Person: BOZKURTLAR, EMİNE
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BOZKURTLAR
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EMİNE
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Publication Metadata only The Importance of Lymph Node Drainage Areas of Ampullary Carcinomas(2022-03-01) BOZKURTLAR, EMİNE; BAĞCI ÇULÇİ, PELİN; Akar K., BOZKURTLAR E., BAĞCI ÇULÇİ P., Balci S.Publication Metadata only Centrally-necrotic/hyalinizing demarcated (CND) carcinomas of the pancreas: A clinico-pathologically distinct group with divergent metaplastic patterns and high-grade characteristics(2022-03-01) BAĞCI ÇULÇİ, PELİN; BOZKURTLAR, EMİNE; Cengiz D., Saka B., BAĞCI ÇULÇİ P., Altinmakas E., Bozkurt E., Armutlu A., PEHLİVANOĞLU B., BOZKURTLAR E., Reid M., Mericoz M. A., et al.Publication Open Access Problems in the reproducibility of classification of small lung adenocarcinoma: an international interobserver study(2019-11-01) BOZKURTLAR, EMİNE; Shih A. R., Uruga H., BOZKURTLAR E., Chung J., Hariri L. P., Minami Y., Wang H., Yoshizawa A., Muzikansky A., Moreira A. L., et al.Aims The 2015 WHO classification for lung adenocarcinoma (ACA) provides criteria for adenocarcinoma in situ (AIS), minimally invasive adenocarcinoma (MIA) and invasive adenocarcinoma (INV), but differentiating these entities can be difficult. As our understanding of prognostic significance increases, inconsistent classification is problematic. This study assesses agreement within an international panel of lung pathologists and identifies factors contributing to inconsistent classification. Methods and results Sixty slides of small lung ACAs were reviewed digitally by six lung pathologists in three rounds, with consensus conferences and examination of elastic stains in round 3. The panel independently reviewed each case to assess final diagnosis, invasive component size and predominant pattern. The kappa value for AIS and MIA versus INV decreased from 0.44 (round 1) to 0.30 and 0.34 (rounds 2 and 3). Interobserver agreement for invasion (AIS versus other) decreased from 0.34 (round 1) to 0.29 and 0.29 (rounds 2 and 3). The range of the measured invasive component in a single case was up to 19.2 mm among observers. Agreement was excellent in tumours with high-grade cytology and fair with low-grade cytology. Conclusions Interobserver agreement in small lung ACAs was fair to moderate, and improved minimally with elastic stains. Poor agreement is primarily attributable to subjectivity in pattern recognition, but high-grade cytology increases agreement. More reliable methods to differentiate histological patterns may be necessary, including refinement of the definitions as well as recognition of other features (such as high-grade cytology) as a formal part of routine assessment.Publication Open Access Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading(2022-06-01) BAĞCI ÇULÇİ, PELİN; BOZKURTLAR, EMİNE; Taskin O. C. , Reid M. D. , Bagci P., Balci S., Armutlu A., Demirtas D., PEHLİVANOĞLU B., Saka B., Memis B., BOZKURTLAR E., et al.© 2021, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3–6 were defined as \"non/minimally infiltrative\" (NI; n = 77), 7–9 as \"moderately infiltrative\" (MI; n = 68), and 10–15 as \"highly infiltrative\" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in \"watchful waiting\" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series.