Background/aim: The purpose of this study was to analyze the clinicopathological characteristics of patients with papillary thyroid carcinoma (PTC) and papillary thyroid microcarcinoma (PTMC) and predictive factors for central lymph node metastasis (CLNM).Materials and methods: Patients diagnosed as having PTC and PTMC were evaluated. Clinical and laboratory parameters were recorded.Results: The mean age at diagnosis was 47.3 +- 11.9 years. Of all 223 patients, 91 (40.8%) had lymph nodes removed, 29 of whom had lymph node metastasis and 24 of whom had only CLNM. Univariate analysis revealed that central lymph node metastasis was associated with male sex, presence of bilaterality, presence of extrathyroidal extension, and tumor size (P = 0.033, P = 0.027, P < 0.001, P < 0.001, respectively). However, multivariate logistic regression analysis showed that sex, age, tumor size, multifocality, bilaterality, extrathyroidal extension, clinical suspicion, and chronic lymphocytic thyroiditis were not significantly correlated with an increased risk for CLNM.Conclusion: Lymph node metastasis is known to be a significant predictor of locoregional recurrence in patients with PTC and PTMC. Further prospective studies are needed to identify the extent of surgery such as central lymph node dissection in patients with PTC or PTMC.
The aims of this study were to evaluate histochemical markers of apoptosis in the cricopharyngeus muscle, which is the gatekeeper of the pharyngoesophageal region during the swallowing process; to investigate the effects of primary aging on this muscle; and to determine whether a relationship exists with gastroesophageal reflux disease.The study included 30 fresh cadavers with a time of death of 12 hours or less obtained from the Turkish Ministry of Justice Forensic Medicine Unit. All cadavers were dissected with routine postmortem skin incisions to extract specimens from the cricopharyngeus muscle and the esophagocardiac junction mucosa. Muscle degeneration and primary aging were demonstrated by immunodetection of Bax, Bcl-2, and Caspase-3 proteins as markers of the apoptosis. Esophageal specimens were examined for the presence of reflux esophagitis.The mean age was 41.5 (14-74) years, and the study included 18 male and 9 female cadavers. Three of them were excluded because of fixation artifacts. The mean Bax, Bcl-2, and Caspase scores showed no statistically significant relationship with age (P = 0.94). The right and left sides of the muscle were investigated separately, and the Bax scores of the right side of the cricopharyngeus muscle showed a statistically significant decrease with age (P = 0.026), whereas the Bax and Bcl-2 scores were increased with age (P = 0.035 and 0.049, respectively) on the left side. Evaluation of the 23 esophagus specimens revealed 10 cases of esophagitis. No relationship was found between the mean of each apoptotic marker and esophagitis.It is histopathologically not possible to demonstrate muscle death due to either primary aging or reflux. This might be attributable to the defensive capability of this unique muscle to maintain the feeding process.
e11549 Background: Educational status may be an important parameter in assessing breast cancer risk and prognosis. The aim of this study was to investigate the correlation between the level of education and clinicopathological characteristics of breast cancer, including tumor grade, HER-2 and estrogen receptor status, tumor size, axillary lymph node involvement and metastasis. Methods: The study included 1800 women who were diagnosed with invasive breast cancer during 2005-2013 at Hacettepe University Cancer Institute. Patients were divided into three groups according to their educational status at the time of diagnosis. This was classified as low (illiterate and elementary school, 5 years or less of education), medium (secondary school and upper secondary school, 6–12 years of education) and high (university level, more than 12 years of education). The associations between educational status and clinicopathologic features of breast cancer at the time of diagnosis were evaluated. Results: In all patient, a significant relationship was found between educational status and T stages (p < 0.0001). Patients with higher educational levels were reported to have smaller tumor size regardless to their age. Patients with high educational level were less likely to have axillary lymph node involvement (p = 0.001) or metastasis (p = 0.001). A significant correlation was found between educational status and estrogen receptor levels in patients over 50 years of age (p = 0,03). When the whole population was evaluated, no statistically significant correlation was shown (p = 0.27). A significant relationship was found between educational status and HER-2 status (p = 0.003), regardless of patients’ age. HER-2 positivity increased in patients with low educational status, however the significant increase was lost in patients over the age of 50 (p = 0.1). Conclusions: The relationship between educational status and biological factors in breast cancer are not conclusive as of yet, but this particular retrospective study revealed that, educational status played a major influence in each of the five breast cancer prognostic factors: hormone receptor status, HER-2 status, tumor size, lymph node status and metastasis.
PURPOSE The objective of the present study was to compare the efficacy of axitinib and nivolumab in metastatic renal cell carcinoma (mRCC) previously treated with targeted therapy. METHODS A total of 79 patients were enrolled (39 patients in axitinib group, 40 patients in nivolumab group). Survival outcomes of patients, progression-free survival (PFS), and overall survival (OS) were estimated using the Kaplan-Meier method and compared with the log-rank test. The associations between potential prognostic variables and OS were evaluated in univariate and multivariate Cox regression analyses. RESULTS The median PFS and OS of all cohort were 8.1 and 36.6 months, respectively. Higher PFS and OS were evaluated in axitinib group than nivolumab group (PFS: 9.4 months vs 6.3 months, p=0.386; OS: 38.2 months vs 36.6 months, p=0.671, respectively). Patients treated with axitinib had numerically higher objective response rate (ORR) and disease control rate (DCR) than those treated with nivolumab (ORR: 43.6% vs 27.6%, p=0.157, DCR: 74.4% vs 62.5%, p=0.157, respectively). Multivariate analysis revealed that the independent predictors of OS were higher tumor grade (hazard ratio [HR]: 6.178, p=0.004), worse response to axitinib and nivolumab (HR:4.902, p=0.011), the presence of lung metastasis (HR:15.637, p=0.002) and the presence of liver metastasis (HR:12.010, p=0.001). CONCLUSION Comparable survival outcomes were detected in the axitinib and nivolumab groups. However, head to head comparisons are needed to highlight the relative efficacy of these therapies in mRCC.
The directors of Academician Publishing House, have been conducting their commercial activities for a long time by transferring their 30 years of broadcasting experience to their legal entities. In the said period, it was proud to publish 750 books, particularly health and social sciences, cultural and artistic topics. The Academician, that defines the platform of being an international publishing house, is in the pursuit of creating a global brand in addition to broadcasting in Turkish and foreign languages.
Abstract A 56-year-old man with thoracal mass suspected of solitary plasmacytoma was referred for 18 F-FDG PET-CT scan. His PET-CT revealed FDG-avid rib mass and cervical lesion at level 2. He also underwent 18 F-fluorocholine (FCH) PET-CT to evaluate possible metastatic spread of the disease. FCH PET-CT showed increased uptake at the rib mass, while the cervical lesion was not FCH-avid. Biopsies confirmed rib lesion was a solitary plasmacytoma; however, the cervical lesion was an amyloid deposited lymph node. This case showed FCH PET-CT is a valuable companion of FDG scan for the evaluation of plasma cell dyscrasias with a better specificity.
period of AHTuse was 1.14 years. Such a short period of treatment was associated with a 33% reduction in the risk of ovarian cancer recurrence (hazard ratio, 0.67; 95% CI, 0.47 to 0.97). When compared with the magnitude of benefit from tamoxifen in breast cancer(treatment of5yearswasassociatedwitha39%reduction in the risk of recurrence), 10 this finding is striking and should be validated in larger cohorts before widespread use can be suggested.
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