Browsing by Author "Saglican, Yesim"

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5-Hydroxyuracil Incision Activity Varies According to the Histological Grade of Non-muscle-invasive Bladder Cancer
(GALENOS YAYINCILIK, 2021-01-01) Keskin, Selcuk; Antmen, Fatma Merve; Somuncu, Berna; Saglican, Yesim; Doganca, Tunkut; Obek, Can; Ince, Umit; Kural, Ali Riza; Muftuoglu, Meltem
Objective: High levels of endonuclease III-like 1 (NTHL1) DNA glycosylase, which plays a role in the first step of the base excision repair pathway, has been related to cancer initiation and progression. 5-hydroxyuracil (5-OHU) oxidative base damage is a substrate for NTHL1 and endonuclease VIII-like 1 enzyme 1 (NEIL1) DNA glycosylases. This study investigates the association of 5-OHU incision activity with the risk of disease progression in patients with non-muscle-invasive bladder cancer (NMIBC) regarding grade and stage. Materials and Methods: During transurethral resection of 17 NMIBC patients, the papillary tumour before monopolar resection and healthy bladder mucosal tissue from the same person were obtained using cold cup biopsy. Both the normal mucosa and NMIBC tumour were pathologically confirmed. The histological grade and stage were also determined. The 5-OHU incision activity of all tissues was measured using a radiolabelled 5-OHU modified base containing DNA substrate. Results: 5-OHU incision activity was significantly higher in all high-grade NMIBC tissue extracts compared with the corresponding normal tissues (p=0.001). However, we found no significant difference in 5-OHU incision activity in low-grade NMIBC tissues (p=0.89). There was also a significant increase in 5-OHU incision activity at the Ta/T1 stage compared with the corresponding normal tissue (p=0.001). Conclusion: The increase in 5-OHU incision activity according to the histological grade of NMIBC tissue indicates that this activity (mainly performed by NTHL1 and NEIL1 DNA glycosylases) might play a role in NMIBC prognosis. Thus, it could be used as a potential prognostic biomarker for NMIBC.
A Comparative Study of Multiparametric MRI Sequences in Measuring Prostate Cancer Index Lesion Volume
(UBIQUITY PRESS LTD, 2022-01-01) Bagcilar, Omer; Alis, Deniz; Seker, Mustafa; Erdemli, Servet; Karaarslan, Umut; Kus, Aylin; Kayhan, Cavit; Saglican, Yesim; Kural, Ali; Karaarslan, Ercan
Objectives: To compare the effectiveness of individual multiparametric prostate MRI (mpMRI) sequences-T2W, diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC), and dynamic contrast-enhanced (DCE)-in assessing prostate cancer (PCa) index lesion volume using whole-mount pathology as the ground-truth
Association of B7-H4 gene polymorphisms in urothelial bladder cancer
(TUBITAK SCIENTIFIC \& TECHNICAL RESEARCH COUNCIL TURKEY, 2017-01-01) Ozgoz, Asuman; Samli, Murat; Dincel, Deniz; Sahin, Ahmet; Ince, Umit; Saglican, Yesim; Balci, Faruk; Samli, Hale
Background/aim: We aimed to study polymorphisms of the B7-H4 gene in order to evaluate a possible association in urothelial carcinoma, as it is highly expressed in cancer tissues. Materials and methods: In this study B7-H4 gene rs10754339, rs10801935, and rs3738414 SNPs were studied by PCR-RFLP method in paraffin-embedded tumor specimens from 62 urothelial carcinoma patients and in a control group including 30 patients without bladder cancer. Results: We detected that the rs10754339 polymorphism was more frequent in the cancer patients when compared with the control group (P < 0.05). Only the rs3738414 polymorphism showed a statistically significant difference in frequency between pathologic diagnostic groups. Conclusion: The rs10754339 AA genotype distribution was found to have a higher frequency whereas the rs3738414 AG genotype distribution was lower in the bladder cancer group (P < 0.05). None of the genotype distributions showed a significant difference from the control group for the rs10801935 polymorphism. We conclude that B7-H4 has the potential to be a useful prognostic marker in urothelial carcinoma.
Bilateral renal cell carcinoma with leiomyomatous stroma: A rare entity diagnosed synchronously and treated surgically in a staged fashion
(AVES, 2017-01-01) Kiremit, Murat Can; Acar, Omer; Saglican, Yesim; Esen, Tarik
Renal cell carcinoma (RCC) accounts for approximately 3\% of adult malignancies and 90-95\% of kidney neoplasms. Renal cell carcinoma with leiomyomatous stroma (RCCLS) is an extremely rare histopathological entity based on available literature data. Herein, we report a 31-year-old male with incidentally detected synchronous bilateral renal masses who was eventually found to harbor RCCLS after being operated sequentially via nephron-sparing surgery.
BRAF(V600E) Mutation: Has It a Role in Cervical Lymph Node Metastasis of Papillary Thyroid Cancer?
(KARGER, 2016-01-01) Kurtulmus, Neslihan; Ertas, Burak; Saglican, Yesim; Kaya, Hakan; Ince, Umit; Duren, Mete
Background: The BRAF(V600E) mutation is common in papillary thyroid cancer (PTC). Lymph node metastasis (LNM) may be associated with poor prognosis. However, the LNM mechanism remains unclear. Objectives: Our aim was to evaluate the prevalence of the BRAF(V600E) mutation in primary tumors and accompanying LNM at the time of diagnosis. Methods: This retrospective study included 51 PTC patients (40 women, 11 men
Comparison of the trifecta outcomes of robotic and open nephron-sparing surgeries performed in the robotic era of a single institution
(SPRINGER INTERNATIONAL PUBLISHING AG, 2015-01-01) Acar, Omer; Isik, Esin Ozturk; Mut, Tuna; Saglican, Yesim; Onay, Aslihan; Vural, Metin; Musaoglu, Ahmet; Esen, Tarik
Purpose: In this study we aimed to report a comparative analysis between open and robotic nephron sparing surgeries (NSS) from a single institutional database. Methods: Patients who have undergone NSS during the robotic era of our institution were included in this study. Open (n = 74) and robotic (n = 59) groups were compared regarding trifecta outcome. Trifecta was defined as
Comparison of the trifecta outcomes of robotic and open nephron-sparing surgeries performed in the robotic era of a single institution (vol 4, 472, 2015)
(SPRINGER INTERNATIONAL PUBLISHING AG, 2015-01-01) Acar, Omer; Ozturk-Isik, Esin; Mut, Tuna; Saglican, Yesim; Onay, Aslihan; Vural, Metin; Musaoglu, Ahmet; Esen, Tarik
Conspicuity of Peripheral Zone Prostate Cancer on Computed Diffusion-Weighted Imaging: Comparison of cDWI(1500), cDWI(2000), and cDWI(3000)
(HINDAWI LTD, 2014-01-01) Vural, Metin; Ertas, Gokhan; Onay, Aslihan; Acar, Omer; Esen, Tarik; Saglican, Yesim; Zengingonul, Hale Pinar; Akpek, Sergin
Introduction and Objective. Disadvantages associated with direct high b-value measurements may be avoided with use of computed diffusion-weighted imaging (cDWI). The purpose of this study is to assess the diagnostic performance of cDWI image sets calculated for high b-values of 1500, 2000, and 3000 s/mm(2). Materials and Methods. Twenty-eight patients who underwent multiparametric MRI of the prostate and radical prostatectomy consecutively were enrolled in this retrospective study. Using a software developed at our institute, cDWI 1500, cDWI 2000, and cDWI 3000 image sets were generated by fitting a monoexponential model. Index lesions on cDWI image sets were scored by two radiologists in consensus considering lesion conspicuity, suppression of background prostate tissue, distortion, image set preferability, and contrast ratio measurements were performed. Results. Lesion detection rates are the same for computed b-values of 2000 and 3000 s/ mm 2 and are better than b-values of 1500 s/ mm(2). Best lesion conspicuity and best background prostate tissue suppression are provided by cDWI(3000) image set. cDWI(2000) image set provides the best zonal anatomical delineation and less distortion and was chosen as the most preferred image set. Average contrast ratio measured on these image sets shows almost a linear relation with the b-values. Conclusion. cDWI 2000 image set with similar conspicuity and the same lesion detection rate, but better zonal anatomical delineation, and less distortion, was chosen as the preferable image set.
Evaluation of Peripheral Zone Prostate Cancer Aggressiveness Using the Ratio of Diffusion Tensor Imaging Measures
(WILEY-HINDAWI, 2017-01-01) Onay, Aslihan; Ertas, Gokhan; Vural, Metin; Acar, Omer; Saglican, Yesim; Coskun, Bilgen; Akpek, Sergin
Purpose. To evaluate the aggressiveness of peripheral zone prostate cancer by correlating the Gleason score (GS) with the ratio of the diffusion tensor imaging (DTI) measures. Materials and Methods. Forty-two peripheral zone prostate tumors were imaged using DTI. Regions of interest focusing on the center of tumor foci and noncancerous tissue were used to extract statistical measures of mean diffusivity (MD) and fractional anisotroy (FA). Measure ratio was calculated by dividing tumor measure by noncancerous tissue measure. Results. Strong correlations are observable between GS and MD measures while weak correlations are present between GS and FA measures. Minimum tumor MD (MDmin) and the ratio of minimum MD (rMD(min)) show the same highest correlation with GS (both rho = -0.73). Between GS <= 7 (3 + 4) and GS >= 7 (4 + 3), differences are significant for all MD measures but for some FA measures. MD measures perform better than FA measures in discriminating GS >= 7 (4 + 3). Conclusion. Ratios of MD measures can be used in evaluation of peripheral zone prostate cancer aggressiveness
HER2/neu Status in Breast Cancer Specimens: Comparison of Immunohistochemistry (IHC) and Fluorescence in situ Hybridization (FISH) Methods
(SOC CHILENA ANATOMIA, 2015-01-01) Saglican, Yesim; Ince, Umit
HER2 amplification or overexpression is considered as disease outcome and a predictive marker of response to treatment in breast cancer. The present study aimed to compare the results of IHC and FISH for determining HER2 and to search the interpretational differences. Samples (n= 169), of which 31 were the paraffin blocks sent from outer centers, that underwent FISH analysis for HER-2 were included. Samples were re-reviewed by IHC in our laboratory. FISH test was negative in 131 (77.5\%) and positive in 38 (22.5\%). When those with previous IHC 0-1+ were re-reviewed, the results were found again 0-1+ and none of them was FISH positive. Inconsistency between re-reviewed IHC and previous IHC results was 25\% for those with 2+ score and 11\% for those with 3+ score. Consistency between IHC and FISH was 17\% and 67\% for previous IHC 2+ and 3+, respectively, whereas it was 23\% and \%75 for re-reviewed IHC 2+ and 3+, respectively. Whilst 79\% of the samples evaluated as 2+ by the inexperienced pathologist were found to be 0-1+ on the re-review, all of them were FISH negative. According to our results, we suggest that samples with IHC 2+ should be re-reviewed by consulting with an experienced pathologist.
Isolated omental metastasis of renal cell carcinoma after extraperitoneal open partial nephrectomy: A case report
(ELSEVIER SCI LTD, 2016-01-01) Acar, Omer; Mut, Tuna; Saglican, Yesim; Sag, Alan Alper; Falay, Okan; Selcukbiricik, Fatih; Tabak, Levent; Esen, Tarik
INTRODUCTION: Metachronous metastatic spread of clinically localized renal cell carcinoma (RCC) affects almost 1/3 of the patients. They occur most frequently in lung, liver, bone and brain. Isolated omental metastasis of RCC has not been reported so far. CASE PRESENTATION: A 62-year-old patient previously diagnosed and treated due to pulmonary sarcoidosis has developed an omental metastatic lesion 13 years after having undergone open extraperitoneal partial nephrectomy for T1 clear-cell RCC. Constitutional symptoms and imaging findings that were attributed to the presence of a sarcomatoid paraneoplastic syndrome triggered by the development this metastatic focus complicated the diagnostic work-up. Biopsy of the {[}18F]-fluorodeoxyglucose (+) lesions confirmed the diagnosis of metastatic RCC and the patient was managed by the resection of the omental mass via near-total omentectomy followed by targeted therapy with a tyrosine kinase inhibitor. DISCUSSION: Late recurrence of RCC has been reported to occur in 10-20\% of the patients within 20 years. Therefore lifelong follow up of RCC has been advocated by some authors. Diffuse peritoneal metastases have been reported in certain RCC subtypes with adverse histopathological features. However, isolated omental metastasis without any sign of peritoneal involvement is an extremely rare condition. CONCLUSION: To our knowledge, this is the first reported case of metachronously developed, isolated omental metastasis of an initially T1 clear-cell RCC. Constitutional symptoms, despite a long interval since nephrectomy, should raise the possibility of a paraneoplastic syndrome being associated with metastatic RCC. Morphological and molecular imaging studies together with histopathological documentation will be diagnostic. (C) 2016 The Authors. Published by Elsevier Ltd. on behalf of IJS Publishing Group Ltd.
Multicenter Multireader Evaluation of an Artificial Intelligence-Based Attention Mapping System for the Detection of Prostate Cancer With Multiparametric MRI
(AMER ROENTGEN RAY SOC, 2020-01-01) Mehralivand, Sherif; Harmon, Stephanie A.; Shih, Joanna H.; Smith, Clayton P.; Lay, Nathan; Argun, Burak; Bednarova, Sandra; Baroni, Ronaldo Hueb; Canda, Abdullah Erdem; Ercan, Karabekir; Girometti, Rossano; Karaarslan, Ercan; Kural, Ali Riza; Pursyko, Andrei S.; Rais-Bahrami, Soroush; Tonso, Victor Martins; Magi-Galluzzi, Cristina; Gordetsky, Jennifer B.; Silvestre e Silva Macarenco, Ricardo; Merino, Maria J.; Gumuskaya, Berrak; Saglican, Yesim; Sioletic, Stefano; Warren, Anne Y.; Barrett, Tristan; Bittencourt, Leonardo; Coskun, Mehmet; Knauss, Chris; Law, Yan Mee; Malayeri, Ashkan A.; Margolis, Daniel J.; Marko, Jamie; Yakar, Derya; Wood, Bradford J.; Pinto, Peter A.; Choyke, Peter L.; Summers, Ronald M.; Turkbey, Baris
OBJECTIVE. The purpose of this study was to evaluate in a multicenter dataset the performance of an artificial intelligence (AI) detection system with attention mapping compared with multiparametric MRI (mpMRI) interpretation in the detection of prostate cancer. MATERIALS AND METHODS. MRI examinations from five institutions were included in this study and were evaluated by nine readers. In the first round, readers evaluated mpMRI studies using the Prostate Imaging Reporting and Data System version 2. After 4 weeks, images were again presented to readers along with the AI-based detection system output. Readers accepted or rejected lesions within four AI-generated attention map boxes. Additional lesions outside of boxes were excluded from detection and categorization. The performances of readers using the mpMRI-only and AI-assisted approaches were compared. RESULTS. The study population included 152 case patients and 84 control patients with 274 pathologically proven cancer lesions. The lesion-based AUC was 74.9\% for MRI and 77.5\% for AI with no significant difference (p = 0.095). The sensitivity for overall detection of cancer lesions was higher for AI than for mpMRI but did not reach statistical significance (57.4\% vs 53.6\%, p = 0.073). However, for transition zone lesions, sensitivity was higher for AI than for MRI (61.8\% vs 50.8\%, p = 0.001). Reading time was longer for AI than for MRI (4.66 vs 4.03 minutes, p < 0.001). There was moderate interreader agreement for AI and MRI with no significant difference (58.7\% vs 58.5\%, p = 0.966). CONCLUSION. Overall sensitivity was only minimally improved by use of the AI system. Significant improvement was achieved, however, in the detection of transition zone lesions with use of the AI system at the cost of a mean of 40 seconds of additional reading time.
Multiparametric MRI guidance in first-time prostate biopsies: what is the real benefit?
(TURKISH SOC RADIOLOGY, 2015-01-01) Acar, Omer; Esen, Tarik; Colakoglu, Bulent; Vural, Metin; Onay, Aslihan; Saglican, Yesim; Tuerkbey, Baris; Rozanes, Izzet
PURPOSE With the increased recognition of the capabilities of prostate multiparametric (mp) magnetic resonance imaging (MRI), attempts are being made to incorporate MRI into routine prostate biopsies. In this study, we aimed to analyze the diagnostic yield via cognitive fusion, transrectal ultrasound (TRUS)-guided, and in-bore MRI-guided biopsies in biopsy-naive patients with positive findings for prostate cancer screening. METHODS Charts of 140 patients, who underwent transrectal prostate biopsy after the adaptation of mp-MRI into our routine clinical practice, were reviewed retrospectively. Patients with previous negative biopsies (n=24) and digital rectal examination findings suspicious for >= cT3 prostate cancer (n=16) were excluded. T2-weighted imaging, diffusion-weighted imaging, and dynamic contrast-enhanced imaging were included in mp-MRI. Cognitive fusion biopsies were performed after a review of mp-MRI data, whereas TRUS-guided biopsies were performed blinded to MRI information. In-bore biopsies were conducted by means of real-time targeting under MRI guidance. RESULTS Between January 2012 and February 2014, a total of 100 patients fulfilling the inclusion criteria underwent TRUS-guided (n=37), cognitive fusion (n=49), and in-bore (n=14) biopsies. Mean age, serum prostate specific antigen level, and prostate size did not differ significantly among the study groups. In TRUS-guided biopsy group, 51.3\% were diagnosed with prostate cancer, while the same ratio was 55.1\% and 71.4\% in cognitive fusion and in-bore biopsy groups, respectively (P = 0.429). Clinically significant prostate cancer detection rate was 69.1\%, 70.3\%, and 90\% in TRUS-guided, cognitive fusion, and in-bore biopsy groups, respectively (P = 0.31). According to histopathologic variables in the prostatectomy specimen, significant prostate cancer was detected in 85.7\%, 93.3\%, and 100\% of patients in TRUS-guided, cognitive fusion, and in-bore biopsy groups, respectively. CONCLUSION In the first set of transrectal prostate biopsies, mp-MRI guidance did not increase the diagnostic yield significantly.
Non-muscle invasive bladder cancer tissues have increased base excision repair capacity
(NATURE PORTFOLIO, 2020-01-01) Somuncu, Berna; Keskin, Selcuk; Antmen, Fatma Merve; Saglican, Yesim; Ekmekcioglu, Aysegul; Ertuzun, Tugce; Tuna, Mustafa Bilal; Obek, Can; Wilson, David M.; Ince, Umit; Kural, Ali Riza; Muftuoglu, Meltem
The molecular mechanisms underlying the development and progression of bladder cancer (BC) are complex and have not been fully elucidated. Alterations in base excision repair (BER) capacity, one of several DNA repair mechanisms assigned to preserving genome integrity, have been reported to influence cancer susceptibility, recurrence, and progression, as well as responses to chemotherapy and radiotherapy. We report herein that non-muscle invasive BC (NMIBC) tissues exhibit increased uracil incision, abasic endonuclease and gap-filling activities, as well as total BER capacity in comparison to normal bladder tissue from the same patient (p<0.05). No significant difference was detected in 8-oxoG incision activity between cancer and normal tissues. NMIBC tissues have elevated protein levels of uracil DNA glycosylase, 8-oxoguanine DNA glycosylase, AP endonuclease 1 and DNA polymerase beta protein. Moreover, the fold increase in total BER and the individual BER enzyme activities were greater in high-grade tissues than in low-grade NMIBC tissues. These findings suggest that enhanced BER activity may play a role in the etiology of NMIBC and that BER proteins could serve as biomarkers in disease prognosis, progression or response to genotoxic therapeutics, such as Bacillus Calmette-Guerin.
The Comparison of Conventional and Retzius-Sparing Robot-Assisted Radical Prostatectomy for Clinical, Pathological, and Oncological Outcomes
(GALENOS YAYINCILIK, 2022-01-01) Karsiyakali, Nejdet; Ozgen, Mahir Bulent; Ozveren, Bora; Durak, Haydar; Saglican, Yesim; Turkeri, Levent
Objective: This study aimed to assess and compare the conventional and Retzius-sparing robot-assisted radical prostatectomy (cRARP and RsRARP) in term of perioperative clinical, pathological, and oncological outcomes. Materials and Methods: This study included 238 consecutive male patients who underwent RARP between May 2008 and November 2020. RARP operations were performed by a single-surgeon. Patients were divided into groups according to the surgical approach and were statistically compared in terms of perioperative clinical, final pathological, and oncological outcomes. Results: The mean age of patients was 64 +/- 7 years. cRARP was performed in 134 (56.3\%) patients, whereas RsRARP in 104 (43.7\%). The frequency of patients with the American Society of Anesthesiologists Class-2 score was higher in the RsRARP group (p<0.001). The median surgery duration was 300 (270-360) min. The median surgery duration was shorter in RsRARP group (290 vs. 330 minute) (p<0.001). No difference was found between the groups in terms of estimated blood loss and postoperative complication rates (p=0.112 and p=0.182, respectively). No difference was found between the groups when they were compared for surgical margin positivity (p=0.453). Although not statistically significant, the frequency of surgical margin positivity with pT3a/pT3b disease was higher in patients who underwent cRARP (p=0.412 and p=0.261, respectively). At a median follow-up of 13 (6-36) months, no difference was found between the groups in terms of biochemical recurrence at months-3,-6,-9,-12,-18,-24, and-30, respectively (p>0.05, for each). Conclusion: RsRARP allows a safe operation with a shorter surgical time and similar surgical margin positivity, oncological outcomes, and complication rates compared to cRARP.
The first recurrent intravascular papillary endothelial hyperplasia (Masson's tumor) of the kidney
(AVES, 2016-01-01) Alkan, Erdal; Saglican, Yesim; Ozkanli, Ahmet Oguz; Balbay, Mevlana Derya
Intravascular papillary endothelial hyperplasia (IPEH, Masson's Tumor) of the kidney is an unusual, benign vascular lesion. A rare case of recurrent IPEH in the kidney was presented in this article. A 50-year-old male with a diagnosis of a suspicious mass in the left kidney was referred to our center for robotic partial nephrectomy. Robotic zero ischemia partial nephrectomy was performed due to the suspicion of a renal malignancy. On the basis of the histopathological results, the patient was diagnosed as IPEH. A urinary ultrasound was performed on the 3rd postoperative month and a hyper echoic solid lesion, which was in the same localization, was detected. Due to the previous atypical pathological result, computed tomography (CT) guided fine-needle aspiration biopsy from the left renal mass was performed but malignant cytology was not confirmed with this biopsy. On follow-up CT done 6 months later, a persistent suspicious left renal mass, measuring 40 x 30 cm in size was detected with no change in its dimensions and appearance. Additionally, magnetic resonance imaging (MRI) scan revealed a bone lesion of 15 x 10 mm in the left hip, which was not present on previous MRI/CT scans. In view of the solid masses in the left kidney, and left hip on CT and MRI scan suspicious for a probably metastatic renal neoplasm, left radical nephrectomy via a left subcostal transperitoneal incision was performed. The ultimate pathological report of the patient was also supported the diagnosis of Masson's tumor and any renal malignancy was not encountered The patient was discharged on the 4th postoperative day and has been followed up for 4 months without any problems. In this case, we discuss the clinical features, histopathological characteristics, and the management of Masson's tumor of the kidney in the light of the current literature.