Objective: The aim of our study is to investigate probable differences between the incidence of target sign detected by diffusion-weighted magnetic resonance imaging (DWI) and apparent diffusion ...coefficient (ADC) values between metastases and hepatocellular carcinomas (HCC).
Materials and Methods: A total of 155 lesions obtained from 57 (female/male: 18/39) patients were included in the study. Dimensions of lesions, the appearance of lesions detected by DWI, minimum ADC (ADCmin) values, and average ADC (ADCav) values were evaluated with 1.5 Tesla MRI using b= 0 and b = 1000 s/mm2 values. Differences between metastases and HCC were investigated in terms of defined parameters. Also, ROC (receiver operating curve) analysis was used to evaluate the performance of ADCmin and ADCav parameters in distinguishing metastases from HCC.
Results: Of the lesions, 131 were metastases, while 24 were HCC. The image showing centrally hypointense, periphery hyperintense signal in DWI defined as target sign. Target sign detected in 72 metastatic lesions (55%) and 6 HCC lesions (25%) with DWI, and the rate of target sign detection was higher in the metastatic group compared with HCC (p
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Amaç: Çalışmamızın amacı, metastazlar ve hepatoselüler karsinomlar (HCC) arasındaki difüzyon ağırlıklı manyetik rezonans görüntüleme (DWI) ile tespit edilen hedef işaret insidansı ve görünür difüzyon katsayısı (ADC) değerleri arasındaki olası farklılıkları araştırmaktır.
Gereç ve Yöntem: 57 (kadın/erkek: 18/39) hastadan elde edilen toplam 155 lezyon çalışmaya dahil edildi. Lezyonların boyutları, DWI ile tespit edilen lezyonların görünümü, minimum ADC (ADCmin) değerleri ve ortalama ADC (ADCav) değerleri, b= 0 ve b = 1000 s/mm2 değerleri kullanılarak 1,5 Tesla MRG ile değerlendirildi. Tanımlanan parametreler açısından metastazlar ve HCC arasındaki farklar araştırıldı. Ayrıca metastazları HCC'den ayırmada ADCmin ve ADCav parametrelerinin performansını değerlendirmek için ROC analizi kullanıldı.
Bulgular: Lezyonların 131'i metastaz, 24'ü HCC idi. Hedef işareti olarak tanımlanan, DWI'da merkezi hipointens, periferik hiperintens izlenen imaj DWI ile 72 metastatik lezyonda (%55) ve 6 HCC lezyonunda (%25) saptandı ve metastatik grupta hedef işareti saptanma oranı HCC'ye göre daha yüksekti (p
Triple-negative breast cancer (TNBC) is a heterogeneous subtype of breast cancer that is often associated with an aggressive phenotype and a poor prognosis. Cytotoxic chemotherapy remains the ...mainstay of treatment for most patients with metastatic TNBC (mTNBC), but duration of response is often short and median overall survival is only 12–18 months. Therefore, it is critical to identify novel treatment strategies to improve outcomes for these patients. In this review article, we discuss recent advances in treatment strategies for patients with mTNBC including the use of immune checkpoint inhibitors, targeted therapies, and antibody–drug conjugates. For each topic, we summarize important preclinical and clinical data, discuss implications for clinical practice, and highlight future research directions.
Aim: In this study, we investigated the association between two miRNA variants and the risk of oral squamous cell carcinoma (OSCC), and explored the interaction between clinical factors in the ...Turkish population.
Methods: In this case control study, a total of 142 subjects were genotyped by polymerase chain reaction-restriction fragment length polymorphism to analyze miR-146aG/C (rs2910164) and miR-149C/T (rs2292832) variants. Associations between OSCC risk and clinicopathological characteristics were analyzed by chi-square test
Results: There was a significant difference in genotype and allele frequencies of miR-146aG/C variant between patients and control individuals. miR-146aG/C CC genotype and C allele were higher in the patient group compared to the control group (p=0.000, p=0.0001, respectively). Significant differences were also observed when the patients and the controls were compared according to CC vs GG+GC (p=0.0002) and GG vs GC+CC (p=0.002). In combined analysis, CC-CT combined genotype increased in patient group compared to controls (p=0.002), while GC-CT combined genotype increased in controls compared to patients (p=0.028),
Conclusion: Our study provides evidence that miR-146aG/C variant may play an important role in susceptibility to OSCC in the Turkish population.
Although definitive chemoradiation (CRT) has been used for locally advanced laryngeal cancer for more than 2 decades, studies focusing on CRT failures in advanced laryngeal cancer are scarce. In this ...study, we aimed to determine the failure patterns and the survival outcomes in the patients who had recurrence after concurrent CRT for laryngeal cancer. Clinical records of the patients who had definitive concurrent CRT for laryngeal cancer between 2001 and 2014 at a tertiary referral center were reviewed. The end points of the study were 1-, 2-, and 3-year overall survival (OS) and disease-specific survival (DSS).In our results, there were 48 failures and the mean time period from the first diagnosis of disease to the diagnosis of recurrence was 18.0 months (range 2-72; standard deviation: 15.6). The most common recurrence pattern was local recurrence in 21 (47.9%) patients followed by regional recurrence in 11 (22.9%) patients. The 1 and 3 years OS rates were 41.7%, and 19.2% for the entire cohort, and 64.5%, and 29.7% for the patients who had not systemic recurrence at presentation of recurrence, respectively. The 1 and 3 years DSS rates were 43.5%, and 20.0% for the entire cohort, and 69.0%, and 31.8% for the patients who had not systemic recurrence at presentation of recurrence, respectively. All patients who had systemic recurrence initially (n = 13) died within 9 months (median = 4 months, range: 1-9 months). This study reveals that survival outcomes are unfavorable in the CRT failures and careful patient selection is critical to minimize failures. In the presence of systemic recurrence, disease course is aggressive.
We aimed to evaluate the efficacy and safety of trastuzumab emtansine in patients with metastatic breast cancer previously treated with pertuzumab plus trastuzumab and taxane. We reviewed the medical ...records of patients who were diagnosed with Human Epidermal Growth Factor Receptor 2 (HER-2) positive metastatic breast cancer and received pertuzumab and then TDM-1 between January 2014 and January 2021 from twenty- five cancer centers. The Kaplan- Meier method estimated progression-free survival (PFS) and overall survival (OS). Additionally, objective response rate (ORR), clinical benefit rate (CBR), and safety were evaluated. One hundred fifty-three patients were included,79.1% of the patients received TDM-1 in the second line, 90.8% had visceral metastasis, and 30.7% had central nervous system involvement. The PFS and OS of TDM-1 were evaluated according to the number of previous lines (on the 2nd line or more than two lines) metastatic sites (visceral and non-visceral) and the presence of central nervous metastasis. In TDM-1 therapy, PFS in second line therapy was ten months (95% CI: 7.7 - 12.2); this was statistically higher than later-line PFS, which was six months (95% CI: 3.3 to 8.6) (p = 0.004). The median OS time was 25 months (95% CI: 21.0 to 28.9) in patients treated with TDM-1 in the second line and 19 months (95% CI: 12.3 to 25.6) in patients who received later than the second line(p = 0.175). There were no significant differences in PFS time of patients with and without visceral and central nervous metastases. Our study showed that TDM-1 was also effective in patients using pertuzumab, contributes significantly to PFS when used in the second line compared to its use in the later line, and does not make any difference in OS.We aimed to evaluate the efficacy and safety of trastuzumab emtansine in patients with metastatic breast cancer previously treated with pertuzumab plus trastuzumab and taxane. We reviewed the medical records of patients who were diagnosed with Human Epidermal Growth Factor Receptor 2 (HER-2) positive metastatic breast cancer and received pertuzumab and then TDM-1 between January 2014 and January 2021 from twenty- five cancer centers. The Kaplan- Meier method estimated progression-free survival (PFS) and overall survival (OS). Additionally, objective response rate (ORR), clinical benefit rate (CBR), and safety were evaluated. One hundred fifty-three patients were included,79.1% of the patients received TDM-1 in the second line, 90.8% had visceral metastasis, and 30.7% had central nervous system involvement. The PFS and OS of TDM-1 were evaluated according to the number of previous lines (on the 2nd line or more than two lines) metastatic sites (visceral and non-visceral) and the presence of central nervous metastasis. In TDM-1 therapy, PFS in second line therapy was ten months (95% CI: 7.7 - 12.2); this was statistically higher than later-line PFS, which was six months (95% CI: 3.3 to 8.6) (p = 0.004). The median OS time was 25 months (95% CI: 21.0 to 28.9) in patients treated with TDM-1 in the second line and 19 months (95% CI: 12.3 to 25.6) in patients who received later than the second line(p = 0.175). There were no significant differences in PFS time of patients with and without visceral and central nervous metastases. Our study showed that TDM-1 was also effective in patients using pertuzumab, contributes significantly to PFS when used in the second line compared to its use in the later line, and does not make any difference in OS.
Aim: Liver biopsy is recommended in the majority of patients with chronic viral hepatitis for fibrosis evaluation. Because of the disadvantages of liver biopsy, many studies related to non‐invasive ...biomarkers and scores have been performed. In this study, we aimed to assess the diagnostic value of serum direct markers and non‐invasive fibrosis models to predict liver fibrosis in the treatment‐naive chronic hepatitis B (CHB) patients and to compare their diagnostic performance.
Methods: This study included 58 patients with a diagnosis of CHB virus infection and 30 healthy controls. Hyaluronic acid, tissue inhibitor of matrix metalloproteinase 1 and amino‐terminal propeptide of type III procollagen were measured by enzyme‐linked immunosorbent assay; and the Original European Liver Fibrosis panel, the Enhanced Liver Fibrosis (ELF) panel, PP score, aspartate aminotransferase to platelet ratio index (APRI) and FIB‐4 indexes were calculated using the formulas taken from previous publications. Fibrosis stage was determined using Ishak's scoring system.
Results: The fibrosis stages identified upon liver biopsy was F0 in 12 patients (20.7%), F1–2 in 36 (62.1%) and F3–5 in 10 (17.2%). The diagnostic value of all the non‐invasive indices was low to detect mild fibrosis. We demonstrated that the diagnostic accuracy of HA is the best for predicting fibrosis of F3 or more (area under the receiver–operator curve, 0.902). In our study, the results from a combination of tests showed that ELF and APRI had the highest diagnostic value sensitivity of 90%, specificity of 100%, positive predictive value of 100% and negative predictive value of 96.4% for detection of fibrosis of F3 or more.
Conclusion: In CHB patients, combination of ELF and APRI has a better diagnostic value in predicting fibrosis of F3 or more.
Patients with metastatic breast cancer are at high risk for developing vertebral compression fractures due to underlying bone metastases and bone density loss. Vertebral augmentation techniques ...including percutaneous vertebroplasty and percutaneous balloon kyphoplasty are techniques used to stabilize compression fractures and improve pain. However, rare complications from these interventions have been observed, including spinal cord compression, nerve root compression, venous cement embolism, and pulmonary cement embolism. These complications pose unique potential challenges for patients with cancer who may already have decreased lung function and potential for venous thromboembolism. In this review, we first describe the role of percutaneous vertebral augmentations in patients with metastatic cancer, with a particular focus on patients with breast cancer. Then, we describe complications of vertebral augmentation in two patients with metastatic breast cancer including long-term symptomatic and radiographic follow-up.
•Balloon kyphoplasty and percutaneous vertebroplasty are used to stabilize compression fractures and improve pain.•Leakage of bone cement can cause cement emboli which can depsit in locations such as the pulmonary and renal vasculature.•Management of cement emboli depends on the amount of cement embolized and the severity of symptoms.•Future studies are needed to better understand the long-term radiographic and clinical consequences of cement emboli.
Introduction: It has been shown that the host immune response and chronic inflammation could play a role as important risk factors for cancer. Oral squamous cell carcinoma (OSCC) is a common cancer ...worldwide. In this study, we aimed to evaluate the impact of interleukin-1 receptor antagonist (IL-1RA) and IL-4 variable number tandem repeat (VNTR) polymorphisms on OSCC susceptibility in a Turkish population. Methods: Study subjects comprised of 36 OSCC patients and 100 healthy controls. Genotyping of the IL-1RA VNTR (rs2234663) and IL-4 VNTR (rs79071878) polymorphisms were analyzed by polymerase chain reaction. Results: The frequency of IL-1RA VNTR 1/2+2/2 genotypes increased in the patients than healthy controls while IL-1RA VNTR 1/1 genotype was higher in the control group than in the patients (p=0.002). The subjects carrying IL-1RA VNTR 1/2+2/2 genotypes showed a 12.011-fold increased risk of susceptibility to OSCC. IL-1RA VNTR allele 1 was higher in the control group than the patient group while IL-1RA VNTR allele 2 was higher in the patient group than the control group (respectively, p=0.000, p=0.000). The subjects carrying IL-1RA VNTR allele 2 showed a 2.609-fold increased risk of susceptibility to OSCC. The IL-4 VNTR P1/P1 and P1/P2 genotype frequencies were higher in the patient group compared to the control group (p=0.039). IL-4 VNTR P1 allele was higher in the patients compared to the controls (p=0.030). Conclusion: The significant association between the functional VNTR polymorphisms of IL-1RA/IL-4 genes and OSCC suspectibility in a Turkish population confirmed a role of altered inflammatory process in OSCC pathogenesis.
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