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Incidental Collision Tumor of Hepatocellular Carcinoma and Neuroendocrine Carcinoma

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Journal of Clinical and Translational Hepatology 2018年第3期6卷 339-344页

作者： Düriye Betül Yilmaz Zeynep Bayramoglu gülsah Ünay Erdem Ayik Cumhur Ibrahim Bassorgun gülsüm ozlem elpek Department of Pathology Akdeniz University Medical SchoolKonyaalti/AntalyaTurkey

The composite tumors of the liver are very rare,including the coexistence of HCC(hepatocellular carcinoma)with NEC(neuroendocrine carcinoma).The rare occurrence of these tumors necessitates more reported cases in order to fully understand their clinical characteristics,behaviors and *** is described an incidental collision tumor of HCC-NEC,along with a review of the literature focusing on their clinicopathological findings and *** tumor presented here was found incidentally in the hepatectomy specimen of a 56-yearold man who had undergone liver transplantation for rapidly progressive liver failure because of alcoholic hepatitis and *** and laboratory examinations did not demonstrate tumor-related *** macroscopic examination,two sharply defined and distinctive areas(1.7 cm and 0.6 cm dimension respectively)were detected among the cirrhotic *** characteristic histopathological features and immunohistochemical findings allowed a diagnosis of HCCNEC to be *** was no evidence of recurrence and metastasis after 10months following *** present case and review revealed that these tumors are frequently found in older ages and *** serum markers are valuable in the discrimination of malignant tumors,their absence cannot completely rule out composite *** requires a comprehensive histopathological evaluation together with *** NEC component might influence the treatment strategy and eventually the outcome of the *** conclusion,the rare occurrence of HCC-NEC and the lack of diagnostic clinical signs and symptoms do not exclude their consideration in the differential diagnosis of liver tumors,especially in patients with the chronic liver disease.

关键词： Liver neoplasm Hepatocel ular carcinoma Neuroendocrine carcinoma

Prognostic significance of tumor budding,desmoplastic reaction,and lymphocytic infiltration in patients with gastric adenocarcinoma

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World Journal of gastrointestinal Pathophysiology 2024年第1期15卷 9-25页

作者： Aysen Yavuz Kubra Simsek Anil Alpsoy Busra Altunay Elif Ocak gedik Betul Unal Cumhur Ibrahim Bassorgun Ali murat Tatli gulsum ozlem elpek Department of Pathology Akdeniz University Medical SchoolAntalya 07070Türkiye Department of medical Oncology Akdeniz University Medical SchoolAntalya 07070Türkiye

BACKgROUND Recent studies have shown that the tumor microenvironment significantly influences the behavior of solid *** this context,Accumulated data suggests that pathological evaluation of tumor budding(TB),desmoplastic reaction(DR),and tumor-infiltrating lymphocytes(TIls)may be crucial in determining tumor behavior in the gastrointestinal *** gastric adenocarcinoma(gAC),although some results suggest that TB and TIls may be effective in determining the course of the disease,the data do not ***,very few studies have investigated the relationship between DR and *** present,the associations between tumor TB,DR and TIls in gAC patients have not been *** To establish the relationships between TB,DR,and TIls in patients with gAC and to assess their influence on *** Our study group comprised 130 patients diagnosed with *** definition of TB was established based on the International TB Consensus *** DR was categorized into three groups according to the level of tumor stroma *** assessment of TIls was conducted using a semiquantitative approach,employing a cutoff value of 5%.The statistical analysis of the whole group and 100 patients with an intestinal subtype of gAC was performed using SPSS version *** A significant correlation between peritumoral budding(PTB)and intratumoral budding(ITB)was noted(r=0.943).Tumors with high PTBs and ITBs had a greater incidence of immature DRs and low TIls(Pgical subtype,lymph node metastasis(LNm),and stage(Pm,DR,and stage were significant risk factors associated with poor *** multivariate Cox regression analysis identified ITB,PTB,and LNm as independent prognostic variables(Pmas,a positive correlation between PTB and ITB was noted(r=0.972).While univariate analysis revealed that LNm,stage,PTB,ITB,and DR were strong parameters for pred

关键词： gastric cancer Tumor budding Desmoplastic stroma Tumor-infiltrating lymphocytes Prognosis

Is sarcopenia effective on survival in patients with metastatic gastric cancer?

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World Journal of gastrointestinal Oncology 2024年第5期16卷 1861-1868页

作者： ozlem Dogan Hayriye Sahinli Yakup Duzkopru Tuba Akdag Abdulkadir Kocanoglu Department of medical Oncology Adıyaman University Training and Research HospitalAdiyaman 02100Turkey Department of medical Oncology Ankara Etlik City HospitalAnkara 06170Turkey Department of Radiology University of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkara 06000Turkey Department of medical Oncology Ankara Ataturk Sanatoryum Training and Research HospitalAnkara 06170Turkey

BACKgROUND Sarcopenia is a progressively diminishing state characterized by the reduction of muscle mass and density,which is frequently observed in malignancies of solid *** To assess how sarcopenia affects the overall survival of individuals who have been diagnosed with metastatic gastric *** The study retrospectively included individuals who had been diagnosed with metastatic gastric cancer between January 2008 and December *** was identified through the calculation of the average Hounsfield units(HUAC)using computed tomography(CT)images taken at the time of diagnosis in *** A total of 118 patients with metastatic gastric cancer were *** was detected in 29 patients(24.6%).The median survival of all patients was 8(1-43)*** median survival of patients with sarcopenia was 2 mo,while it was 10 mo for those without sarcopenia(Pgnificant relationship was found between sarcopenia and *** Sarcopenia has been observed to impact survival outcomes in various types of solid tumor *** patients can be identified in a short time,easily and inexpensively,by HUAC measurements from CT images used for diagnosis,and survival could be promoted with nutritional support.

关键词： Hounsfield units Sarcopenia gastric cancer Survival Psoas muscle mass muscle density

mixed neuroendocrine–nonneuroendocrine neoplasms of the gastrointestinal system:An update

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World Journal of gastroenterology 2022年第8期28卷 794-810页

作者： gulsum ozlem elpek Pathology Akdeniz University Medical SchoolAntalya 07070Turkey

mixed neuroendocrine-nonneuroendocrine neoplasms(mi NENs)of the digestive tract are a rare heterogeneous group of tumors that present many challenges in terms of diagnosis and *** the years,the diagnostic criteria,classification,and clinical behavior of these tumors have been the subjects of ongoing debate,and the various changes in their nomenclature have strengthened the challenges associated with mi *** review is performed to provide an understanding of the key factors involved in the evolution of the designation of these tumors as mi NEN,highlight the current diagnostic criteria,summarize the latest data on pathogenesis and provide information on available ***,this work seeks to increase the awareness about these rare neoplasms by presenting the clinicopathological features and prognostic factors that play important roles in their behavior and discussing their different regions of origin in the gastrointestinal system(gIS).Currently,the mi NEN category also includes tumors in the gIS with a nonneuroendocrine component and epithelial tumors other than adenocarcinoma,depending on the organ of *** is based on the presence of both morphological components in more than 30%of the ***,this value needs to be reconfirmed with further studies and may be a limiting factor in the diagnosis of mi NEN by ***,available clinicopathological data suggest that the inclusion of amphicrine tumors in the definition of mi NEN is not supportive and warrants further *** diagnosis of these tumors is not solely based on immunohistochemical *** are not hybrid tumors and both components can act independently;thus,careful grading of each component separately is *** addition to parameters such as the metastatic state of the tumor at the time of diagnosis and the feasibility of surgical resection,the aggressive potential of both components has paramount importance in the choice of treatment.R

关键词： mixed neuroendocrine–nonneuroendocrine neoplasms mixed adeno neuroendocrine carcinoma gastrointestinal system Liver Pancreas gallbladder

Distribution of transient receptor potential vanilloid-1 channels in gastrointestinal tract of patients with morbid obesity

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World Journal of Clinical Cases 2022年第1期10卷 79-90页

作者： Unal Atas Nuray Erin gokhan Tazegul gulsum ozlem elpek Bülent Yıldırım Department of Internal medicine Akdeniz University Medical SchoolAntalya 07070Turkey Department of Pharmacology Akdeniz University Medical SchoolAntalya 07070Turkey Department of Pathology Akdeniz University Medical SchoolAntalya 07070Turkey Department of gastroenterology Akdeniz University Medical SchoolAntalya 07070Turkey

BACKgROUND Transient receptor potential vanilloid-1(TRPV1),a nonselective cation channel,is activated by capsaicin,a pungent ingredient of hot *** studies have suggested a link between obesity and capsaicin-associated pathways,and activation of TRPV1 may provide an alternative approach for obesity ***,data on the TRPV1 distribution in human gastric mucosa are limited,and the degree of TRPV1 distribution in the gastric and duodenal mucosal cells of obese people in comparison with normal-weight individuals is *** To clarify gastric and duodenal mucosal expression of TRPV1 in humans and compare TRPV1 expression in obese and healthy *** Forty-six patients with a body mass index(BmI)of>40 kg/m^(2) and 20 patients with a BmI between 18-25 kg/m^(2) were *** biopsies from the fundus,antrum,and duodenum tissues were obtained from subjects between the ages of 18 and 65 who underwent ***,sex,history of alcohol and cigarette consumption,and past medical history regarding chronic diseases and medications were accessed from patient charts and were analyzed *** with anti-TRPV1 antibody was performed separately according to cell types in the fundus,antrum,and duodenum tissues using an immunoreactivity *** were analyzed using SPSS *** TRPV1 expression was higher in the stomach than in the duodenum and was predominantly found in parietal and chief cells of the fundus and mucous and foveolar cells of the *** foveolar cells in the antrum,TRPV1 was relatively low in foveolar cells in the fundus(4.92±0.49 vs 0.48±0.16,Pmann-Whitney U test).Additionally,the mucous cells in the duodenum also had low levels of TRPV1 compared to mucous cells in the antrum(1.33±0.31 vs 2.95±0.46,Pmann-Whitney U test).TRPV1 expression levels of different cell types in the fundus,antrum,and duodenum tissues of the morbidly obese group were similar to those of th

关键词： Capsaicin Transient receptor potential vanilloid 1 Immunohistochemistry morbid obesity Obesity Transient receptor potential channels Transient receptor potential vanilloid cation channels

Assessment of the potential interactions between favipiravir and radiocontrast agents

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World Journal of Radiology 2024年第5期16卷 128-135页

作者： Sonay Aydin ozlem Celik Aydin mesut Furkan Yazar Huseyin Aydemir mecit Kantarci Sureyya Barun Department of Radiology Erzincan Binali Yıldırım UniversityFaculty of MedicineErzincan 24100Türkiye Department of Pharmacology Gazi UniversityFaculty of MedicineErzincan 24100Türkiye Department of Radiology Bilecik Education and Reseach HospitalBilecik 11230Türkiye Department of Radiology Atatürk UniversityFaculty of MedicineErzurum 25030Türkiye

BACKgROUND In cases of coronavirus disease 2019(COVID-19),favipiravir is commonly included to the therapy *** interactions between favipiravir and other COVID-19 therapy drugs are frequently ***,no research on possible drug interactions between Favipiravir and radiocontrast agents,which have become almost crucial in diagnostic processes while not being part of the treatment,has been *** To determine potential medication interactions between Favipiravir and radiocontrast *** The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography(CT)or magnetic resonance imaging(mRI)test while taking the *** computerized patient files of the cases included in the study,as well as the pharmacovigilance forms in the designated hospital,were evaluated for this *** The study included the evaluation of data from 1046 *** study sample's mean age was 47.23±9.48 *** mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions(P=0.003).When evaluated with logistic regression analysis,a 1-year raises in age increases the risk of developing drug interactions by 1.63 times(P=0.023).There was no statistically significant difference in the occurrence of medication interactions between the sexes(P=0.090).Possible medication interactions were discovered in 42 cases(4%).CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values,as well as an increase in the frequency of nausea and *** majority of drug interactions discovered were modest enough that they were not reflected in the *** interactions become more common as people get older.

关键词： Favipiravir Iohexol gadoxetic acid meglumine gadoterate Drug interactions

Correlation of hepatitis B surface antigen expression with clinicopathological and biochemical parameters in liver biopsies: A comprehensive study

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World Journal of Hepatology 2022年第1期14卷 260-273页

作者： Anil Alpsoy Haydar Adanir Zeynep Bayramoglu gulsum ozlem elpek Department of Pathology Akdeniz UniversityMedical SchoolAntalya 07070Turkey Department of gastroenterology Akdeniz UniversityMedical SchoolAntalya 07070Turkey

BACKgROUND Chronic viral B hepatitis(CHB)is a potentially life-threatening liver disease that may progress to liver failure and ***,although combinations of different laboratory methods are used in the follow-up and treatment of CHB,the failure of these procedures in some cases has led to the necessity of developing new *** CHB,the intrahepatic expression pattern of viral antigens,including hepatitis B surface antigen(HBsAg),is related to different phases of ***,many studies have focused on the intracytoplasmic properties of HBsAg staining,and HBsAg positivity in liver tissue has not been evaluated by objective quantitative *** To investigate the relationship of image analysis-based quantitative HBsAg expression and its staining patterns with clinicopathological factors and treatment in *** A total of 140 liver biopsies from treatment-naïve cases with CHB infection were included in this *** diagnosis,all patients were treated with entecavir(0.5 mg)and followed up at three-month *** percentage of immunohistochemical HBsAg(p-HBsAg)expression in the liver was determined in whole tissue sections of biopsies from each case by image *** immunohistochemical staining pattern was also evaluated separately according to 3 different previously defined *** A positive correlation between p-HBsAg and serum levels of hepatitis B virus(HBV)DNA and HBsAg was observed(Pg value was significantly higher in younger patients than in older *** the groups were categorized according to the hepatitis B e antigen(HBeAg)status in HBeAgpositive cases,p-HBsAg was correlated with HBV DNA,hepatitis activity index(HAI)and fibrosis scores(Pgroup,p-HBsAg and HBsAg expression patterns were also correlated with the viral response(VR)and the serological response(SR)(Pmultivariate analysis revealed that p-HBsAg was an independent predictor of eit

关键词： Hepatitis B Hepatitis B surface antigens Hepatitis B e antigens Fibrosis Immunohistochemistry Image analysis

molecular pathways in viral hepatitis-associated liver carcinogenesis: An update

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World Journal of Clinical Cases 2021年第19期9卷 4890-4917页

作者： gulsum ozlem elpek Department of Pathology Akdeniz University Medical SchoolAntalya 07070Turkey

Hepatocellular carcinoma(HCC)is the most common type of cancer among primary malignant tumors of the liver and is a consequential cause of cancerrelated deaths *** recent years,uncovering the molecular mechanisms involved in the development and behavior of this tumor has led to the identification of multiple potential treatment *** the vast amount of data on this topic,HCC remains a challenging tumor to treat due to its aggressive behavior and complex molecular ***,the number of studies aiming to elucidate the mechanisms involved in both carcinogenesis and tumor progression in HCC continues to *** this context,the close association of HCC with viral hepatitis has led to numerous studies focusing on the direct or indirect involvement of viruses in the mechanisms contributing to tumor development and *** line with these efforts,this review was undertaken to highlight the current understanding of the molecular mechanisms by which hepatitis B virus(HBV)and hepatitis C virus(HCV)participate in oncogenesis and tumor progression in HCC and summarize new *** evidence indicates that HBV DNA integration promotes genomic instability,resulting in the overexpression of genes related to cancer development,metastasis,and angiogenesis or inactivation of tumor suppressor *** addition,genetic variations in HBV itself,especially preS2 deletions,may play a role in malignant *** dysregulation caused by both viruses might also contribute to tumor formation and metastasis by modifying the methylation of DNA and histones or altering the expression of ***,viral proteins of both HBV and HCV can affect pathways that are important anticancer *** effects of these two viruses on the Hippo-Yap-Taz pathway in HCC development and behavior need to be ***,comprehensive studies are also needed to determine these viruses'interaction with integrins,farnesoid X,and the

关键词： Hepatitis B virus Hepatitis C virus Hepatocellular carcinoma Carcinogenesis molecular pathways Viral hepatitis

Orosomucoid in liver diseases

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World Journal of gastroenterology 2021年第45期27卷 7739-7747页

作者： gulsum ozlem elpek Department of Pathology Akdeniz University Medical SchoolAntalya 07070Turkey

In this editorial,the roles of orosomucoid(ORm)in the diagnoses and follow-up assessments of both nonneoplastic diseases and liver tumors are discussed with respect to the publication by Zhu et al presented in the previous issue of World Journal of gastroenterology(2020;26(8):840-817).ORm,or alpha-1 acid glycoprotein(AgP),is an acute-phase protein that constitutes 1%to 3%of plasma proteins in humans and is mainly synthesized in the *** exists in serum as two variants:ORm1 and *** the variants share 89.6%sequence identity and have similar biological properties,ORm1 constitutes the main component of serum *** interesting feature of ORm is that its biological effects differ according to variations in glycosylation *** variable feature makes ORm an attractive target for diagnosing and monitoring many diseases,including those of the *** findings suggest that a sharp decrease in ORm level is an important marker for HBV-associated acute liver failure(ALF),and ORm1 plays an important role in liver *** viral hepatitis,increases in both ORm and its fucosylated forms and the correlation of these increases with fibrosis progression suggest that this glycoprotein can be used with other markers as a noninvasive method in the follow-up assessment of *** addition,similar findings regarding the level of the asialylated form of ORm,called asialo-AgP(AsAgP),have been reported in a follow-up assessment of fibrosis in chronic liver *** increase in ORm in serum has also been shown to improve hepatocellular carcinoma(HCC)diagnosis performance when combined with other *** addition,determination of the ORm level has been useful in the diagnosis of HCC with AFP concentrations less than 500 ng/*** monitoring patients with AFP-negative HCC,a unique trifucosylated tetra-antennary glycan of ORm may also be used as a new potential *** fact that there are very few studies investigating the expression of this glycopro

关键词： Orosomucoid Alpha-1-acid glycoprotein Viral hepatitis cirrhosis Hepatocellular carcinoma Downregulation