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Öğe Alpha-fetoprotein (AFP) elevation gastric adenocarcinoma and importance of AFP change in tumor response evaluation(Asian Pacific Organization for Cancer Prevention, 2015) Tatli A.M.; Urakci Z.; Kalender M.E.; Arslan H.; Taştekin D.; Kaplan M.A.Background: Elevated serum alpha-fetoprotein (AFP) levels in adults are considered abnormal. This parameter is used mostly in the diagnosis and follow-up of hepatocellular carcinomas and yolk sac tumors. Among the other rare tumors accompanied with elevated serum AFP levels, gastric cancer is the most common. In this study, we evaluated the follow-up and comparison of the treatment and marker response of patients with metastatic gastric cancer who had elevated serum AFP levels. Materials and Methods: We performed a retrospective study, including all consecutive patients with advanced gastric cancer, who received systemic chemotherapy with elevated AFP level. Results: Seventeen metastatic gastric cancer patients with elevated AFP levels at the time of diagnosis were evaluated. Fourteen (82.4%) were males and three (17.6%) were females. The primary tumor localization was the gastric body in 8 (76.4%), cardia in 7 (41.2%), and antrum in 2 (11.8%). Hepatic metastasis was observed in 13 (76.4%) at the time of diagnosis. When the relationship of AFP levels and carcinoembryonic antigen (CEA) response of the patients with their radiologic responses was evaluated, it was found that the radiologic response was compatible with AFP response in 16 (94.1%) patients and with CEA response in 12 (70.6%); however, in 5 (29.4%) patients no accordance was observed between radiological and CEA responses. Conclusions: Follow-up of AFP levels in metastatic gastric cancer patients with elevated AFP levels may allow prediction of early treatment response and could be more useful than the CEA marker for follow-up in response evaluation.Öğe Cancer and thrombotic thrombocytopenic purpura: Presentation of two cases(Turkiye Klinikleri, 2008) Altintaş A.; Çil T.; Atay A.E.; Kaplan M.A.; Işikdoğan A.; Ayyildiz O.Thrombotic thrombocytopenic purpura (TTP) is a rare and fatal disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, neurologic disorder, renal function deterioration and fever. TTP may be idiopathic or secondary to autoimmune diseases, drugs, cancer and infections. Clinical findings of TTP are also present in cancer patients with disseminated intravascular coagulation and sepsis. TTP must be considered in the differential diagnosis in the case of concurrent microangiopathic hemolytic anemia and thrombocytopenia with or without leukoerythroblastic blood smear in cancer patients. Here we presented two patients who were followed up in our clinic with TTP secondary to metastatic breast cancer. Copyright © 2008 by Türkiye Klinikleri.Öğe Cutaneous and scalp metastases of pancreatic carcinoma: Case report(2011) Küçüköner M.; Kaplan M.A.; Inal A.; Sula B.; Firat U.; Uçmak F.; Işikdoğan A.Pancreatic carcinomas are very rapidly progressing tumors. Approximately 50% patients with newly diagnosed pancreatic cancer have many kinds of metastases. The most frequent sites of metastasis of the pancreatic carcinomas are the lymph nodes, lungs, liver, adrenal glands, kidneys and bones. Cutaneous metastases from pancreatic adenocarcinomas are very rare, far less common sites of pancreatic metastases are the scalp and skull metastases. The most common site of cutaneous metastasis is the umbilicus, there are scant reports of pancreatic cutaneous metasta sis at nonumbilical areas. In the literature, togetherness of cutaneous, scalp and skull metastases have not usually been reported and in our interesting case, we present these rare metastases together. Copyright © 2011 by Türkiye Klinikleri.Öğe Hepatitis B virus infection in patient with Hodgkin's and non-Hodgkin's lymphoma and clinical significance(2007) Altintaş A.; Kaplan M.A.; Çil T.; Yilmaz Ş.; Bayan K.; Daniş R.; Ayyildiz O.Hepatitis B virus (HBV) is a hepatotrophic virus that have also a potential to replicate in lymphoid cells. This has led to evaluation of potential association between HBV infection and lymphomas. In this study, we retrospectively determined the HBV surface antigen and anti-HBs antibody in Southeastern region of Turkey where the prevalence of this infection is relatively high. A total of 276 patients were recruited, 203 (73.6%) with non-Hodgkin's lymphoma (NHL) and 73 (26.4%) with Hodgkin's lymphoma (HL), in the period of January 1995 and December 2005. In total, 40 (14.5%) patients were positive for HBsAg. Of them, 12 (16.4%) were in HL group and 28 (13.7%) were in NHL group. Anti-HBs antibody was positive in total of 123 patients [29 (39.7%) in HL and 94 (46.3%) in NHL]. Eleven patients were taken lamivudine prophylaxis (100 mg po / day) in the last two years. Ten were not developed a reactivation, while one with diffuse large-cell NHL reactivated. Besides, one patients with HL who was not taking prophylaxis developed anti-HBcIgM positive with aminotransferase elevations compatible with acute hepatitis. Although HBsAg positivity was higher in lymphoma patients than in general population in our study, for a possible casual association there is need for prospective studies with wider populations. In conclusion, prophylaxis with lamivudine of HBV carriers is important and treatment should be continued until one year after termination of chemotherapy.Öğe Hereditary thrombophilic risk factors in patients with deep venous thrombosis(2007) Altintaş A.; Çil T.; Kaplan M.A.; Yurt M.; Batun S.The prevalence of hereditary risk factors for deep venous thrombosis (DVT) varies greatly in different parts of the world. Factor V Leiden (FVL) and prothrombin G 20210A (FT G20210A) are the most common genetic defects leading to venous thrombosis. The aim of this study was to investigate the frequency of FVL and PT G20210A mutations in adult patient with DVT in our region. Between September 2001 and August 2006, 52 patients with documented venous thrombosis were investigated in our center for the presence of FVL and PT G20210A mutations. Fourteen of 52 patients with thrombosis (%26.9) were detected to have a FVL mutation. The PT G20210A mutation was detected in 6 (%11) of the 52 patients. Our findings reveal that FVL and PT G20210A mutations are significantly higher in patients with DVT than in the healty population in the southeast of Turkey.Öğe Is eribulin treatment prognostic factor in patients with metastatic breast cancer treated with this drug? Retrospective analysis of a multicentre study(Zerbinis Publications, 2019) Oruc Z.; Kaplan M.A.; Geredeli C.; Sari N.Y.; Ozaslan E.; Aytekin A.; Elkiran E.T.Purpose: This study aimed to analyze prognostic factors for survival and the reliability and the effectiveness of eribulin therapy in metastatic breast cancer (MBC) patients. Methods: A total of 80 patients treated with eribulin in 12 medical oncology centers in Turkey between 2013-2017 were retrospectively evaluated. Sixteen potential prognostic variables were assessed for analysis. Results: The patients had received a median of 5 prior chemotherapy regimens and a median of 3 eribulin cycles for MBC. Median progression-free survival (PFS) was 5.5 months (95% Cl: 4.1-7.8) and median overall survival (OS) was 11 months (95 % Cl: 6-15). Multivariate analysis showed that eribulin treatment line was shown to have independent prognostic significance for PFS. PFS difference was demostrated in patients who received 3 chemotherapy lines for advanced disease compared to those who had more than 3 chemotherapy lines [median PFS; 3 lines: 8.6 months (6.2-11) and >3 lines: 4.6 months (3.7-4.6) p=0.00]. The clinical benefit rate (CBR) was 52.5 and 35% in patients treated with three lines and with >3 previous chemotherapeutic regimens. Most common toxicities were neutropenia (62.5%), fatigue (52.5%), alopecia (50%) and nausea (37.5%). Conclusions: Eribulin treatment line was identified as in-depedent prognostic factor for PFS in MBC patients. © 2019 Zerbinis Publications. All rights reserved.Öğe Lack of any relationship between ABO and Rh blood groups and clinicopathological features in patients with gastrointestinal stromal tumors: Turkish oncology group(Asian Pacific Organization for Cancer Prevention, 2012) Urün Y.; Utkan G.; Yalçin S.; Coşkun H.S.; Koçer M.; Ozdemir N.Y.; Kaplan M.A.Background: An association between the ABO blood group and the risk of certain malignancies, including pancreatic and gastric cancer, has been reported previously. However, it is unclear whether this association is valid for gastrointestinal stromal tumors (GIST). In this study, ABO blood groups and the Rh factor were investigated in a series of GIST cases. Material and Methods: In 162 patients with GIST, blood group and Rh factor were examined and compared with a control group of 3,022,883 healthy volunteer blood donors of the Turkish Red Crescent between 2004 and 2011. The relationship of blood groups with tumor size, mitotic activity, and age were also evaluated. Results: Overall, the ABO blood group and Rh factor distributions of the 162 patients with GIST were similar to those of the general population. There were no significant differences between both ABO blood types and Rh factor in terms of tumor size, mitotic activity, and age. Conclusion: This is the first study reported on this issue. In our study, we didn't find any relationship between GIST and ABO blood group and Rh factor. However further studies with larger number of patients are needed to establish the role of blood groups in this population.Öğe Patients with Hodgkin's disease: Clinical and pathological evaluation(2006) Altintaş A.; Çil T.; Kaplan M.A.; Atay A.E.; Işikdoğan A.; Büyükbayram H.; Ayyildiz O.Hodgkins' disease accounts 25% of all lymphoid malignancies and 1% of all cancers. In this study, 150 patients with Hodgkins' disease were reviewed retrospectively and compared according to age, gender, histopathologic subtype and stage of disease. 102 (68%) of patients were male and 48 (32%) were female with a median age of 41 (16-73) years. The frequencies of histopathological subtypes, mixed cellularity, nodular sclerosis, lymphocyte-rich and lymphocyte-depletion, were 63 (42%), 37 (24.6%), 25 (16.6%) and 21 (14%), respectively. Histological subtype was not determined in 4 (2.7%) patients. Distribution of patients according to stages were; 18 (12%) patients were in stage I, 35 (23.3%) patients were in stage II, 52 (34.7%) patients were in stage III and 43 (28.7%) patients were in stage IV. Sufficient staging procedure was not performed in two patients. SPSS 11.0 program was used for statistical analyzes. Patients were divided into two groups; older and younger than 40 years age and no statistical significancy was detected between groups. Also there was no significant relation between histopathological subtype and age. In conclusion; Hodgkin disease predominantly seen in males (M/F: 2.1). Mixed celularity HD was the most frequent subtype and 63.7% of our patients were in advanced stage (stage III ve IV).Öğe The predictive role of Paraoxonase 1 (PON1) activity on survival in patients with metastatic and nonmetastatic gastric cancer(Societa Editrice Universo, 2014) Atay A.E.; Kaplan M.A.; Evliyaoglu O.; Ekin N.; Isikdogan A.Background. Oxidative stress is known to be implicated in the pathogenesis of malignancies including gastric cancer (GC). Paraoxonase 1(PON1) is a member of antioxidant defense system which acts by hydrolysing peroxidases. Our aim is to assess the levels PON1 activity in different stages and localizations of GC and analyze the predictive role of PON1 activity on overall survival in GC. Materials and Methods. One hundred and twenty six patients with GC were enrolled to the study. Patients were divided into two groups; group I (nonmetastatic GC, n=65) and group II (metastatic GC, n=61). Paraoxonase 1 activity, albumine and lactate dehidrogenase levels and whole blood count were analyzed. Union Internationale Contre le Cancer system was used for staging procedure. Results. Patients at advanced N or M stage have significantly lower levels of PON1 (34.26 U/L and 29.88 U/L, p=0.04 and p=0.03; respectively). Gender, Lauren's classification, grade, localization and T stage of tumor have nonsignificant impact on PON1 activity. PON1 activity was a significant prognostic factor in GC as well as metastasis, localization of tumor and low hemoglobine or albumine level. Conclusions. Lower levels of paraoxonase 1 activity in patients with metastatic gastric cancer may reflect the presence of enhanced oxidative stress in advanced stages of the disease. PON1 activity is a significant and independent predictor of overall survival. Identifying novel prognostic markers can help to establish appropriate therapeutic strategies, to determine preventive measures and to improve survival rates. © Società Editrice Universo (SEU).Öğe Significance of hormone receptor status in comparison of 18F-FDG-PET/CT and 99mTc-MDP bone scintigraphy for evaluating bone metastases in patients with breast cancer: Single center experience(Asian Pacific Organization for Cancer Prevention, 2015) Teke F.; Teke M.; Inal A.; Kaplan M.A.; Kucukoner M.; Aksu R.; Urakci Z.Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDG-PET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. x statistics were calculated for 18F-FDGPET/CT and BS. The x-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the x-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The x-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the x-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.Öğe Thrombotic thrombocytopenic purpura associated with Graves' disease(2007) Altintaş A.; Çil T.; Ayyildiz O.; Kaplan M.A.; Müftüoğlu E.Thrombotic thrombocytopenic purpura (TTP) is characterized by microangiopathic hemolytic anemia and thrombocytopenia, usually accompanied by fever, renal failure and neurological deficits. TTP usually occurs in previously healthy people, but in a significant number of cases, the syndrome is associated with autoimmune disorders. We report a case of a 53 year old male patient suffering from TTP associated with Graves' disease (GD). After the diagnosis of TTP and Graves' disease plasmapheresis and antithyroid therapy were initiated. After the 15th seans of plasmapheresis, complaints were dissolved and hematologic parameters were recovered. This case draws the reader's attention to a rare condition that TTP associated with GD. Although immune thrombocytopenic purpura (ITP) and pernisious anemia must be initially considered in the event that thrombocytopenia accompanies to GD, TTP is likely in the presence of microangiopathy. The presence of microangiopathic haemolytic anemia and thrombocytopenia is sufficient for the diagnosis of TTP, thus prompt diagnosis and appropriate therapy is crucial for TTP.Öğe The value of micro-ELISA test in the diagnosis of Fasciola hepatica infection.(2013) Kaya M.; Beştaş R.; Çiçek M.; Önder A.; Kaplan M.A.In sero-diagnosis of parasitic infection, it is essential to inspect cross-reactivity between the target parasite and other parasites in order to assess diagnostic performance. The aim of this study was to determine the cut-off value of antibody titer for diagnosis of F. hepatica (FH) infection by using the micro-ELISA and diagnostic performance of this test. The study population consisted of the following groups: FH group (n=42), Echinococcus granulosus (EG) group (n=27) and control group (n=33). The micro-ELISA test for detection of anti-F. hepatica antibody was performed in all groups. The test was positive in all patients with FH, in 3 out of 27 (11%) patients with EG and in none of the control group. Mean antibody titer was significantly higher in the FH group compared to the EG group (23.8 ± 0.9 DU vs. 5.7 ± 1.2 DU; p < 0.001) and compared to the control group (23.8 ± 0.9 DU vs. 2.4 ± 0.2 DU; p < 0.001). When we used 11,5 DU as a cut-off value for sero-diagnosis of FH, the positive predictive value was 93.3%, negative predictive value was 100%, sensitivity was 100%, and specificity was 95%. Cross-reactions are an important issue in serological diagnosis of parasitic infections. The micro-ELISA test for FH antibody can not definitely discriminate fascioliasis from hydatid disease.
