Browsing by Author "Tunca, Muzeyyen Zeyneb"

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    Gastrointestinal Stromal Tumors: A Clinicopathologica and Immunohistochemical Study of 65 Cases
    (2018) Tepeoglu, Merih; Ozgun, Gonca; Tunca, Muzeyyen Zeyneb; Tezcaner, Tugan; Ozdemir, Binnaz Handan; 0000-0002-7528-3557; 29630088; X-8540-2019
    Objective: Hie clinical behavior of gastrointestinal stromal tumors is divergent. The aim of the present study was to define the clinicopathological features that determine the patient's outcome. Material and Method: Sixty-five gastrointestinal stromal tumors were reviewed with their histological, immunohistochemical and clinical features and compared with their clinical outcome statistically. Results: Tumors were located in the stomach (n=39, 60%), small intestine (n=22, 33.8%) and large intestine (n=4, 6.2%). Immunohistochemically, CD 117 positivity was found in 90.8%, whereas CD34, Smooth muscle actin, Desmin and S100 positivity was found in 73.3%, 61.7%, 11.7% and 28.3% of tumors respectively. All six "CD 117-negative" cases expressed DOG-1. The mean Ki-67 proliferation index was 8.69%+/- 12.76. Liver metastasis was detected in seven cases. A significant association was detected between decreased mean survival time and increased tumor size (p<0.001), large bowel localization (p-0.047), mitosis (p<0.001), the presence of necrosis (p=0.001), metastasis (p=0.033), Ki-67 proliferation index (p-0.002) and risk category (p<0.001). CD 34 positivity was mostly seen in the stomach (p-0.001), and CD 34 positive tumors had longer overall survival (92.85.+/- 5.77 months versus 67.21 +/- 13.68 months) (p=0.046). Higher Ki-67 proliferation index (6%) was also correlated with the presence of metastases (p=0.015). Conclusion: Our study indicates that in addition to well-known risk factors such as increased tumor size, high mitotic activity and metastasis; higher Ki-67 proliferation index, the presence of necrosis, and CD34 negativity also correlate with shorter survival time.
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    Importance of Liver Biopsy Findings on Prognosis of Kidney Transplant Patients
    (2016) Ozgun, Gonca; Ozdemir, Binnaz Handan; Tunca, Muzeyyen Zeyneb; Borcek, Pelin; Haberal, Mehmet; 0000-0002-7528-3557; 0000-0002-3462-7632; 27805508; X-8540-2019; AAJ-8097-2021
    (O)bjectives: Chronic hepatitis infection among kidney transplant recipients is not infrequent, with those with hepatitis C virus infection having worse survival. Here, we evaluated liver biopsy changes and its effects on prognosis in kidney transplant recipients. Materials and Methods: Patients with liver biopsies were selected from 1275 kidney transplant recipients who were treated at Baskent University from January 1990 to December 2012. Demographic and clinical findings were evaluated, including age, sex, liver biopsy findings, amyloid and hemosiderin accumulation, and patient survival. Results: Among 1275 renal transplant patients, only 149 patients had liver biopsies. Of 149 patients, 68 patients (45.3%) had liver biopsy only before and 81 patients had liver biopsy after transplant, with 20 of the 81 patients also having biopsy before transplant. The 81 patients who had a liver biopsy after renal transplant were included in the study. In our patient group, mean follow-up was 166 +/- 29 months, female-to-male ratio was 26/55, and mean age was 30.2 +/- 9.87 years (range, 15-56 y). Only 2 of 81 liver biopsies (2.4%) were diagnosed as normal or nonspecific. Biopsy findings of the remaining 79 patients (97.6%) showed variable pathologies, including hepatocellular damage and minimal cholestatic changes in 29 patients (35.8%), chronic nonviral hepatitis in 9 (11.1%), and viral hepatitis in 41 (50.6%). The mean time between the first liver biopsy taken before transplant and second biopsy after transplant was 44.5 +/- 38.0 months (range, 11-139 mo). Among 81 patients, 6 (7.4%) showed amyloid deposition and 13 (16.0%) showed hemosiderosis. Conclusions: Testing for viral infections is critical in transplant recipients. It is well known that these infections can affect the frequency of rejection episodes and also negatively affect survival in solidorgan transplant recipients. Livers should be evaluated by biopsy even if the variance in liver enzymes or serology is minimal.