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Öğe Can Numeric Maturation Value Be Used as a Prognostic Indicator and Diagnostic Tool in Cutaneous Melanomas? A Morphometric Study(Sci Printers & Publ Inc, 2019) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, BinnurOBJECTIVE: Some melanocytic lesions can be difficult to diagnose because of ambiguous histological and immunohistochemical features. Morphometric features of melanocytes in the upper and lower parts of a challenging lesion may help to facilitate an accurate diagnosis. STUDY DESIGN: We studied 32 cases of invasive cutaneous melanoma, 35 cases of mild or moderate dysplastic nevus, and 31 cases of benign melanocytic nevus. All cases were immunostained with Sox10. The nuclear areas of 30 melanocytes were measured on each papillary (upper al1) dermis and reticular dermis/subcutaneous tissue (lower ILI) in all cases by using the Image J analysis program. Then, a maturation index (U/L) was calculated for each case. Also, cutaneous melanomas were categorized into 2 groups that displayed pseudo-maturation or the lack of it. RESULTS: Mean maturation index was 1.04 +/- 0.29 in melanomas, 1.23 +/- 0.28 in dysplastic nevi, and 1.52 +/- 0.33 in benign melanocytic nevi, respectively. There were statistically significant differences between melanoma and dysplastic nevus (p = 0.012) and between melanoma and benign melanocytic nevus (p < 0.001) for the maturation index. Although pseudo-maturation was associated with low mitotic activity and thin Breslow thickness, there was no significant difference between survival distributions of 2 melanoma groups. CONCLUSION: Calculation of the maturation index can be used as a supporting tool for the differential diagnosis of challenging cases. However, it may possess limitation for evaluation of nevoid melanoma, melanoma in situ, or clonal nevus.Öğe Can numeric maturation value be used as prognostic indicator and diagnostic tool in cutaneous melanomas (a morphometric study)?(Springer, 2018) Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Sungur, Mehmet Ali; Özlü, Emin; Bahçıvan, Atike; Önal, Binnur…Öğe CD123 immunoexpression in cutaneous lupus erythematosus, polymorphous light eruption, pityriasis rosea, and mycosis fungoides(Termedia Publishing House Ltd, 2021) Karagün, Ebru; Gamsızkan, Mehmet; Büyücek, Şeyma; Coşkun, SinemIntroduction: CD123-positive plasmacytoid dendrocytes are prominent in the infiltrate of cutaneous lupus erythematous. Aim: To determine the significance of the CD123 immunostain, which labels plasmacytoid dendritic cells (PDC), in cutaneous lupus erythematous (CLE), polymorphous light eruption (PLE), pityriasis rosea (PR) and mycosis fungoides Material and methods: A total of 76 cases, including MF (n = 27), CLE (n = 19), PR (n = 19), and PLE (n = 11), were included in the study after reviewing their diagnostic clinical features and pathologic findings. The primary antibody against CD123 was performed in all cases. Results: CD123+ immunostaining in PDCs was positive in all cases. The highest mean percentage was noted in CLE (15.2%), followed by PLE (15%), PR (8.8%), and MF (2%). Besides, the clustering of CD123-positive cells was significant in CLE and PLE compared to MF and PR. Conclusions: PDC may have an important role in the aetiology of PLE and CLE cases. CD123 is a useful marker for differentiating CLE and PLE from MF and PR.Öğe Clinicopathological features of melanomas in our university and comparison of meta-analysis in a specific region(Springer, 2018) Büyücek, Şeyma; Gamsızkan, Mehmet; Coşkun, S. Kantarcıoğlu; Yalçın, A.; Karagün, E.; Gamsızkan, Zerrin; Önal, Binnur…Öğe Combination of Biochemical and Cytological Findings for Better Diagnosis in Pleural Effusions(Springer, 2022) Elmas, Hatice; Biancosino, Christian; Önal, Binnur; Schmitt, Fernando; Büyücek, Şeyma; Nordholt, Gerhard; Sauter, GuidoSerous pleural effusions result from increased permeability and changed hydrostatic or colloid osmotic pressure. Laboratory biochemical findings provide conclusions about the effusion compositions. Together with the anamnesis and clinical assessment, they enable the evaluation of the effusion nature. The present study retrospectively analyzed combined biochemical and morphological findings in 2307 effusions of patients from two clinical centers: LungenClinic Grosshansdorf in Germany and Duzce University in Turkey. The effusion cytology results of 1771 and 536 patients from the respective centers were combined with clinical/radiological/biochemical findings and counter compared with the final diagnoses. Cytology verified 738 malignant tumors (643 and 95, respectively). Most effusions were benign (n = 1569; 77%) and 367 of them were paramalignant (293 and 74, respectively) and 594 were inflammatory (465 and 129, respectively). There was a distinctly lower number of malignant tumors in transudates than exudates (87 vs. 725; p < 0.0001). Squamous cell carcinoma was more frequent in paramalignant pleura effusions (122 cases out of the 367 effusions) than pleural carcinomatosis (32 cases out of the 780 malignant tumors; p < 0.0001). The cell formula was a suitable marker for malignant mesothelioma, predominantly mesothelial, or neutrophilic characterized by elevated LDH (>500 U/L) in the early stage of empyema or its late manifestation. İn conclusion, most effusions are benign. Cytologists, assisted by clinical and biochemical data and microscopic findings, can make significant differential diagnostic contributions beyond the sole detection of malignancy. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.Öğe Mesane infiltratif ürotelyal karsinomlarında KRAS, BRAF, PIK3CA mutasyon analizi(Düzce Üniversitesi, 2021) Büyücek, Şeyma; Önal, Binnur; Coşkun, Sinem KantarcıoğluAMAÇ: Mesane kanseri, genitoüriner sistemde prostattan sonra en sık görülen kanserdir ve dünyadaki kanserler arasında en yaygın 7. kanserdir. Dünyada ve Türkiye'de erkeklerde sıklığı belirgin olarak yüksektir ve Türkiye'de erkeklerde gözlenen en sık 4. kanserdir. Mesane kanserleri invaziv-olmayan ve infiltratif ürotelyal karsinom (İÜK)'lar olarak iki gruba ayrılmaktadır. İÜK'da daha agresif tedavi yöntemleri (sistektomi, kemoterapi) uygulanmakta ve evrede ilerleme, metastaz sık görülmektedir. Bu bağlamda İÜK'da yeni tedavi yöntemleri geliştirmek, moleküler yolakların keşfi önem kazanmaktadır. Moleküler analizler, hedefe yönelik tedavilerin geliştirilmesinde yol gösterici olmuştur. Hücre büyümesinde tirozin-reseptör-kinazın sinyal yolağında; RAS-BRAF-MEK-ERK ve PIK3CA-PTEN-AKT kaskadlarının onkogenlerinin mutasyona uğraması kanser gelişmesine yol açmaktadır. Çalışmamızda İÜK'da PIK3CA, KRAS ve BRAF mutasyonlarının analizini amaçladık. GEREÇ VE YÖNTEM: DÜTF Patoloji ABD'da tanı alan 24 İÜK çalışmaya dahil edildi. İÜK olguları diferansiasyon (glandüler, sarkomatoid vb) gösteren/göstermeyen olarak ayrıldı. Dokulardan parafinin ayrıştırılması sonrası DNA ekstraksiyonu yapıldı. İzole DNA, RANDOX cihazı biyoçip dizilerine konularak KRAS, PIK3CA ve BRAF mutasyon analizi yapıldı. Mutasyon sıklıkları olguların demografik, histopatolojik, klinik bulguları ile karşılaştırıldı; genel/hastalıksız sağkalım oranları, aldıkları kemoterapi türü/sayısı ve TNM evresine göre değerlendirildi. BULGULAR: İÜK vakalarının ortalama tanı yaşı 70.1 olup erkek/kadın:11/1'dir. İÜK olgularının %33.3'ünde KRAS, %12.5'inde PIK3CA, %8.3'ünde BRAF mutasyonu saptanmıştır. Çoğunluğu gemsitabin+sisplatin olmak üzere 14 hasta kemoterapi tedavisi görmüştür. Tümörlerin %79,1'i evre 2'de tanı almıştır ve histopatolojik incelemede eşlik eden in-situ karsinom (n:8), nekroz (n: 13), lenfovasküler invazyon (n: 12) ve perinöral invazyon (n: 10) saptanmıştır. Mutasyon glandüler, sarkomatoid ve skuamöz diferansiasyonlu olgularda mevcut iken mikropapiller ve berrak hücre diferansiasyonlu olgularda saptanmamıştır. Histopatolojik özelliklerin mutasyon analizi ile karşılaştırılmasında istatistiksel olarak anlamlı sonuç gözlenmedi. Bu çalışmada yapılan analizlere göre (KRAS, BRAF, PIK3CA) olguların sağkalım oranları arasında fark görülmedi. TARTIŞMA: Tümörlerin moleküler karakterlerinin belirlenmesi, hedeflenen tedavi algoritmalarının oluşturulmasında ve uygun hastanın seçilmesinde bir kılavuzdur. Reseptör tirozin kinaz yolu, tümörlerde en sık mutasyona uğrayan yollardan biridir. Sonuç: Mesane kanseri olan hastaların tedavisine yön verebilecek mutasyon profillerini bulmak için daha geniş serili çalışmalara ihtiyaç vardır. Ayrıca, bunların prognoza etkisinin daha geniş serilerde araştırılması gerekir.Öğe Receptor Tyrosine Kinase Pathway and Infiltrating Urothelial Carcinoma(Begell House Inc, 2023) Büyücek, Şeyma; Coşkun, Sinem Kantarcıoğlu; Önal, Binnur; Gamsızkan, Mehmet; Cangür, Şengül; Esbah, OnurReceptor tyrosine kinase pathway is frequently searched for cancer causing mutations in tumors. Emerg-ing targeted therapies are gleam of hope for them. Infiltrating urothelial carcinoma can have many morphological aspects according to their differentiation/variants. To evaluate KRAS, BRAF, and PIK3CA mutations and HER2, EGFR, and p16 expression, we divided urothelial carcinomas into two groups: differentiated/variants (n = 12) and conventional (n = 12). We compared results with clinical, demographic, histopathologic features and survival rates. No statistically sig-nificant results could be obtained in the comparison of histopathologic properties/survival rates with mutation analysis and EGFR, HER2, and p16 status. Differentiated/variants urothelial carcinoma showed higher EGFR expression (P < 0.001). Glandular differentiation was the most frequent type, followed by squamous and sarcomatoid differentiation. We observed the most common mutation at KRAS with a propensity for urothelial carcinoma with glandular differentiation. More than one mutation/high protein expression was seen in some tumors. Targeted therapies for KRAS mutation can be effective at urothelial carcinoma with glandular differentiation. Heterologous expression of relevant proteins and genes can be a cause for targeted treatment obstacle. The determination of the molecular characters of tumors is a guide in creating targeted treatment algorithms and in choosing the patient.Öğe TERT promoter mutation and HER2 gene amplification in malignant peripheral nerve sheath tumours: is there a molecular signature playing role in malignant transformation?(Springer, 2018) Coşkun, S. Kantarcıoğlu; Gamsızkan, Mehmet; Yılmaz, İsmail; Yalçınkaya, Ulviye; Sungur, Mehmet Ali; Büyücek, Şeyma; Önal, Binnur…