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    Association between IL28B gene polymorphism (rs12979860) and sustained virological response in patients infected with hepatitis C virus Genotype 1
    (Wiley-Blackwell, 2012) Akkiz, Hikmet; Sezgin, Orhan; Altintas, Engin; Yalcin, Kendal; Ekin, Nazim; Uskudar, Oguz; Sandikci, Macit U.
    [Abstract Not Available]
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    C-Reactive Protein and Platelet-Lymphocyte Ratio as Potential Tumor Markers in Low-Alpha-Fetoprotein Hepatocellular Carcinoma
    (Karger, 2019) Suner, Asli; Carr, Brian I.; Akkiz, Hikmet; Karakulah, Gokhan; Uskudar, Oguz; Yalcin, Kendal; Kuran, Sedef
    The hepatocellular carcinoma (HCC) tumor marker alpha-fetoprotein (AFP) is only elevated in about half of the HCC patients, limiting its usefulness in following the effects of therapy or screening. New markers are needed. It has been previously noted that the inflammation markers C-reactive protein (CRP) and platelet-lymphocyte ratio (PLR) are prognostically important and may reflect HCC aggressiveness. We therefore examined these 2 markers in a low-AFP HCC cohort and found that for HCCs > 2 cm, both markers significantly rise with an increasing maximum tumor diameter (MTD). We calculated the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Youden index value for each marker, and their area-under-the-curve values for each MTD group. Patients were dichotomized into 2 groups based on the CRP and PLR from the receiver-operating characteristic curve analysis. In the logistic regression models of the 4 different MTD patient groups, CRP and PLR levels were statistically significant to estimate MTD in univariate logistic regression models of MTD groups > 2 cm. CRP and PLR were then combined, and the combination was statistically significant to estimate MTD groups of 3-, 4-, and 5-cm cutoffs. CRP and PLR thus have potential as tumor markers for low-AFP HCC patients, and possibly for screening. (C) 2018 S. Karger AG, Basel
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    Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients
    (Karger, 2018) Akkiz, Hikmet; Carr, Brian I.; Yalcin, Kendal K.; Guerra, Vito; Kuran, Sedef; Altintas, Engin; Uskudar, Oguz
    A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and alpha-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large >= 5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar >= 5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels <= 100 IU/mL ( and 42.1% had values <= 20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups. (C) 2017 S. Karger AG, Basel