezinde önemli rol oynayabilir.
Lymph Node Ratio Predicts Long-Term Survival in Lymph Node-Positive Breast Cancer
(Galenos Publ House, 2020) Sakin, Aysegul; Aldemir, Mehmet Naci
Objective: In this study, we aimed to evaluate the prognostic value of axillary lymph node ratio (LNR) for disease-free survival (DFS) in node positive breast cancer (BC) patients with long term follow-up. Materials and Methods: A total of 179 stage II to III female BC patients, who were followed between December 2001 and January 2019 at the department of medical oncology, were included in this study. Patients were classified into 3 groups based on the LNR as follows; LNR<0.21, LNR=0.21-0.65, and LNR>0.65. SPSS 22 for windows was used for statistical analysis. Results: The median age was 49 (range, 24-83) years. The numbers of patients with stage II and stage III disease were 81 (45.3%) and 98 (54.7%), respectively. The median number of lymph node (LN) resected and positive LN were 15 (range, 3-48) and 3 (range, 1-29), respectively. There were 90 patients (50.3%) with LNR<0.21, 62 (34.6%) with LNR=0.21-0.65, and 27 (15.1%) with LNR>0.65. The median disease-free survival (DFS) was not reached in patients with LNR<0.21, 81 months in patients with LNR=0.21-0.65, and 43 months in patients with LNR>0.65 (p<0.001). Overall survival (OS) was found to be significantly related to LNR (p=0.042). In patients with LNR<0.21 and LNR=0.21-0.65, the median OS was not reached. In patients with LNR>0.65, the median OS was 101 months. In multivariate analysis, LNR=0.21-0.65 (Hazard ratio [HR], 6.99), LNR>0.65 (HR, 28.99), and HER-2 negativity (HR, 4.64) were the factors associated with DFS (p<0.05). Conclusion: LNR is a more useful prognostic factor than the pathological lymph node staging for predicting survival in patients with nod-positive BC.
Metastatik Küçük Hücreli Akciğer Kanserinde Platin Seçiminin Sağkalim Üzerine Etkisi ve Sağkalimi Etkileyen Faktörler: Tek Merkez Deneyimi
(2021) Aldemir, Mehmet Naci; Sakin, Ayşegül; Alay, Murat
Amaç: Bu retrospektif çalışmada, metastatik KHAK hastalarında platin (karboplatin veya sisplatin) seçiminin sağkalım üzerine etkisini ve sağkalımı etkileyen faktörlerin belirlenmesini amaçladık. Gereç ve Yöntem: ilkseri tedavi de platin bazlı kemotrapi ile tedavi edilen, 18 yaş ve üzeri, dataları mevcut toplamda 87 metastatik KHAK tanılı hasta alındı. Hastalar aldığı platin bazlı tedavi tipine göre sisplatin+etoposit(SE) ve karboplatin + etoposit(KE) olarak gruplandırıldı. Bulgular: Çalışmaya alınan 87 hastanın 16 (%18,4) sı kadındı. Ortanca yaşı 58 idi. SE ve KE ile tedavi edilen hasta sayıları sırası ile 65 ve 22 idi. SE ve KE ile tedavi edilen hastaların ortanca progresyonsuz sağkalımı(PSK), sırasıyla 6 ay ve 5 aydı (p=0.171), karşılık gelen ortanca genel sağkalım (GSK) süreleri 9 ay ve 8 aydı (p=0.173). Performans skoru, torakal radyoterapi uygulanması ve ilk seri tedavi yanıtı sağkalımı etkileyen bağımsız faktörler olarak bulundu. Sonuç: Çalışmamızda, ilk seri tedavide SE ‘ye kıyasla KE tedavisi metastatic KHAK’inde etkilemedi. Ancak tanı anında performans skoru kötü olanların sağlamının performans skoru iyi olanlardan daha düşük olduğu gözlendi. Bunun yanında, torakal radyotertapi verilmesi ve ilk seri kemoterapiye daha iyi bir yanıt sağkalımı iyileştirdi.
Peripheral Blood Levels of Cellular and Humoral Immunity Parameters in Esophageal and Gastric Cancer Patients
(Termedia Publishing House Ltd, 2013) Begenik, Huseyin; Turkdogan, Mehmed Kursad; Dulger, Ahmet Cumhur; Aldemir, Mehmet Naci; Esen, Ramazan; Mete, Rafet
Aim: To evaluate parameters of cellular and humoral immunity in gastric and esophageal cancer patients. Material and methods: In this study, we recruited 40 patients with newly diagnosed esophageal cancer (20 of them) or stomach cancer (20 of them) and 20 healthy individuals of similar age as a control group. In the study and control groups we measured CD3, CD4, CD8, CD19, CD4/CD8 ratio and the ratio of natural killer cells using the flow cytometer device. Results were evaluated with factorial analysis of variance and Duncan test. Results: The CD3 and CD8 ratios were significantly higher in patients with esophageal cancer (p = 0.012, p = 0.003, respectively) and the ratio of NK cells was significantly higher in patients with stomach cancer (p = 0.001) when compared to the control group. The ratio of CD19 was significantly lower in the two cancer groups (p = 0.031). There were no significant differences in the ratio of CD4 and CD4/CD8 between the groups. No correlation between the stage of cancer and the ratio of CD cells was detected. Discussion: In conclusion, understanding of the cancer immunology of esophageal and stomach cancer will provide insight into the pathogenesis of the cancer Therefore, further and extensive cancer immunology studies should be conducted to understand the nature of the upper gastrointestinal tract cancers.
The Prognostic Effect of Pretreatment 18f-Fdg Pet/Ct Metabolic Parameters in Locally Advanced Esophageal Squamous Cell Carcinoma Treated With Definitive Chemoradiotherapy
(Elsevier Sci Ltd, 2022) Sakin, Abdullah; Ozcelik, Mahsun; Sahin, Suleyman; Aydemir, Ozan; Aldemir, Mehmet Naci; Iliklerden, Umit Haluk; Kotan, Mehmet Cetin
Introduction: In this study, we aimed to examine the relation between pre-treatment 18F-FDG PET/CT metabolic parameters [(including the maximum standard uptake value (SUVmax), metabolic tumor volume (MTV), and tumor lesion glycolysis (TLG)] and treatment response and survival in locally-advanced Esophageal Squamous Cell Cancer (ESCC) treated with definitive chemoradiotherapy (dCRT). Methods: A total 76 patients with locally-advanced ESCC who received dCRT between June 2015 and December 2019 were included in this retrospective study. Patients were divided into two groups as complete response (CR) or non-complete response (Non-CR) according to response to treatment. AUC was obtained as 0.749 (p < 0.001) in the ROC curve drawn by MTV for the CR. The MTV value was <= 12 cm(3), with 72.1% sensitivity and 73.0% specificity. Results: Of the 76 patients, 38 (50%) were male and 38 (50%) were female. The median age was 62 (39-84) years. The treatment response in 35 (46%) patients was CR. MTV value was > 12cm3 in 41(54%) patients. Median follow-up time was 14.5 months. In patients with MTV > 12cm3, median progression-free survival(mPFS) and median overall survival(mOS) were 9 months and 11 months, respectively, whereas mPFS and OS could not be reached in those with MTV & LE;12 cm3 (p < 0.001 and p < 0.001, respectively). In patients with non-CR, mPFS and mOS were 8 months and 9 months, respectively, whereas mPFS and OS could not be reached in patients with CR (p < 0.001 and p < 0.001, respectively). In multivariate analysis, age (odds ratio [OR], 1.07), ECOG PS (OR, 11.1), and MTV (OR, 4.73) were found to be the factors affecting treatment response. Conclusion: In our study, treatment response and MTV were found to be the factors associated with survival in patients treated with dCRT, showing the pre-treatment MTV value as a predictor of treatment response.
Prognostic Significance of Basal 18f-Fdg Pet/Ct Maximum Standardized Uptake Value in Patients With Metastatic Renal Cell Carcinoma Who Were Treated With Sunitinib
(Imprimatur Publications, 2020) Aytekin, Aydin; Aldemir, Mehmet Naci; Sakin, Abdullah; Telci, Ufuk; Esen, Ramazan
Purpose: To determine whether there is a relationship between maximum standardized uptake (SUVmax) value of basal 18-Fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18F-FDG-PET/CT) that was performed before sunitinib treatment and treatment related survival in patients with metastatic renal cell carcinoma (mRCC). Methods: The data of 36 patients (female/male: 1/1, median age 57.36 years, range 31-74) were retrospectively analyzed in whom sunitinib treatment was started due to mRCC between 2008 and 2019 and who underwent basal 18F-FDG PET/CT examination before this treatment. The median SUVmax value was 6.8. Progression-free survival (PFS) and overall survival (OS) rates of patients, who had SUVmax value >6.8 (group I) (50%, n=18) and <= than 6.8 (group II) (50%, n=18), were compared. Results: Both PFS and OS were significantly lower in the group with high SUVmax (SUVmax> 6.8, group I) before the sunitinib treatment than the group with low SUVmax (SUVmax <= 6.8, group II). When patients with SUVmax value> 6.8 (group I) (50%, n=18) and <= 6.8 (group II) (50%, n=18) were compared the median PFS of group I patients was 6.83 months (95%CI: 6.14-7.52), while the median PFS of group II patients was 11.24 months (95%CI: 8.4-14.06) (p=0.035). The median OS in group I and II was 12.91 months (95%CI: 10.17-15.65) and 54.54 months (95%CI: 8.51-100), respectively (p=0.042). Conclusion: In this study it was found that PFS and OS were low in patients with high SUVmax value in 18F-FDG PET/CT performed before sunitinib treatment. As a result, 18F-FDG PET/CT SUVmax values measured before sunitinib treatment can be used to predict survival in mRCC patients.
Prognostic Significance of Neutrophil-To Ratio in Esophageal Squamous Cell Carcinoma
(Kare Publ, 2021) Sakin, Aysegul; Alay, Murat; Sahin, Suleyman; Aydemir, Ozan; Aldemir, Mehmet Naci; Sakin, Abdullah; Kotan, Cetin
OBJECTIVE: The purpose of the study was to assess the effect of neutrophil-to-lymphocyte ratio (NLR) on recurrence and survival in patients with Esophageal Squamous Cell Carcinoma (ESCC) undergoing surgery. METHODS: This was a retrospective analysis of the 80 resectable ESCC patients who underwent surgery at Yuzuncu Yil University Faculty of Medicine between 2008 and 2018. Receiver operator characteristics curve of NLR was plotted for disease-free survival (DFS). The area under the curve of NLR was 0.692 (p=0.008) with 65.2% sensitivity and 2.8 with 69.5% specificity. Patients were divided into two groups based on the NLR as follows: NLR <2.8 and NLR >= 2.8. RESULTS: Among 80 ESCC patients, 54 (65.5%) were female. The median age was 55 years (range, 26-77). The NLR was <2.8 in 47 (58.7%) patients. Median DFS was 55 months in patients with NLR >= 2.8, whereas it was not reached in those with NLR <2.8 (p=0.008), with corresponding overall survival (OS) durations of 71 months and not reached (p=0.027). Eastern Cooperative Oncology Group performance score 2, presence of obstruction at diagnosis, lower 1/3 esophageal localization, neoadjuvant treatment, and NLR >= 2.8 were found to be the factors related to survival. CONCLUSION: The present study demonstrated that high pre-treatment NLR was associated with worse DFS and OS in patients with resectable esophageal cancer. We believe that pre-treatment NLR may help guide predicting treatment outcomes in non-metastatic resectable ESCC patients.
The Prognostic Value of Postoperative Lymph Node Ratio in Gastric Adenocarcinoma Patients Treated With Neoadjuvant Chemotherapy
(Springernature, 2021) Sakin, Abdullah; Atci, Muhammed M.; Aldemir, Mehmet Naci; Akagunduz, Baran; Sahin, Suleyman; Arici, Serdar; Cihan, Sener
Objective In this study, we aimed to investigate the prognostic value of postoperative lymph node ratio (LNR) in locally advanced gastric cancer (GC) patients receiving neoadjuvant chemotherapy (NACT). Methods LNR was calculated as the ratio of positive LNs to the total LNs removed. The receiver operating characteristic (ROC) curve was plotted to estimate the cut-off value of LNR for recurrence. The area under the curve of LNR was 0.714 (95% CI: 0.604-0.825, p<0.001) with 60% sensitivity and >0.255 with 76% specificity. Patients were grouped as group I (<= 0.255) and group II (>0.255). Results In this study, 157 GC patients were included (39.5% female and 60.5% male). Of the patients, 97 (61.8%) were in group I and 60 (38.2%) were in group II. Disease-free survival (DFS) was not reached in group I, and it was 16 months in group II (p<0.001). Overall survival (OS) was 58 months in group I and 28 months in group II (p>0.001). In multivariate analysis, lymphovascular invasion, neoadjuvant response, adjuvant treatment, and LNR were found to be the factors associated with DFS and OS (p<0.05). Conclusion In our study, it was observed that LNR can predict survival rates better than LN staging.