GÝRÝÞ ve AMAÇ: MR görüntülemenin meme kanserinde kullanýmý artmaktadýr. Son yýllarda MRG, meme kanseri lezyonlarý hakkýnda önemli bilgiler saðlayabilen bir yöntem olarak kullanýlmaya baþlanmýþtýr. Amacýmýz, dinamik MRG bulgularý ile prognoz belirlemek için kullanýlan faktörler arasýnda önemli bir iliþki olup olmadýðýný saptamaktý.
YÖNTEM ve GEREÇLER: Ýnvaziv meme kanseri tanýsý ve meme MR görüntülemesi olan seksen bir hasta retrospektif olarak tarandý ve çalýþmaya dahil edildi. Meme MR görüntülerinde kinetik MR özellikleri belirlendi ve histopatolojik sonuçlarý yeniden gözden geçirilerek prognostik faktörleri kaydedildi.
BULGULAR: Kinetik MR özellikleri ilk faz kontrastlanma düzeyine göre gruplandý ve 35 hastada %50’nin altýnda, 18 hastada %50 ile %100 arasýnda ve 28 hastada %100’den fazlaydý. Çalýþmamýzda, analiz edilen prognostik faktörlerin herhangi biri ile erken kontrastlanma özellikleri ve dinamik eðri türleri arasýnda herhangi bir anlamlý iliþki tespit edemedik.
TARTIÞMA ve SONUÇ: Görüntüleme birçok hastalýk türünün tanýsý, teþhisi ve deðerlendirilmesinde önemli veriler saðlasa da görüntüleme bulgularý her zaman hasta kliniði ve prognozu ile iliþkili deðildir. Þimdiye kadar, bu konudaki çalýþmalar çoðunlukla, çalýþmamýzla benzer þekilde anlamlý bir iliþki bulamadý, ancak çalýþmamýzda bildirilen bazý verilerin gelecekteki çalýþmalarý etkileyebilir.

INTRODUCTION: The use of MR imaging in breast cancer is increasing. In recent years, MRI has been gaining use as a modality that can provide important information about breast cancer lesions. Our aim was to determine if any significant relationship existed between dynamic MRI findings and factors which are currently being used to establish prognosis.
METHODS: Eighty-one patients with a diagnosis of invasive breast carcinoma and breast MRI were retrospectively reviewed and included in the study. Kinetic MRI features were determined on breast MR images, histopathological results were reviewed and prognostic factors were recorded.
RESULTS: Thirty-five patients’ initial enhancement was lower than fifty percent, while 18 patients were between fifty and one hundred percent and 28 patients higher than one hundred percent. Our study is one of the latter, we could not identify any significant relationships between initial enhancement characteristics and dynamic curve types with any of the analyzed prognostic factors.
DISCUSSION AND CONCLUSION: Although imaging can provide important data in the identification, diagnosis, and evaluation of many types of disease; imaging findings do not always correlate with patient clinic and prognosis. Up until now, studies on this matter have mostly found nothing of high significance; our study was no exception, however some of the data reported in this study can influence future studies.

GÝRÝÞ ve AMAÇ: HBME1, PAX8, CD56 ve CITED1’ in tiroidin benign lezyonlarýný, malign tümörlerden ve tiroidin farklý malign tümörlerini birbirinden ayýrt etmedeki rolünü deðerlendirmektir.

YÖNTEM ve GEREÇLER: 2007-2013 yýllarý arasýnda tiroidektomi yapýlan Nodüler Hiperplazi: 22, Foliküler Adenoma: 14, Papiller Benzeri Nükleer Özellikler Gösteren non-Ýnvaziv Foliküler Tiroid Neoplazmý: 3, Ýyi Diferansiye Karsinoma, Spesifiye Edilememiþ: 3, Papiller Karsinoma: 22, Papiller Karsinoma, Foliküler Varyant: 12, Minimal Ýnvaziv Foliküler Karsinoma: 9, Az Diferansiye Karsinoma: 4, Anaplastik Karsinoma: 3 çalýþmaya dahil edildi. Ýmmünhistokimyasal yöntem ile HBME1, CITED1, PAX8, CD56 uygulandý. Ýstatistiksel analizde markerlerýn duyarlýlýk, özgüllük, pozitif ve negatif prediktif deðerleri hesaplandý.
BULGULAR: CD56 (ekspresyon kaybý), HBME1, Papiller Karsinoma ve Papiller Karsinoma, Foliküler Varyantta, diðer malign tümörlere göre anlamlý yüksekti. Malign tümörler için en duyarlý markerlar PAX8 ve CITED1( %90, %88) idi. Malign tümörler için en spesifik markerlar HBME1, CITED1 (%97, %92)idi. Papiller Karsinoma, Papiller Karsinoma, Foliküler Varyant için en duyarlý ve spesifik marker HBME1 (%100, %80) idi. Papiller Karsinoma, Folliküler Varyant için en duyarlý markerlar CD56 (ekspresyon kaybý) ve CITED1 (%86, %86)idi.
TARTIÞMA ve SONUÇ: HBME1, Papiller Karsinoma için duyarlý ve spesifik bulundu. CITED1’in sitoplazmik ekspresyonun Papiller Karsinomada, tiroidin diðer malign tümörlerine göre anlamlý þekilde yüksekti. PAX8'in nükleer ekspresyonu benign olgularda malign olgulara göre anlamlý þekilde yüksek bulundu. HBME1, CD56 (ekspresyon kaybý), Papiller Karsinoma ve Papiller Karsinoma, Foliküler Varyantta diðer malign tümörlere göre anlamlý þekilde yüksek bulundu.

INTRODUCTION: To evaluate the role of HBME1, PAX8, CD56 and CITED1 in distunguishing benign lesions of the thyroid from malignant tumors and different malignant tumors of the thyroid.
METHODS: The patients that underwent thyroidectomy between 2007 and 2013 were included to the study. Patients with Nodular Hyperplasia: 22, Folicular Adenoma: 14, Noninvasive Folicular Thyroid Neoplasm With Papillary-Like Nuclear Features: 3, Well Diferentiated Carcinoma, Not Otherwise Specified: 3, Papillary Carcinoma: 22, Papillary Carcinoma Folicular Variant: 12, Minimally Invasive Folicular Carcinoma: 9, Poorly Diferentiated Carcinoma: 4, Anaplastic Carcinoma: 3 were included to the study. HBME1, CITED1, PAX8, CD56 were applied by immunohistochemical method. In statistical analysis, the sensitivity, specificity, positive predictive and negative predictive values of markers were calculated.
RESULTS: CD56 (loss of expression), HBME1 was significantly higher in Papillary Carcinoma, Papillary Carcinoma Folicular Variant compared to other malignant neoplasms. The most sensitive markers for malignant tumors were PAX8 and CITED1 (90%, 88% ). The most specific markers for malignant tumors were HBME1, CITED1 (97%, 92% ). The most sensitive and specific marker for Papillary Carcinoma, Papillary Carcinoma Folicular Variant was HBME1 (100%, 80%). CD56 (loss of expression), CITED1 was the most sensitive markers for Papillary Carcinoma Folicular Variant ( 86%,86%).
DISCUSSION AND CONCLUSION: HBME1 was found an both sensititive and specific marker for Papillary Carcinoma. The cytoplasmic expression of CITED1 was significantly higher in PC compared to other malignant tumors. Nuclear expression of PAX8 was found significantly higher in benign cases compared to malignant tumors. HBME1,CD56 (loss of expression) was found significantly higher in Papillary Carcinoma, Papillary Carcinoma Folicular Variant compared to other malignant tumors.

GÝRÝÞ ve AMAÇ: Primer santral sinir sistemi lenfomalarý (PSSSL) nadir görülen bir ekstranodal Non-Hodgkin lenfoma alt grubu olarak tanýmlanmaktadýr. Ýndüksiyon tedavileri, çoðunlukla PSSSL'li hastalar için yüksek doz metotreksat bazlý kemoterapileri içerir. Konsolidasyon tedavisi için hala standart bir yaklaþým yoktur. Son zamanlarda, yüksek doz kemoterapi sonrasý otolog kök hücre transplantasyonu (OKHN) ile konsolidasyon tedavide yaygýn olarak kullanýlmaktadýr. Bu çalýþmada, merkezimizde OKHN uygulanan PSSSL hastalarýnýn sonuçlarýný deðerlendirmeyi hedefliyoruz.
YÖNTEM ve GEREÇLER: Dr. Abdurrahman Yurtaslan Ankara Onkoloji Hastanesi Hematoloji Ünitesi'nde 2010-2021 yýllarý arasýnda taný konulan PSSSL hastalarýnýn verileri geriye dönük olarak incelendi.
BULGULAR: On bir hastaya PSSSL tanýsý konuldu. Çalýþmaya dahil edilen hastalarýn medyan yaþý 53.5 yýl (38-68) idi. Sekiz hastaya indüksiyon tedavisi sonrasý upfront konsolidasyon amacýyla OKHN uygulandý. Yedi hasta OKHN'den üç ay sonra tam yanýta ulaþtý; bir hasta naklin ilk ayýnda çýkýþ nedeniyle deðerlendirilmedi. Üç hastaya, transplantasyona uygun olmamalarý ve mobilizasyon baþarýsýzlýðý nedeniyle OKHN yapýlamadý. Çalýþmadaki ortanca takip süresi 26 aydý (8-82 ay). Median genel saðkalýma ulaþýlmadý. Nakille iliþkili mortalite % 12.5 ve tüm kohortta mortalite oraný % 27 idi. OKHN olmuþ hastalarýn % 62.5’unda iki yýla yakýn toplam saðkalým avantajý saptandý. Tüm kohort için hastalarýn %73'ü takipte daha uzun süreli saðkalým þansý saðlamýþtýr.
TARTIÞMA ve SONUÇ: Bizim kohortumuzda, PSSSL hastalarý çoðunlukla yüksek riskli hastalýða sahip olmasýna raðmen hastalarýn dörtte üçü OKHN olabildi ve ayný oranda hasta uzun süreli saðkalým avantajý saðladý.

INTRODUCTION: Primary central nervous system lymphomas (PCNSL) are defined as a rare extranodal Non-Hodgkin lymphoma subgroup. The induction regimens involve high dose methotrexate-based chemotherapies mostly for the patients with PCNSL. There is still no standard approach for consolidation therapy. Recently, consolidation with autologous stem cell transplantation (ASCT) after high-dose chemotherapy has been widely used in the treatment of PCNSL. We aim to evaluate the results of PCNS patients who underwent ASCT in our center.
METHODS: The data of PCNSL patients diagnosed in Hematology Unit of Dr. Abdurrahman Yurtaslan Ankara Oncology Hospital between 2010 and 2021 were analyzed retrospectively.
RESULTS: Eleven patients were diagnosed with PCNSL diagnosis. The patients' median age included in the study was 53.5 years (range 38-68). Eight patients underwent ASCT for upfront consolidation. Seven patients achieved CR three months after ASCT; one patient was not evaluated due to exitus in the first month of the transplant. Three patients could not achieve ASCT due to transplantation ineligibility patients and mobilization failure. The median follow-up period in the study was 26 months (range 8-82 months). The median overall survival was not reached. Transplant-related mortality was 12.5%, and the mortality rate was 27% in the whole cohort. In patients who received ASCT, of the 62.5 % had an almost two-year survival advantage. For the whole cohort, 73% of the patients had change for more prolonged survival among follow-up.
DISCUSSION AND CONCLUSION: In our cohort, the PCNSL patients had mostly high-risk disease; however, three-quarters of the patients could receive ASCT, and at the same rate of the patients had advantages for long-term survival.

GÝRÝÞ ve AMAÇ: Bu çalýþmada, BCR / ABL-negatif kronik miyeloproliferatif neoplazmý (KMPH) olan hastalarýn, kemik mineral dansitometri ölçümlerindeki deðiþiklikleri ve prognostik faktörlerle iliþkisini incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: KMPH tanýsý alan 38 erkek (% 52.1) ve 35 kadýn (% 47.9) olgunun verileri retrospektif olarak incelendi. Taný sýrasýnda gerçekleþtirilen femur boynu ve lomber omurganýn yaþ, cinsiyet, taný (polisitemia vera (PV), esansiyel trombositoz (ET)), JAK2V617F mutasyon pozitifliði, KMPH komplikasyonlarýnýn varlýðý ve kemik mineral dansitometrisi (KMD) ölçümleri her hasta için kaydedildi. Hastalar; erkekler için 65 yaþ altý ve 65 yaþ üstü, kadýnlar için menopoz öncesi ve menopoz sonrasý durum olarak dört gruba ayrýldý. Ayrýca T skoru; femur boynu ve lomber omurgaya göre normal ve azalmýþ kemik yoðunluðu olarak gruplandýrýldý.
BULGULAR: Kadýn hastalarda lomber omurgada daha fazla kemik kaybý olduðu bulundu (p = 0.031). Kadýn hastalarda, lomber omurga KMD'sindeki azalma postmenopozal grupta daha fazlaydý (p = 0.012). Femur boynundaki kemik yoðunluðunda azalma 65 yaþ üstü grupta daha fazla bulundu (p = 0.01). KMD ile ET ya da PV tanýsý, JAK2V617F mutasyon pozitifliði, tromboz ve kanama gibi KMPH komplikasyonlarý arasýnda iliþki yoktu.
TARTIÞMA ve SONUÇ: Çalýþmamýzda elde edilen sonuçlara göre, KMPH varlýðý kadýn hastalarda lomber bölgede kemik kaybýný arttýrmaktadýr. Bu nedenle, menopoz öncesi grupta KMD ölçümü ve kalsiyum destekleyici tedavi planlamasýnýn kadýn KMPH hastalarda faydalý olduðu düþünülmektedir.

INTRODUCTION: This study aims to determine the changes in and the factors related to the bone mineral density in patients with BCR/ABL-negative chronic myeloproliferative neoplasm (CMPD).
METHODS: The data of 38 males (52.1%) and 35 females (47.9%) patients diagnosed with CMPD were analyzed retrospectively. The age, gender, diagnosis (polycythemia vera (PV), essential thrombocythemia (ET)), JAK2V617F mutation positivity, the presence of the CMPD complications and the bone mineral densitometry (BMD) measurements of femur neck and lumbar spine carried out during the diagnosis were recorded for each patient. The patients were divided into four groups: under 65 and over 65 years old for men, premenopausal and postmenopausal status for women. They were also grouped according to the T score of the femur neck and lumbar spine with normal and decreased bone density.
RESULTS: Female patients were found to have more bone loss in the lumbar spine (p=0.031). In female patients, the reduction in the lumbar spine BMD was greater in the postmenopausal group (p=0.012). The decrease in bone density in the femur neck was found to be greater in the group above 65 years of age (p=0.01). There was no relationship between BMD and ET, PV, JAK2V617F mutation positivity, and CMPD complications such as thrombosis and hemorrhage.
DISCUSSION AND CONCLUSION: According to the results obtained in our study, the presence of CMPD increases bone loss in lomber area in female patients. Therefore, the BMD measurement and calcium-D supportive treatment planning in the premenopausal group are thought to be beneficial in female patients.

GÝRÝÞ ve AMAÇ: Kolon kanseri tüm dünyada en sýk görülen maligniteler arasýndadýr. Kansere baðlý ölüm nedenleri arasýnda 4. Sýradadýr. Lenfovasküler invazyon (LVI), küçük lenfatik veya kan (tipik olarak venöz) damarlarýn tümör tarafýndan tutulmasý iken perinöral invazyon (PNI) ise sinirlerin ve sinir kýlýflarýnýn içinde, çevresinde ve boyunca tümörün büyümesidir. Çalýþmamýzda LVI ve PNI’nýn kolon kanserli hastalarda prognoz, tümör evresi ve lenf nodu metastazýna etkisi araþtýrdýk.
YÖNTEM ve GEREÇLER: Þubat 2013 - Ocak 2020 tarihleri arasýnda kolon kanseri nedeniyle opere edilen hastalarýn verileri retrospektif olarak inceledi. Hastalarýn ameliyat ve patoloji raporlarý, demografik özellikleri, genel saðkalýmlarý incelendi.
BULGULAR: 248 hasta kolon kanseri nedeniyle opere edildi. 120 hastada LVI, 105 (41.9%) PNI hastada vardý. Grade, lenf nodu pozitifliði, LVI, PNI, T ve N evrelerinin saðkalýmla iliþkisi istatistiksel olarak anlamlý bulunmuþ olup sýrasýyla p deðerleri: 0.028, <0.001, <0.001, <0.001, 0.005 ve <0.001’dir. LVI ve PNI'nin diðer faktörlerle iliþkisi incelendiðinde, T ve N evresi, metastatik lenf nodu ve saðkalým süresi açýsýndan her iki grupta da istatistiksel olarak anlamlý bir iliþki olduðu gösterilmiþtir. (p <0,001)
TARTIÞMA ve SONUÇ: LVI ve PNI varlýðý özellikle erken evre hastalarda prognozun, lenf nodu metastazýnýn bir belirleyici olmasýndan dolayý; LVI ve PNI pozitif olan hastalarýn yakýn izlemin, adjuvan tedavi için multidisipliner konseyde deðerlendirilmenin prognoza olumlu etkilerinin olabileceðini düþünmekteyiz.

INTRODUCTION: Colon cancer is one of the most common types of malignant tumours in the world. Colon cancer ranks fourth among cancer-related deaths. Lymphovascular invasion (LVI) is the tumour involvement of small lymphatic or blood (typically venous) vessels while perineural invasion (PNI) is the growth of the tumour in, around, and along the nerves and nerve sheaths. In our study, we investigated the effects of LVI and PNI on prognosis, tumour stages, and lymph node metastasis in colon cancer patients.
METHODS: The data of patients, who underwent colon cancer surgery in the period between February 2013 and January 2020, were analyzed retrospectively. The surgery and pathology reports, demographic characteristics, and overall survival of the patients were examined.
RESULTS: A total of 248 patients were operated due to colon cancer. LVI and PNI were present in 120 (48.3%) and 105 (41.9%) patients, respectively. The relationship of the grade, of the presence of positive lymph nodes, LVI, and PNI, and of the T- and N-stages with the survival were statistically significant with the following p-values of 0.028, <0.001, <0.001, <0.001, 0.005, and <0.001, respectively. When the relationship of LVI and PNI with other factors was examined, it was shown that there was a statistically significant relationship in both groups in terms of T and N stage, metastatic lymph node and survival time. (p <0.001)
DISCUSSION AND CONCLUSION: Because the presence of LVI and PNI is a determinant of prognosis and lymph node metastasis especially in early-stage patients; we think that close follow-up of patients with LVI and PNI and the evaluation of such patients by a multidisciplinary council for the administration of adjuvant therapy, may affect prognosis favourably.

GÝRÝÞ ve AMAÇ: Jukstakortikal (yüzey) kondrosarkom(JKK), kondrosarkomlarýn daha çok genç eriþkinlerde görülen çok nadir bir alt tipidir. Bu çalýþmada JKK'ye ait demografik verilerin ve ortalama sað kalým oranlarýnýn raporlanmasý amaçlandý.
YÖNTEM ve GEREÇLER: Sürveyans, Epidemiyoloji ve End Results (SEER) veritabanýnýn en son versiyonu kullanýlarak yapýlan bu çalýþmada, hastalar, cinsiyet, yaþ, ýrk/etnik köken, lezyonun vücutta yerleþim yeri, tümörün diferansiasyon derecesi, uygulanan cerrahiler ve takip süreleri altbaþlýklarýnda incelendi. Tanýmlayýcý istatistikler ortalama ± standart sapma, sýklýk ve yüzde olarak verildi.
BULGULAR: Çalýþmaya toplam 52 hasta dahil edildi, bu hastalarýn 16'sý kadýn 36'i (%69) erkekti ve yaþ ortalamalarý 41,3±20,0 std (8-84 yaþ arasý) idi. Etnik köken açýsýndan incelendiðinde en fazla beyaz ýrkta (%84,6) görüldüðü saptandý. Tümöral lezyonlarýn en sýk görüldüðü lokalizasyon alt ekstremite uzun kemikleri ve iliþkili eklemleri(%50) idi. Tümör diferansiasyonlarý açýsýndan incelendiðinde en sýk düþük dereceli tümörler (tüm tümörlerin %45'i) görüldü. Ortalama takip süresi 125,5 ay (4-358 ay arasý) idi.
TARTIÞMA ve SONUÇ: JKK çok nadir bir kondrosarkom türüdür ve sýklýkla diðer kondrosarkom tiplerine göre daha düþük grade'li olarak görülür. Erkeklerde biraz daha sýktýr. En sýk alt ekstremiteye, özellikle de femur diafizine olmak üzere, uzun kemiklere yerleþim eðilimindedir.

INTRODUCTION: Juxtacortical (surface) chondrosarcoma (JCC) is a very rare subtype of chondrosarcoma, mostly seen in young adults. In this study, we aimed to report demographic data and avarage survival rates of JCC.
METHODS: In this study we used the latest version of the Surveillance, Epidemiology and End Results (SEER) database, patients were examined under the titles of gender, age, race / ethnic origin, lesion location in the body, degree of tumor differentiation, applied surgeries and follow-up periods. Descriptive statistics were given as mean ± standard deviation, frequency and percentage.
RESULTS: A total of 52 patients were included in the study, of which 16 were female and 36 were male (69%), with a mean age of 41.3 ± 20.0 years (range: 8-84 years). When examined for ethnicity, it was found that it was seen most in white race (84.6%).The most common localization of tumor lesions was the lower extremity long bones (50%).Low grade tumor (45% of all tumors) was the most common tumor differentiation. The mean follow-up was 125,5 months (range 4 to 358 months).
DISCUSSION AND CONCLUSION: JCC is a very rare type of chondrosarcoma, and often seen as lower grade compared to other types of chondrosarcoma. It's a little more common in men. It tends to settle on the long bones, most commonly on the lower extremity, especially the femoral diaphysis.

GÝRÝÞ ve AMAÇ: Amaç: Rektum hacim deðiþiklikleri prostat radyoterapisi sýrasýnda verilen dozu etkilemektdir. Hacimsel Ayarlý Ark Terapi (VMAT) uygulanan prostat kanseri hastalarýnda tedavi süresince laksatif kullanýmýnýn rektum hacim ve dozlarýna etkisinin deðerlendirilmesi amaçlandý.

YÖNTEM ve GEREÇLER: Gereç ve Yöntem: Kliniðimizde tedavi edilen 20 hastanýn tedavi planlama tomografi (simCT) ve koni ýþýnlý bilgisayarlý tomografi (CBCT) görüntüleri retrospektif olarak deðerlendirildi. Laksatif kullanan (L+)(n: 10) ve laksatif kullanmayan (L-)(n: 10) hastalar olacak þekilde 2 grup belirlendi. Toplam 160 tane CBCT görüntüsünde rektum hacimleri yeniden konturlandý. Her hastanýn kendi VMAT planý kendi CBCT görüntüleri üzerinde tekrar hesaplatýlarak rektum dozlarý elde edildi.
BULGULAR: Bulgular: Tüm hastalarýn rektum hacimleri CBCT görüntülerinde simCT görüntülerine göre artýþ göstermiþtir. Belirli bir dozu alan rektum hacminin % deðeri (Vx) için simCT ve CBCT planlarý karþýlaþtýrýldýðýnda 40Gy, 50Gy, 60Gy ve 70Gy dozlarýnýn hepsi için tüm hastalarda tedavi süresince artýþ bulunmuþtur. Laksatif kullanan hasta grubunun tedavi planlarýndaki Dmean deðerleri simCT görüntülerde 39 Gy ve CBCT görüntülerde 43 Gy bulunmuþtur (p = 0.009). Alternatif olarak, laksatifleri kullanmayan hasta grubunda, tedavi planlarýndaki Dmean deðerleri simCT görüntülerinde 40 Gy ve CBCT görüntülerinde 44 Gy bulunmuþtur (p = 0.047).
TARTIÞMA ve SONUÇ: Sonuç: Prostat radyoterapisi uygulanan hastalarda tedavi sýrasýnda rektum hacmi ve aldýðý radyasyon dozu, laksatif kullanýmýndan baðýmsýz olarak, baþlangýç tedavi planýna göre artmaktadýr.

INTRODUCTION: Objective: Changes in rectum volume can affect dose delivery during prostate radiotherapy. The aim of this study was to evaluate how laxative use affected rectum volumes and doses in patients with prostate cancer treated with Volumetric Modulated Arc Therapy (VMAT).
METHODS: Material and Methods: Treatment planning computed tomography (simCT) and cone-beam computed tomography (CBCT) images collected from 20 patients with prostate cancer were retrospectively evaluated. These patients were divided into two groups as those who either used or did not use laxatives during radiotherapy. Rectum volumes were re-contoured on 160 CBCT images, and VMAT treatment plans were re-calculated to determine rectum doses.
RESULTS: Results: In all patients, CBCT images showed increased mean rectum volumes and doses relative to simCT images. Furthermore, the percent volume (Vx) of the rectum receiving 40, 50, 60, and 70 Gy doses based on CBCT results were larger than those based on simCT. The Dmean values in the treatment plans for the group with laxative use were 39 Gy on simCT images and 43 Gy on CBCT images (p = 0.009). Alternatively, in the group without laxatives, the Dmean values in the treatment plans were 40 Gy on simCT images and 44 Gy on CBCT images (p = 0.047).
DISCUSSION AND CONCLUSION: Conclusion: In patients undergoing prostate radiotherapy, rectum volume and doses increase regardless of laxative use. Although laxatives can limit volume expansion of the rectum, they do not have the expected effect on rectum doses and actually significantly increase all dosimetric parameters.

GÝRÝÞ ve AMAÇ: Ýmmünohistokimya kullanýlarak, Diffüz büyük B hücreli lenfoma (DBBHL) vakalarý germinal merkez B hücresi benzeri (GCB) ve ABC grubu olmak üzere prognositk açýdan önemli olan alt tiplere ayrýlabilir. Biz bu çalýþmada DBBHL’li hastalarýn patoloji preparatlarýnda CD10, B hücreli lenfoma 2 ve 6 (BCL2 ve BCL6) ve multipl miyelom onkogen 1 (MUM1) markerlarýnýn sýklýðýný ve rituksimab içeren kemoterapi gruplarýndaki prognostik etkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Hastalar, kemoterapi rejimleri açýsýndan, siklofosfamid, doksorubisin, vinkristin ve prednizon (CHOP) veya Rituksimab-CHOP olarak 2'ye ayrýldý. Hastalarýn tedaviye yanýtý, takip süreleri ve tedavi sonuçlarý kaydedildi. Taný anýndaki patoloji preparatlarýndan CD10, BCL6 ve MUM1 / IRF 4 biyomarkerlarý için boyama yapýlarak hastalar immünohistokimyasal panel açýsýndan GCB veya ABC olarak alt gruplara ayrýldý.
BULGULAR: Toplam 81 hasta (39 erkek, 42 kadýn) çalýþmaya dahil edildi. Taný sýrasýnda 31 hastada (% 38,3) CD10; 53 hastada BCL-6 (% 65,4); MUM-1 47 hastada (% 58); BCL-2 53 hastada (65,4) pozitifti. Bu sonuçlarla 36 hasta (% 44.4) GCB grubu, 45 hasta (% 55.6) ABC grubu olarak tanýmlandý. Saðkalým analizinde gruplar ve biyomarkerlar arasýnda istatistiksel olarak anlamlý bir farklýlýk saptanmamýþtýr.
TARTIÞMA ve SONUÇ: DLBCL hastalarýnýn saðkalýmýnda CD10, BCL-6, MUM-1 veya BCL-2 pozitifliði veya GCB ve ABC gruplarýnýn anlamlý bir etkisi saptanmamýþtýr.

INTRODUCTION: Immunohistochemistry may serve as a surrogate to define Diffuse large B-cell lymphoma (DLBCL) cases as germinal center B cell-like (GCB) or non-GCB subtypes and to provide prognostic information. In this study, we aimed to investigate the frequency and prognostic impact of CD10, B-cell lymphoma 2 and 6 (BCL2 and BCL6) and multiple myeloma oncogene 1 (MUM1) expressions in pathology sections of patients with DLBCL to determine the response of these subgroups to the rituximab including chemotherapy regimens.
METHODS: Patients were grouped into 2 regarding the chemotherapy regimens they were treated, as cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or Rituximab-CHOP. The treatment response, follow-up periods and outcomes of patients were recorded. The immunohistochemical panel was stained in pathology sections for CD10, BCL6 and MUM1/IRF 4 biomarkers. The patients were subgrouped as GCB or ABC regarding the immunohistochemical panel.
RESULTS: Totally 81 patients, (39 male, 42 female) were included in the study. At the time of diagnosis, CD10 was positive in 31 patients (38.3%); BCL-6 in 53 patients (65.4%); MUM-1 was positive in 47 patients (58%) and BCL-2 was positive in 53 patients (65.4). With these results, 36 patients (44.4%) were in the GCB group and 45 patients (55.6%) were in the ABC group. No significant difference was found between the individual markers and subgroups in survival analyses.
DISCUSSION AND CONCLUSION: We did not determine any significant effect of CD10, BCL-6, MUM-1 or BCL-2 positivity or GCB and non-GCB groups in the survival of patients with DLBCL.

GÝRÝÞ ve AMAÇ: Bu kesitsel çalýþma meme kanseri hastalarýnda kinezyofobi sýklýðýnýn belirlenmesi ve hayat kalitesi ve komorbidite baþta olmak üzere yorgunluk, lenfödem, depresyon gibi klinik özellikler ile iliþkisini araþtýrmayý amaçlamaktadýr.

YÖNTEM ve GEREÇLER: Çalýþmaya Kasým-Aralýk 2020 tarihlerinde Aydýn Atatürk Devlet Hastanesi Týbbi Onkoloji Polikliniði’nde meme kanseri tanýsý ile remisyonda izlemde olan 54 kadýn dahil edilmiþtir. Hastalarýn taný anýndaki klinikopatolojik özellikleri kaydedildi. Hareketten kaçýnma durumu Kinezyofobi Tampa Kinezyofobi Skalasý (TKS) ile deðerlendirildi. Lenfödem varlýðý her iki koldan çap ölçümüleri ile deðerlendirildi. Depresyon varlýðýnýn araþtýrýlmasý için Beck depresyon ölçeði (BDÖ), hayat kalitesinin deðerlendirilmesi için Avrupa Kanser Araþtýrma ve Tedavi Organizasyon Grubu (EORTC) hayat kalitesi formu QLQ-C30 (versiyon 3.0) kullanýldý. Komorbiditelerin belirlenmesi için Charlson Komorbidite Indexi (CKI) ve yorgunluk için 10 cm’lik vizüel analog skala (VAS) kullanýlmýþtýr. TKS ile CKI, BDÖ, VAS-yorgunluk, EORTC-30 arasýndaki iliþki deðerlendirildi.
BULGULAR: Hastalarýn ortalama yaþý 52.11±11.10 yýl idi. Hastalardan 36’sý (%66,7) TKS skorlarýna göre kinezyofobik olarak sýnýflandýrýldý (TKS>37). Kinezyofobik grupta adjuvan radyoterapi alma oraný anlamlý olarak daha yüksekti. Ayrýca kinezyofobik hastalarýn EORTC-30 hayat kalitesi anketinin genel saðlýk, fiziksel ve duygusal iþlev puanlarý anlamlý olarak daha düþük, maddi zorluk, semptom skalasý, BDÖ ve VAS-yorgunluk puanlarý ise anlamlý olarak daha yüksekti. Lenfödem varlýðý, CKI ve diðer klinik parametrelerde fark tespit edilmedi (p>0.05). Maddi zorluk ve semptom skalasý dýþýndaki tüm EORTC QLQ-30 sub-grup skorlarý ve TKS arasýnda negatif yönde anlamlý iliþki saptanýrken, VAS-yorgunluk, BDÖ, EORTC QLQ-30 semptom skalasý ve maddi zorluk puanlarý ile anlamlý pozitif iliþki gözlendi. TSK ile CKI arasýnda iliþki bulunmadý.

TARTIÞMA ve SONUÇ: Kinezyofobi meme kanseri hastalarýnda oldukça sýk görülmekte olup hayat kalitesi, depresyon ve yorgunlukla iliþkili bulunmuþtur. Hastalarýn bu konuda biligilendirilip daha aktif bir hayat tarzý için motive edilmesi yararlý olabilir.

INTRODUCTION: This cross-sectional study aims to determine the frequency of kinesiophobia in breast cancer survivors and evaluate its relationship with mainly quality of life and comorbidities, also fatigue, lymphedema, and depression.
METHODS: This study included 54 women with breast cancer who were followed in remission in Aydýn Atatürk State Hospital Medical Oncology Clinic between November-December 2020. Clinicopathological characteristics of the patients were recorded. Kinesiophobia was assessed using the Turkish version of Tampa Scale for Kinesiophobia (TSK). Lymphedema was evaluated with bilateral upper extremity measurements. Depressive status and quality of life were determined using the Beck Depression Inventory (BDI) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Version 3.0 (EORTC QLQ-C30 v3). Comorbidities were assessed using the Charlson Comorbidity Index (CCI) while fatigue was evaluated by 10 cm visual analogue scale (VAS). The relationship between the TSK and CCI, BDI, VAS-F, EORTC-30 were investigated.
RESULTS: The mean age of patients was 52.11±11.10 years. Of the patients, 36 (66.7%) had kinesiophobia based on having TSK scores above 37. The rate to recieve adjuvant radiotherapy was higher in kinesiophobic group. Kinesiophobic patients had statistically significantly lower global health, physical functioning, and emotional functioning scores and higher depression and VAS-fatigue scores. Kinesiophobic patients also had higher financial difficulty and higher sypmtom scale scores. Comorbidities and presence of lymphedema did not differ between groups (p>0.05). All EORTC QLQ-30 sub-parameter scores except financial difficulty and symptom severity had negative significant correlations with TSK scores while VAS-fatigue, BDI, EORTC QLQ-30 symptom scale and financial difficulties showed significant positive correlations. TSK score was not associated with comorbidity.
DISCUSSION AND CONCLUSION: Kinesiophobia is rather high in breast cancer survivors and has correlations with worse quality of life and higher depression and fatigue scores. These patients should be trained and encouraged for an active life style.

GÝRÝÞ ve AMAÇ: BCR / ABL-negatif miyeloproliferatif neoplaziler, kemik iliðindeki miyeloid öncül hücrelerin aþýrý üretimi ile karakterizedir. Polisitemi vera, esansiyel trombositemi ve primer miyelofibrozis en sýk görülen miyeloproliferatif neoplazilerdir. Bu çalýþmanýn amacý hastalarýn demografik özelliklerini, klinik seyir ve laboratuvar bulgularýný komplikasyonlar ve saðkalým ile birlikte analiz etmektir.
YÖNTEM ve GEREÇLER: Bu çalýþmaya 2008-2019 yýllarý arasýnda miyeloproliferatif neoplazi tanýsý alan hastalar dahil edildi. Kan parametreleri, demografik bilgiler, mutasyon analizi, tedavi, komplikasyonlar ve takip süreleri kaydedildi. Saðkalým oranlarý hesaplandý ve parametrelerin genel saðkalým üzerindeki etkisi analiz edildi.
BULGULAR: 105 Polisitemi vera, 126 esansiyel trombositemi ve 16 primer miyelofibrozis olmak üzere oluþan toplam 247 hasta deðerlendirildi. Takip sýrasýnda 11 polisitemi vera, 14 esansiyel trombositemi ve 2 primer miyelofibrozis hastasýnda tromboembolik komplikasyon geliþti. Polisitemi vera ve esansiyel trombositemi hastalarýnda ortalama genel saðkalýma ulaþýlamadý, ancak primer miyelofibrozis hastalarýnda 70.3 ay olarak belirlendi. Taný anýnda yaþ, LDH, ferritin ve trombosit / lenfosit oraný ve tromboembolik komplikasyonlarýnýn tüm miyeloproliferatif neoplazi hastalarýnda saðkalým üzerinde istatistiksel olarak anlamlý bir etkisi olduðu belirlenmiþtir. Primer miyelofibrozis hastalarýnda daha düþük saðkalým oranlarý görülmesine raðmen, tromboembolik komplikasyon oraný 3 hasta alt grubunun hepsinde benzer oranlarda izlenmiþtir.
TARTIÞMA ve SONUÇ: Yaþ ve tromboembolik komplikasyonlar gibi bilinen risk faktörlerine ek olarak, LDH, ferritin ve PLR gibi hastalýk aktivitesini ve inflamasyonu gösteren parametreler de bu hastalýklarýn takibinde prognostik belirteç olarak kullanýlabilir.

INTRODUCTION: BCR/ABL-negative myeloproliferative neoplasms are characterized by over-production myeloid lineages in the bone marrow. Polycythemia vera, essential thrombocythemia and primary myelofibrosis are the most common myeloproliferative neoplasms. The aim of this study was to analyse patient demographic characteristics, laboratory findings, mutational status together with complications, clinical course and survival.
METHODS: This study was conducted on patients diagnosed with myeloproliferative neoplasms between 2008 and 2019. Blood parameters, demographic information, mutation analysis, management, complications and follow-up periods were recorded. Survival rates were calculated and the effect of the parameters on overall survival was analyzed.
RESULTS: Evaluation was made of 247 patients, comprising 105 polycythemia vera, 126 essential thrombocythemia and 16 primary myelofibrosis patients. During follow-up, 11 polycythemia vera, 14 essential thrombocythemia and 2 primary myelofibrosis patients developed thromboembolic complications. Median overall survival could not be reached in polycythemia vera and essential thrombocythemia patient and determined as 70.3 months in primary myelofibrosis patients. Age, LDH, ferritin and platelet/lymphocyte ratio at the time of diagnosis and thromboembolic complications were determined to have a statistically significant effect on survival in all patients. Lower survival rates were seen in the primary myelofibrosis patients although thromboembolic complications were observed at similar rates in all 3 disease subgroups.

DISCUSSION AND CONCLUSION: In addition to known risk factors such as age and thromboembolic complications, parameters such as LDH, ferritin and PLR, which may be considered to indicate disease activity and inflammation, can also be used as prognostic markers.

GÝRÝÞ ve AMAÇ: Reproduktif dönemde taný alan epitelyal over tümörlerinin (EOTs) ayýrýcý tanýsýnda tam kan sayýmý inflamatuar parametreleri ile serum Ca-125 seviyelerinin prediktif deðerlerinin karþýlaþtýrýlmasý.
YÖNTEM ve GEREÇLER: Bu çalýþmada reproduktif dönemde olan 105 kadýn sýrasýyla retrospektif olarak incelenmiþtir. Dahil edilen kadýnlar klinik, laboratuar ve patolojik özellikleri açýsýndan incelenmiþtir.
BULGULAR: Hastalarýn ortalama yaþý 41.5 ± 8.6 ve BMI 28.6 ± 5.8 idi. Tüm çalýþma populasyonunun 54 (51.5%) tanesi benign EOTs, 18 (17.1) tanesi borderline EOTs ve 33 (31.4%) tanesi malign EOTs idi. Bu üç tümör grubunun karþýlaþtýrýlmasýnda serum Ca-125 [14.7 U/mL (2.7-238.6) vs 60.2 U/mL (7.8 – 557) vs 416.5 U/mL (2.4-7695), p<0.001, sýrasýyla], platelet count [294, x103/ μL (133-744) vs 303, x103/ μL (160-468) vs 383, x103/ μL (128-725), p= 0.018, sýrasýyla], neutrophil count [4.2, x103/ μL (1.9 -8.9) vs 4.9, x103/ μL (2.6-10.9) vs 5.1, x103/ μL (2.2 – 10.7), p= 0.012], neutrophil-to-lymphocyte ratio (NLR) [2.1 (0.1-8.2) vs 2.6 (1.2 – 5.9) vs 3.1 (1-6.8), p= 0.021, sýrasýyla] ve platelet-to-lymphocyte ratio (PLR) [154.4 (82.1-658.4) vs 168.1 (91.1-377.8) vs 201.5 (29.6-499.2), p= 0.008, sýrasýyla] deðerleri açýsýndan anlamlý fark saptandý. ROC analizinde, serum Ca-125 seviyesi (AUC= 0.818, p<0.001), platelets (AUC= 0.673, p= 0.005) ve PLR (AUC= 0.690, p= 0.002) deðerleri malign EOTs’lerini anlamlý olarak öngörmekte idi.
TARTIÞMA ve SONUÇ: Preopratif platelet sayýsý, nötrofil sayýsý ve PLR epitelyal over kanserlerini anlamlý olarak öngörmektedir. Ancak her üç parametrenin de tanýsal öngörü deðerleri ca-125’den daha düþüktür. Bu nedenle ca-125 hala EOTs’lerinin preoperative ayýrýcý tanýsýnda kullanýlabilecek en deðerli serum biyokimyasal belirteçtir.

INTRODUCTION: Comparison of predictive values of complete blood count inflammatory parameters and serum CA-125 levels in the differential diagnosis of patients with epithelial ovarian tumor (EOTs) diagnosed in the reproductive period.
METHODS: In this study, 105 women patients in the reproductive period were retrospectively analyzed. The patients included were examined in terms of clinical, laboratory and pathological features.
RESULTS: The mean age of the patients was 41.5 ± 8.6 and BMI was 28.6 ± 5.8. Of the whole study population, 54 (51.5%) were benign EOTs, 18 (17.1%) were borderline EOTs and 33 (31.4%) were malignant EOTs. When comparing these three tumor groups, a significant difference was found in terms of serum CA-125 [14.7 U/mL (2.7-238.6) vs 60.2 U/mL (7.8 – 557) vs 416.5 U/mL (2.4-7695), p<0.001, respectively], platelet count [294 x103/ μL (133-744) vs 303, x103/ μL (160-468) vs 383 x103/ μL (128-725), p = 0.018, respectively], neutrophil count [4.2, x103/ μL (1.9 -8.9) vs 4.9 x103/ μL (2.6-10.9) vs 5.1 x103/ μL (2.2 – 10.7), p = 0.012], neutrophil-to-lymphocyte ratio (NLR) [2.1 (0.1-8.2) vs 2.6 (1.2 – 5.9) vs 3.1 (1-6.8), p = 0.021, respectively] and platelet-to-lymphocyte ratio (PLR) [154.4 (82.1-658.4) vs 168.1 (91.1-377.8) vs 201.5 (29.6-499.2), p = 0.008, respectively] values. In the ROC analyses, serum CA-125 levels (AUC= 0.818, p <0.001), platelet count (AUC= 0.673, p = 0.005) and PLR (AUC= 0.690, p = 0.002) values significantly predicted malignant EOTs.
DISCUSSION AND CONCLUSION: Preoperative platelet count, neutrophil count and PLR predict epithelial ovarian cancers significantly. However, diagnostic predictive values of all three parameters are lower than CA-125. Therefore, CA-125 is still the most valuable serum biochemical marker that can be used in the preoperative differential diagnosis of EOTs.

GÝRÝÞ ve AMAÇ: Baþarýlý otolog hematopoetik kök hücre nakli için yeterli dozda CD34+ kök hücre mobilizasyonu ön koþuldur. Yapmýþ olduðumuz çalýþmada orjinal filgrastim (Neupogen) ile biyobenzer filgrastimin (Tevagrastimin) çevre kaný kök hücre mobilizasyonunda etkinlik açýsýndan karþýlaþtýrýlmasý amaçlanmýþtýr.
YÖNTEM ve GEREÇLER: Ankara Numune Eðitim ve Araþtýrma Hastanesi Kemik Ýliði Nakil servisinde Ocak 2015 ile Kasým 2018 tarihleri arasýnda kök hücre mobilizasyonu yapýlan 95 hasta retrospektif olarak analiz edildi. Tüm hastalara mobilizasyon rejimi olarak birinci gün siklofosfamid (düþük dozda: 2g/m2 veya yüksek dozda: 3-4 g/m2) ve kemoterapiden 1 gün sonra 5 g/kg dozunda G-CSF baþlanmýþtýr.
BULGULAR: Doksan beþ hastanýn 50’sine neupogen ile, 45’ine tevagrastim ile kök hücre mobilizasyonu yapýldý. Hastalarýn demografik özellikleri arasýnda yaþ, taný, radyoterapi alýp almamasý açýsýndan istatistiksel anlamlý farklýlýk yok iken (p> 0.05); alýnan siklofosfamid dozu (neupogen alan kolda daha çok yüksek doz siklofosfamid kullanýlmýþtýr.) ve cinsiyet (neupogen kolunda cinsiyet daðýlýmý eþit iken, tevagrastim kolunda daha çok erkek hastalar vardý.) açýsýndan farlýlýk tespit edildi (p<0.05). Yeterli engraftman için gereken minimum CD34 + hücre dozu olan 2 x 106/kg ve çift nakil için 4 x 106/kg lýk hedefe ulaþmak açýsýndan orjinal ve biyobenzer ürün kullanýmý arasýnda istatistiksel olarak anlamlý bir fark saptanmadý (p>0,05). Ancak 6 x 106/kg'ýn üzerinde kök hücre hedefine bakýldýðýnda neupogen lehine tevagrastim koluna göre istatistiksel olarak anlamlý bir fark izlenmiþtir (p=0,021). Otolog kök hücre nakli sonrasý nötrofil engraftman günleri karþýlaþtýrýldýðýnda, nötrofil engraftman zamanýnýn neupogen grubunda tevagrastim grubuna göre daha kýsa olduðu gözlenirken (yaklaþýk 1 gün) (p=0.015), trombosit engraftman zamaný neupogen ve tevagrastim gruplarýnda benzerdi (p=0.186).
TARTIÞMA ve SONUÇ: Calismamizda 6 x 106/kg'ýn üzerinde kök hücre toplanmasý hedeflendiðinde neupogen lehine farklýlýk gözlenmiþtir. Bu farklýlýðýn nedeni kullanýlmýþ olan siklofosfamid dozunun orjinal molekül (Neupogen) kolunda daha yüksek olmasý ile iliskili düþünülmüþtür. Daha çok vaka serileri içeren, yüksek doz siklofosfamidin kullanýldýðý, biyobenzer molekül (tevagrastim) ile orjinal molekülün (neupogen) kýyaslandýðý çalýþmalara ihtiyaç vardýr.

INTRODUCTION: A sufficient dose of CD34+ stem cell mobilization is a prerequisite for successful autologous hematopoietic stem cell transplantation. We aimed to compare the original filgrastim (Neupogen) with the biosimilar filgrastim (Tevagrastimin) in terms of efficacy in peripheral blood stem cell mobilization.
METHODS: Ninety-five patients who underwent stem cell mobilization, were analyzed retrospectively. We used Cyclophosphamide (low dose: 2g / m2 or high dose: 3-4 g / m2), as a mobilization regimen, on the first day and G-CSF at a dose of 5 g / kg was started one day after chemotherapy.
RESULTS: Stem cell mobilization was performed with Neupogen in 50 patients and with Tevagrastim in 45 patients. While there was no statistically significant difference between the demographic characteristics of the patients out of cyclophosphamide dose. Higher dose cyclophosphamide was used more in the arm receiving Neupogen (p <0.05). No statistically significant difference was found between the use of original and biosimilar products in terms of achieving the target of 2 x 106 / kg, which is the minimum CD34+ cell dose required for adequate engraftment, and 4 x 106 / kg for double transplantation (p> 0.05). However, if the target level of CD34+ stem cell was above 6 x 106 / kg, a statistically significant difference was observed in favor of Neupogen arm (p = 0.021). Neutrophil engraftment was shorter in the Neupogen arm compared to the Tevagrastim arm (p = 0.015).
DISCUSSION AND CONCLUSION: The difference was observed in favor of the Neupogen arm, when stem cell collection was aimed at above 6 x 106 / kg. The reason for this difference was thought to be related to the higher dose of cyclophosphamide used in the original molecule arm. We need further studies that were included more cases which are used high-dose cyclophosphamide for comparing the biosimilar molecule with the original molecule.

GÝRÝÞ ve AMAÇ: Sitomegalovirus (CMV) replikasyonunun, graft-versus-host hastalýðýnýn (GVHH) bir nedeni olduðu tartýþmalýdýr. Bu çalýþmanýn amacý CMV replikasyonunun akut GVHH geliþimine neden olup olmadýðýný deðerlendirmektir.
YÖNTEM ve GEREÇLER: Çalýþma, geriye dönüktür. Daha önceden allojenik hematopoietik hücre nakli (allo-HHN) öyküsü olan akut GVHH tanýsý alan hastalar çalýþmaya dahil edilmiþtir. Dahil edilen tüm hastalar 01/01/2013-31/10/2019 tarihleri arasýnda kemik iliði nakil ünitesinde takip edilmiþtir. Kontrol grubu olarak, allo-HHN sonrasý akut GVHH öyküsü olmayan hastalar alýnmýþtýr. Allojenik hematopoietik hücre naklinden sonra akut GVHH'si olan hastalar ile nakil sonrasý bilinen akut GVHH'si olmayan hastalarýn verileri karþýlaþtýrýlmýþtýr.
BULGULAR: Allojenik hematopoietik hücre naklinden sonra akut GVHH'li 59 hasta ve akut GVHH'si olmayan 178 hasta çalýþmaya dahil edilmiþtir. Akut GVHH'li hastalarýn 16'sý kadýn, 43'ü erkektir. Akut GVHH olmayan hastalarýn 62'si kadýn, 116'sý erkektir. Akut GVHH grubunda CMV replikasyonu olan hastalarda ortalama CMV-DNA düzeyi 1871,0 [821,0-16720,0] kopya/ml bulunmuþtur. Akut olmayan GVHH grubunda ise CMV-DNA düzeyi ortalamasý 1607,5 [601,0-119181,0] kopya/ml bulunmuþtur. Ýki grup arasýnda istatistiksel olarak anlamlý bir fark saptanmamýþtýr.
TARTIÞMA ve SONUÇ: CMV replikasyonunun, allo-HHN sonrasý akut GVHD geliþimine katkýda bulunmadýðý görülmektedir. CMV replikasyonunun baskýlanmasý akut GVHH geliþimini engellemeyebilir.

INTRODUCTION: It is controversial that cytomegalovirus (CMV) replication is a cause of graft-versus-host disease (GVHD). The aim of this study is to evaluate whether CMV replication causes acute GVHD development or not.
METHODS: The study is retrospective. Patients diagnosed with acute GVHD with a prior history of allogeneic hematopoietic cell transplantation (allo-HCT) were included in the study. All the included patients were followed-up in the bone marrow transplantation unit between 01/01/2013-10/31/2019. As the control group, patients without a history of acute GVHD after allo-HCT were included. The data of patients with acute GVHD after allo-HCT and patients with out known acute GVHD were compared.
RESULTS: Fifty nine patients with acute GVHD and 178 patients without acute GVHD after allo-HCT were included in the study. Sixteen of the patients with acute GVHD were female and 43 were male. Sixty two of the patients without acute GVHD were female and 116 were male. The average CMV-DNA level was found as 1871.0 [821.0-16720.0] copies/ml in patients who had CMV replication in the acute GVHD group. On the other hand, the average of CMV-DNA level was found as 1607.5 [601.0-119181.0] copies/ml in the non-acute GVHD group. There was no statistically significant difference between the two groups.
DISCUSSION AND CONCLUSION: CMV replication does not seem to contribute to acute GVHD development after allo-HCT. Suppression of CMV replication may not prevent acute GVHD development.

GÝRÝÞ ve AMAÇ: Parosteal osteosarkomlar nadir gözlenen bir osteosarkom tipidir. Klasik olarak kemoterapi ve radyoterapiye duyarsýz, düþük dereceli bir lezyondur. Ancak kolaylýkla çevre dokulara invazyon gösterebilmektedirler.Amacýmýz parosteal osteosarkomlarda manyetik rezonans görüntüleme (MRG) ile tespit edilen özelliklerin; cerrahi sýnýr, prognoz, onkolojik ve fonsiyonel sonuçlara etkilerini deðerlendirmektir.
YÖNTEM ve GEREÇLER: Kliniðimizde 2006-2018 yýllarý arasýnda parosteal osteosarkom tanýsý ile cerrahi tedavi uygulanmýþ asgari 2 yýl takip edilmiþ 15 hastanýn (4 Erkek/11 Kadýn) klinik ve radyolojik verileri retrospektif olarak deðerlendirildi. Epidemiyolojik verilerin yanýnda taný için uygulanan biyopsi yöntemi (açýk/kapalý) ve tanýda gecikme süresi not edildi. Hastalarýn tanýsal MRG kesitlerinde lezyonun azami çevresel uzaným oraný, intrameduller tutulum oraný, ve nörovasküler paket tutulumu deðerlendirildi. Rezeksiyon tipleri (segmental ekleme uzanan/hemikortikal) ve rezeksiyon sonrasý cerrahi sýnýrlar deðerlendirildi. Hastalarýn son kontrollerindeki fonksiyonel ve onkolojik sonuçlarý deðerlendirildi.
BULGULAR: Çalýþma grubumuzda ortalama yaþ 31.7(17-71), ortalama takip süresi 50.1(24-176) ay idi. En sýk tespit edilen tutulum distal femurdu. Kapalý biyopsi yöntemlerinin tekrarlayan biyopsiler/yanlýþ taný/uygunsuz giriþimlere yol açtýðý belirlendi(p<0.001,p=0.023). Lezyonun intrameduller tutulum oranýnýn, azami çevresel uzaným miktarý ile iliþkili olduðu belirlendi(p=0.006). %25’in altýnda intrameduller tutulum oranýnýn yapýlan uygun rezeksiyonlarla nüks veya metastazlara yol açmadýðý belirlendi. Ortalama MSTS skoru %87.8 idi. Nörovasküler tutulum varlýðýnýn metastazlar, derin enfeksiyonlar ve tekrarlayan cerrahiler ile iliþkili olduðu belirlendi(p=0.017, p=0.002, p=0.005). En sýk uygulanan rezeksiyon tipi segmental, ekleme uzanan rezeksiyon (9 hasta) idi. Hemikortikal rezeksiyon ve biyolojik rekonstrüksiyonlarýn en iyi MSTS skorlarýna sahip olduðu belirlendi (p=0.002). Yüksek azami çevresel uzaným miktarý, intrameduller tutulum oraný ve nörovasküler tutulum varlýðýnýn düþük MSTS skorlarý ile iliþkili olduðu belirlendi. 5-yýllýk genel saðkalýmýn %92.3, lokal-progresyonsuz saðkalýmýn %86.2 ve metastassýz saðkalýmýn ise %86.2 olarak tespit edildi.
TARTIÞMA ve SONUÇ: Parosteal osteosarkomlarda iðne biyopsisinin güvenilirliði sorgulamaya açýktýr. Tanýsal MRG’de ekleme uzaným kadar lezyonun azami çevresel uzaným miktarý, intrameduller tutulum oraný ve nörovasküler tutulum varlýðý cerrahi öncesi planlamada ve rekonstrüksiyon yöntemi belirlemede önem taþýmaktadýr. MRG’de lezyonun azami çevresel uzaným miktarý cerrahi sýnýrlarý belirleyebilmek açýsýndan önem taþýmaktadýr.

INTRODUCTION: Parosteal osteosarcoma is a rare low grade surface osteosarcoma variant which typically resistant to chemotherapy and radiotherapy. The aim of this study is to evaluate significance of Magnetic Resonance Imaging (MRI) characteristics and their effects on surgical margins, prognosis, oncological and functional outcomes of parosteal osteosarcoma in our clinic.
METHODS: Fifteen patients (4 male/11 female) who operated with the diagnosis of parosteal osteosarcoma in our clinic were retrospectively reviewed. The epidemiological data, biopsy method and delay in diagnosis are noted. The lesions maximum circumferential extension, intramedullary involvement and neurovascular extension in MRI sections were evaluated. The resection type (segmental articular/hemicortical) and surgical margins were noted. Functional and oncological results at last follow-up were assessed.


RESULTS: The mean age was 31.7 (17-71) years; mean follow-up was 50.1 (24-176) months. The most common site was distal femur. The closed biopsies were related with increased number of re-biopsies and misdiagnosis/improper interventions. (p<0.001,p=0.023) Intramedullary involvement percentage was related with maximum circumferential extension percentage (p=0.006) The intramedullary involvement ratio of ≤25% suggested no recurrence or metastasis. The mean MSTS score was 87.8% (range, 60-100%). The neurovascular involvement was related with metastatic disease, deep infections and complication related surgeries. (p=0.017, p=0.002,p=0.005) The most common resection type was segmental articular resection (9 patients). Hemicortical resections with biological reconstructions had the best MSTS scores. (p=0.002) The maximum circumferential extension percentage, intramedullary involvement percentage and neurovascular involvement showed lower MSTS scores. The 5-year overall survival was 92.3%, local recurrence-free survival was 86.2% and metastasis-free survival was 86.2%.
DISCUSSION AND CONCLUSION: The reliability of needle biopsy sampling is controversial in parosteal osteosarcomas. The lesions extent of intramedullary involvement, neurovascular bundle proximity and maximum periosteal circumferential extension on MRI should be considered when planning the surgery. The evaluation of maximum circumferential extension on MRI is crucial for the resection margins.

GÝRÝÞ ve AMAÇ: Özofagus adenokarsinomlarýnda birçok belirteç çalýþýlmýþ olmasýna raðmen, þu anda klinik kullaným için bir belirteç bulunmamaktadýr. Bu çalýþmada apoptozun Barrett's özofagusu ve adenokarsinom karsinogenezindeki rolünü araþtýrmayý, apoptotik-nekrotik belirteçler M30 ve M65'in prediktif deðeri olup olmadýðýný belirlemeyi ve Barrett's mukozasýný ve kanserli dokuyu immünohistokimyasal yöntemle incelemeyi amaçladýk.
YÖNTEM ve GEREÇLER: 18 yaþýndan büyük ve yeni taný almýþ katýlýmcýlara üst gastrointestinal endoskopi ile özofagus doku biyopsisi yapýldý. Kontrol grubu olarak Barrett's özofagusu olan 20, özofagus kanseri hastasý ve 20 gastroözofageal reflü hastalýðý olan hasta vardý. Alýnan doku örneklerinden M30 ve M65 immunohistokimyasal yöntemlerle boyandý. Örnekler, M30 ve M65 boyamasý açýsýndan gruplar arasýnda anlamlý bir immünohistokimyasal farklýlýk olup olmadýðýný görmek için incelendi.
BULGULAR: Gruplar arasýnda M30 ekspresyonu açýsýndan istatistiksel olarak anlamlý fark yoktu (p = 0,329). Kontrol ve Barrett's özofagus gruplarý ile karþýlaþtýrýldýðýnda, adenokarsinom grubunda M65 pozitifliði anlamlý olarak daha yüksekti (p = 0.0001).
TARTIÞMA ve SONUÇ: Çalýþmamýzda gruplar arasýnda M30 ekspresyonunda istatistiksel olarak anlamlý fark yoktu. Özofagus adenokarsinomunda M65 anlamlý olarak yüksek bulundu. Bu, özofagus adenokarsinomunun patogenezinde nekrozun daha baskýn olduðunu göstermektedir. M65, özofagus adenokarsinomunda prediktif bir belirteç olarak kullanýlabilir.

INTRODUCTION: Although many markers have been studied in esophageal adenocarcinomas, there is no marker currently available for clinical use. This study aimed to investigate the role of apoptosis in Barrett’s esophagus and adenocarcinoma carcinogenesis, determine whether there is a predictive value of apoptotic-necrotic markers M30 and M65, and examine Barrett’s mucosa and cancerous tissue by the immunohistochemical method.
METHODS: Esophageal tissue biopsy with an upper gastrointestinal endoscopy was performed on participants, who were older than 18 years and newly diagnosed. There were 20 with Barrett’s esophagus, 20 esophageal cancer patients and 20 gastroesophageal reflux disease patients as a control group. Among the tissue samples taken, M30 and M65 were stained with immunohistochemical methods. The samples were examined to see whether there was a significant immunohistochemical difference among the groups in terms of M30 and M65 staining.
RESULTS: There was no statistically significant difference among the groups in terms of M30 expression (p = 0.329). When compared to the control and the Barrett’s esophagus groups, M65 positivity was significantly higher in the adenocarcinoma group (p = 0.0001).
DISCUSSION AND CONCLUSION: There was no statistically significant difference in M30 expression among the groups in our study. M65 was found to be significantly high in esophageal adenocarcinoma. This suggests that necrosis is more dominant in the pathogenesis of esophageal adenocarcinoma. M65 can be used as a predictive marker in esophageal adenocarcinoma.

Meme kanseri çeþitli morfolojik, klinik ve moleküler özelliklere sahip heterojen bir hastalýktýr. Adjuvan tedavi endikasyonunu belirlemek için geleneksel olarak patolojik parametreler ve hastalýðýn klinik evresi kullanýlýr, ancak bu özellikler tedaviye ihtiyacý olan hastalarý belirlemek için yeterli deðildir. Kiþiselleþtirilmiþ tedaviler geliþtirmek için prognostik ve prediktif biyobelirteçlere ihtiyaç vardýr. Prediktif faktörler, belirli bir tedaviye yanýtýn göstergeleridir. MammaPrint® (Agendia, Amsterdam, Hollanda), Oncotype DX® (Genomic Health, Redwood City, CA), Prosigna® (Nanostring teknolojileri, Seattle, WA) ve Endopredict® (Myriad Genetics) adjuvan kemoterapinin yararý ve ek prognostik ve/veya prediktif bilgileri tahmin etmek için kullanýlan gen ekspresyon profilleridir. Bu derlemede, meme kanserli hastalarýn tedavi kararýnda gen ekspresyon imzalarýnýn rolünü güncel literatür ýþýðýnda tartýþmayý hedefledik.

Breast cancer is a heterogenous disease with various morphological, clinical and molecular features. Traditionally, pathologic parameters and clinical stage of the disease are used to determine indication of adjuvant treatment, however these features are not sufficient to identify the patients that need treatment. Prognostic and predictive biomarkers are needed to develop personalized treatments. Predictive factors are indicators of response to a particular treatment. MammaPrint® (Agendia, Amsterdam, the Netherlands), Oncotype DX® (Genomic Health, Redwood City, CA), Prosigna® (Nanostring technologies, Seattle, WA) and Endopredict® (Myriad Genetics) are gene expression profiles that are used to predict the benefit of adjuvant chemotherapy and provide additional prognostic and/or predictive information. In this review, we discuss the role of gene expression signatures in treatment decision of patients with breast cancer.