Browsing by Author "Gursoy, Alptekin"

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Biomolecular Markers for Improving Management of Follicular and Medullary Thyroid Cancer
(2014) Mousa, Umut; Anil, Cuneyd; Isildak, Serife Mehlika; Gursoy, Alptekin; Carpi, Angelo; https://orcid.org/0000-0002-8078-9376; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0002-2602-1657; I-1735-2018; AAA-4216-2021
Thyroid cancer usually presents as a thyroid nodule. According to different reports, more than 95% of thyroid nodules are benign. The gold standard for preoperative diagnosis of thyroid cancer is fine-needle aspiration cytology (FNAC). Especially in diagnosing medullary thyroid carcinoma (MTC) and some cases of well-differentiated thyroid carcinomas, biomolecular markers are proposed to increase the diagnostic value of FNAC. In this chapter, we mainly focused on classification, genetics, use of biomolecular and invasive markers, as well as treatment of follicular thyroid cancer (FTC) and MTC. In the case of FTC, some molecular and immunohistochemical markers are proposed and are currently under investigation principally for improving preoperative diagnosis. Unlike MTC, there is no powerful biomarker such as calcitonin (Ct) for FTC diagnosis. In the follow-up, serum thyroglobulin (Tg) and whole-body iodine-131 scintigraphy are effective. MTC has relatively poor prognosis. Postsurgical therapy is scarcely effective. Blood Ct is the best studied and preferred marker in the diagnosis and follow-up of MTC. It can be measured in the basal state or after provocative stimuli such as pentagastrin and high-dose calcium. Carcinoembryonic antigen (CEA) and chromogranin A (CgA) are the other markers currently used for selected cases. Ct and CEA doubling times are gaining importance for the prognosis of MTC. The importance of rearranged during transfection (RET) proto-oncogene screening in MTC is also discussed in this chapter. RET has also become a therapeutic target. In conclusion, the management of FTC and MTC includes diagnostic and therapeutic problems. However, thanks to the development of translational medicine, the biomolecular marker studies are improving FTC and MTC diagnosis, prognosis, and therapy.
Comment on "Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study"
(2017) Nar, Asli; Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 0000-0002-1816-3903; 0000-0003-0998-8388; 0000-0003-3534-2628; 0000-0003-2730-7144; 0000-0003-3802-9733; 27802445; ABG-5027-2020; AAA-2743-2021; W-2366-2017
Distribution of RET Mutations and Evaluation of Treatment Approaches in Hereditary Medullary Thyroid Carcinoma in Turkey
(2016) Aydogan, Berna Imge; Yuksel, Bagdagul; Tuna, Mazhar Muslum; Basaran, Mehtap Navdar; Kocaeli, Aysen Akkurt; Ertoner, Melek Eda; Aydin, Kadriye; Güldiken, Sibel; Simsek, Yasin; Karaca, Zuleyha Cihan; Yilmaz, Merve; Akkurt, Mujde; Anaforoglu, Inan; Kebapci, Nur; Duran, Cevdet; Taslipinar, Abdullah; Kulaksizoglu, Mustafa; Gursoy, Alptekin; Dagdelen, Selcuk; Erdogan, Murat Faik; 26758973
Objective: This retrospective multicenter study, centrally conducted and supported by the Society of Endocrinology and Metabolism of Turkey, aimed to evaluate the impact of free RET proto-oncogene testing in medullary thyroid carcinoma (MTC) patients. Surgical timing, adequacy of the treatment, and frequency of prophylactic thyroidectomy (PTx) in mutation carriers were also assessed. Methods: Genetic testing for MTC and pheochromocytoma was conducted between July 2008 and January 2012 in 512 patients. Application forms and RET mutation analyses of these patients whose blood samples were sent from various centers around Turkey were assessed retrospectively. An evaluation form was sent to the physicians of the eligible 319 patients who had confirmed sporadic MTC, familial MTC (FMTC), multiple endocrine neoplasia type 2 (MEN2), or who were mutation carriers. Physicians were asked to give information about the surgical history, latest calcitonin levels, morbidity, mortality, genetic screening, and PTx among family members. Twenty-five centers responded by filling in the forms of 192 patients. Results: Among the 319 patients, RET mutation was detected in 71 (22.3%). Cys634Arg mutation was the most prevalent mutation (43.7%), followed by Val804Met in 18 patients (25.4%), and Cys634Tyr in 6 patients (8.5%). Among 192 MTC patients, the diagnosis was sporadic MTC in 146 (76.4%), FMTC in 14 (7.3%), MEN2A in 15 patients (7.9%), and MEN2B in one patient. The number of mutation carriers among 154 apparently sporadic MTC patients was 8 (5.2%). Ten patients were submitted to PTx out of twenty-four mutation carriers at a mean age of 35 +/- 19 years. Conclusion: Turkish people have a similar RET proto-oncogene mutation distribution when compared to other Mediterranean countries. Despite free RET gene testing, the number of the PTx in Turkey is limited and relatively late in the life span of the carriers. This is mainly due to patient and family incompliance and incomplete family counselling.
Metformin Decreases Thyroid Volume and Nodule Size in Subjects with Insulin Resistance: A Preliminary Study
(2016) Anil, Cuneyd; Kut, Altug; Atesagaoglu, Berna; Nar, Asli; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 26618447
Objective: The aim of this study was to investigate the effects of metformin on thyroid volume and nodule size. Subjects and Methods: Prospective data were gathered on 100 newly diagnosed subjects with insulin resistance (68 female, 32 male) between August 2008 and May 2010. Each subject followed a standard diet and exercise program, and received 1,700 mg/day of metformin therapy for 6 months. The height, weight, waist circumference (WC) and thyroid hormone levels of each subject were measured. Additionally, the dimensions of the thyroid lobes and maximum diameter of each thyroid nodule were determined by ultrasonography. BMI and thyroid volumes were also calculated. Insulin resistance was estimated by homeostasis model assessment. All these parameters were measured at the beginning and at the end of the treatment period. Results: BMI and WC decreased significantly after metformin therapy (34.5 +/- 5.1 vs. 32.7 +/- 4.8, p < 0.0001, and 106.3 +/- 11.8 vs. 101.8 +/- 19.0 cm, p = 0.008, respectively). Insulin resistance also decreased after metformin therapy (4.5 +/- 1.9 vs. 2.9 +/- 1.7, p < 0.0001). The mean thyroid volume (22.5 +/- 11.2 vs. 20.3 +/- 10.4 ml, p < 0.0001) and mean thyroid nodule size (12.9 +/- 7.6 vs. 11.7 +/- 7.2 mm, p < 0.0001) also decreased after treatment. Conclusion: In subjects with insulin resistance, metformin therapy significantly decreased thyroid volume and nodule size. (C) 2015 S. Karger AG, Basel
The Relationship Between Thyroid Volume and Malignant Thyroid Disease
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Altundag, Ozden; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; https://orcid.org/0000-0003-3802-9733; https://orcid.org/0000-0003-0998-8388; https://orcid.org/0000-0003-0197-6622; https://orcid.org/0000-0002-1816-3903; 24338169; AAA-2743-2021; W-9219-2019; ABG-5027-2020
The present retrospective study aimed to investigate the relationship between thyroid volume and prevalence of thyroid cancer. We investigated the data of 3,850 patients who underwent fine-needle aspiration biopsy (FNAB). Biopsy results were evaluated as diagnostic or nondiagnostic, and diagnostic results were classified as benign, malignant, and indeterminate. We included 2,672 patients who underwent FNAB firstly in our hospital and evaluated as diagnostic biopsy except subgroup of indeterminate. We obtained cytologic data, levels of serum thyroid-stimulating hormone (TSH), and thyroid volumes of those patients retrospectively. Among 2,672 patients with thyroid nodule, 2,562 (95.9 %) patients had benign cytology and 110 (%4,1) patients had malignant cytology. There was no correlation between the malignancy and gender (p = 0.935), and patients with malignant cytology were younger (52 vs 59, p < 0.001). Also, TSH levels were higher in patients with malignant than benign cytology (p = 0.017). Median volume of right part, left part, and total thyroid for patients who had malignant cytology was significantly lower than patients who had benign cytology (8.3, 7.1, 15.9 vs 10.8 ml, 9.0 mml, 20.6 ml, respectively, p <= 0.001 for all parameters). The results demonstrated that thyroid cancer prevalence was higher in patients with low thyroid volume. According to our results, thyroid volume should be considered as a risk factor for malignancy in the evaluation of thyroid nodules.
Thyroid Nodules Are More Prevalent in Subjects with Colon Polyps, Independent of Insulin Resistance
(2019) Mousa, Umut; Anil, Cuneyd; Demir, Canan Cicek; Bozkus, Yusuf; Ozturk, Kubra; Tutuncu, Neslihan Bascil; Gursoy, Alptekin; 30861528
Objective: Colorectal polyps and thyroid nodules are common disorders linked to hyperinsulinemia and metabolic syndrome (Mets). The direct association between these two diseases is not clear. We aimed to analyze the prevalence of thyroid nodules in subjects with and without colorectal polyps. The secondary aim was to establish the prevalence of Mets and its parameters in both disorders and to determine if insulin resistance and hyperinsulinemia are common underlying pathophysiological mechanisms. Subjects and Methods: One hundred and five subjects with colorectal polyps (71 males, 34 females) and 68 controls (28 males, 40 females) were enrolled. The parameters of Mets together with TSH, insulin, low-density lipoprotein cholesterol, and homeostasis model for assessment of insulin resistance levels were calculated. We performed thyroid ultrasonography in all participants. Results: The prevalence of Mets was similar in the colorectal polyp and control groups (37.1 vs. 37.3%, p = 0.982). The prevalence of Mets was nonsignificantly higher in subjects with a documented thyroid nodule compared to subjects without a thyroid nodule (43.0 vs. 32.6%, p = 0.205). The prevalence of thyroid nodules in subjects with colorectal polyps was significantly higher than in subjects without polyps (52.9 vs. 35.3%, p = 0.017). Compared to subjects with no colorectal polyps, we established a significant increase in the odds of having thyroid nodules (OR 2.05; 95% CI: 1.097-3.860, p = 0.017). The presence of colorectal polyps and age in the adjusted model were established to be independent risk factors for having thyroid nodules (p = 0.025 and p = 0.007, respectively). Conclusion: These results may support the presence of other common mechanisms in the development of these two pathologies other than insulin resistance and hyperinsulinemia. (C) 2019 The Author(s) Published by S. Karger AG, Basel
Thyroid volume in patients with glucose metabolism disorders
(2014) Duran, Ayse Ocak; Anil, Cuneyd; Gursoy, Alptekin; Nar, Asli; Inanc, Mevlude; Bozkurt, Oktay; Tutuncu, Neslihan Bascil; 25465604
Objective: Thyroid volume and the prevalence of thyroid nodules are higher in patients with insulin resistance. A relationship between thyroid volume and glucose metabolism disorders (GMD) has not as yet been clarified. The present retrospective study aimed to investigate the association between GMD and thyroid volume. Subjects and methods: We investigated the data of 2,630 patients who were evaluated for thyroid biopsy in our hospital. The study population included 602 patients with GMD, 554 patients with diabetes mellitus (DM) and 1,474 patients with normal glucose metabolism as a control group. We obtained the levels of serum thyroid stimulating hormone (TSH) and the thyroid volumes of those patients retrospectively. Results: The median ages for the control group, GMD group and DM group were 55 (15-91) years, 60 (27-97) years, and 65 (27-91) years respectively and there was a statistically significant difference between the groups with regard to age and gender (p < 0.001). Levels of TSH were similar in all groups. The median total thyroid volumes for patients with DM and GMD were significantly higher than that of the control group [22.5 (3-202) mL, 20.2 (4-190) mL, and 19.2 (3-168) mL respectively, p <= 0.001 for all parameters]. Also the median total thyroid volume for patients with DM was significantly higher than that of the GMD group (p < 0.001). According to the correlation analysis, thyroid volume was significantly correlated with age (r = 0.92, p < 0.001) and TSH (r = 0.435, p < 0.001). Age, gender, TSH levels, GMD and DM diagnosis were independently correlated with thyroid volume. Conclusion: The thyroid gland is one of the target tissues of metabolic disorders. We reported a positive correlation between GMD/type 2 DM and thyroid volume. Further controlled, prospective, randomized studies on this subject are required to gain more information.