Browsing by Author "Karabulut, Erdem"

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Gastric Carcinoma with Lymphoid Stroma: A Combination of Mismatch Repair Deficient Medullary Type and Epstein-Barr Virus-associated Gastric Carcinomas
(2022) Uner, Meral; Isik, Aynur; Oztop, Sidika; Karabulut, Erdem; Demirkol-Canli, Secil; Akyol, Aytekin; https://orcid.org/0000-0001-5653-6080; 35188817; AAJ-7911-2020
Gastric carcinomas consist of a heterogeneous group of neoplasms with broad cytological and architectural variations. Gastric carcinomas with lymphoid stroma show poor correlation between their histomorphology and biological behavior. This contrast causes a need for more detailed analysis and molecular exploration of lymphoid stroma-rich gastric carcinomas with medullary like features and lack of glandular differentiation. In this study, we performed a detailed retrospective analysis of 53 gastric carcinomas among 654 gastric tumors from surgical resection specimens, all of which had no prominent glandular differentiation. Morphological and clinical data were compared with immunohistochemistry (MLH1, PMS2, MSH2 and MSH6 for mismatch repair mechanism deficiency; CD2, CD8 and CD163 for immune infiltration; and PD-1, PD-L1, LMP-1, ERBB2 and ki-67) besides EBER in situ hybridization and molecular studies (PCR based microsatellite instability and BRAF V600E mutation analysis). Morphological, immunohistochemical and molecular findings lead us to classify lymphoid stroma-rich advanced gastric carcinomas (n = 40/53) into two distinct entities originating from two different pathogenetic pathway: one is gastric carcinomas revealing predominantly medullary type morphology with defective DNA mismatch repair mechanism (n = 30/53) and the other is EBV associated carcinomas (n = 10/53). In addition, we suggest that biomarker based classification algorithms besides morphological evaluation are necessary to identify these two entities. Distinguishing these entities is crucial to apply different treatment strategies, including alternative treatments such as immunotherapy.
The Practices of Treating Deep Carious Lesions Compared with the Dental Curriculum in Turkish Dentistry
(2022) Kerimova, Leyla; Karabulut, Erdem; Yamanel, Kivanc; Arhun, Neslihan
Objective: The aim of this cross-sectional study is to investigate Turkish dentists' opinions and preferences regarding the management of deep carious lesions and compare them with modern dental education concepts as provided by dental schools. Methods: Questionnaire 1 and Questionnaire 2 were sent separately to dental practitioners via the Turkish Dental Association and to university department heads of restorative dentistry. The data obtained were analyzed using chi-square tests and one-way ANOVA tests (p < 0.05). Results: Regarding Questionnaire 1, most of the dentists (89.3%) responded that caries lesions should be removed completely up to the hard cut-off condition of the cavity floor. There was a statistically significant difference between female and male dentists' preferences on less invasive treatment (p < 0.05). Female dentists prefer less invasive treatment compared with male dentists (p = 0.002). Relatively older dentists (mean age = 41.8) are more inclined towards complete caries removal even if pulp exposure is likely (p = 0.040). The results of Questionnaire 2 reveal that there is no association between the time spans of education at dental schools and their caries removal approach curriculum (p > 0.05). Most department heads of restorative dentistry prefer to apply complete caries removal (78.5%, n = 51). Conclusion: Despite today's curriculum encouraging less invasive caries removal techniques, most dentists prefer more invasive treatment options. Continuous education of contemporary dentistry could update these clinical treatment attitudes of dentists and improve their clinical practice.
Squamous cell carcinoma of the penis: a clinicopathological study from a population with late circumcision
(2019) Baydar, Dilek Ertoy; Akkaya, Hampar; Apa, Duygu Dusmez; Bal, Nebil; Demirsam, Asli; Gucluer, Berrin; Nese, Nalan; Sari, Aysegul Akder; Kirdar, Sevin; Akdogan, Bulent; Karabulut, Erdem; 31658325
Squamous cell carcinoma (SCC) of the penis has been subject to only a few studies in populations where late childhood circumcision is performed. To asses clinicopathological features and human papillomavirus (HPV) status of penile SCC in men with late circumcision, eight institutions in the country volunteered to collaborate and 15 cases of penile SCC were collected from their pathology archives. The presence and genotype of HPV were determined in addition to clinicopathological features of the tumors. Findings were correlated with disease outcome. The mean age of the patients evaluated was 66.5 years. Histological subtypes were usual SCC (6/15), papillary (2/15), mixed (2/15), basaloid (2/15), acantholytic (1/15), pseudohyperplastic (1/15), and warty-basaloid (1/15) carcinomas. HPV was identified in 33.3% of samples; HPV16 was detected in 60% of positive cases and was associated with basaloid and/or warty morphology. Cause-specific 1-year and 2-year survivals were 76.9% and 54.5%, respectively. The usual subtype and nodal metastasis were associated with worse outcome (p=0.045 and p=0.047, respectively). As a conclusion, our results suggest an inclination for penile SCC to develop at a later age in a population with late circumcision than the patients from the regions of high penile cancer incidence. These men seem to have less frequent HPV association and their outcome appears poorer than other populations, although reaching substantial provision is not possible due to our limited case number.
Three Dimensional Conformal Radiotherapy and Androgen Deprivation Therapy in Patients with Clinically Localized Prostate Cancer; Hacettepe University Experience
(2015) Ozdemir, Yurday; Akyol, Fadil; Ozyiğit, Gokhan; Hurmuz, Pervin; Onal, Cem; Selek, Ugur; Karabulut, Erdem
The aim of this study into evaluate the treatment results of three dimensional conformal radiotherapy (3DCRT) and androgen deprivation therapy (ADT) in patients with clinically localized prostate cancer (CLPC). Between June 1998 and December 2011, 577 patients with the diagnosis of CLPC were treated. ADT was started 3 months prior to radiotherapy (RT). 3DCRT was delivered to prostate and the seminal vesicles (SV) to a total dose of 70Gy. Additionally, patients with lymph node (LN) positivity received 50.4Gy RT to pelvic LN's. Median follow up time was 65 months. Five-ten years overall survival (OS), cause specific survival (CSS), PSA relapse-free survival (PSA-RFS) and distant metastasis-free survival (DMFS) rates were 92-74%, 97-91%, 77-55% and 94-88%, respectively. OS was negatively affected from LN positivity (p < 0.001). In the subgroup of patients With GS 8, there was no significant difference between < 1 years and 1 years of ADT in terms of CSS, PSA-RFS and DMFS. OS was better in patients with < 1 years of ADT (p = 0.01). Five year OS (p = 0.02), CSS (p = 0.05), PSA-RFS (p = 0.01) and DMFS (p = 0.07) rates were inferior in the high risk group patients that used ADT 1 year. Acute and late RTOG grade III/IV gastrointestinal system toxicity rates were 1.7% and 5% and acute and chronic RTOG grade III/IV genitourinary system toxicity rates were 1.4% and 5%, respectively. 3DCRT and ADT combination is an effective treatment modality with acceptable toxicities in patients with clinically localized prostate cancer.