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UĞURLU, MUSTAFA ÜMİT

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UĞURLU

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MUSTAFA ÜMİT

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  • Publication
    Neoadjuvan kemoterapi uygulanan meme kanserli olgularda güvenli tümör-meme ucu mesafesini meme MR öngörebilir mi?
    (2022-02-24) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; BUĞDAYCI, ONUR; KAYA, HANDAN; AKOĞLU, HALDUN; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., BUĞDAYCI O., KAYA H., AKIN TELLİ T., AKOĞLU H., GÜLLÜOĞLU M. B.
  • Publication
    Prognostic Role of Immune Markers in Triple Negative Breast Carcinoma
    (SPRINGER, 2020) KAYA, HANDAN; Sahin Ozkan, Hulya; Ugurlu, Mustafa Umit; Yumuk, Perran Fulden; Kaya, Handan
    Tumor immune microenvironment (TIME) is a significant prognostic parameter for triple negative breast carcinomas (TNBC) due to being a target for immunotherapeutic agents and its essential role during the cancer immunoediting process. In this study, CD8, FOXP3, CD163, PD-L1/SP142 and PD-L1/SP263 antibodies were examined in a sample of 51 TNBC cases. Patients who received neoadjuvant therapy were excluded. CD8, FOXP3 and CD163 antibodies were evaluated separately in intratumoral area (ITA) and tumor stroma (TS). PD-L1 status was also examined in tumor cells (TC) and immune cells (IC) using both SP142 and SP263 antibodies. In multivariate Cox regressions, the only antibody that was found to be significantly associated with survival was SP142. SP142-positivity in TC and IC was related to increased overall survival. Higher CD163 expression in ITA and SP263-positivity in IC were associated with younger age. Lymphatic/angioinvasion was more frequent in cases with negative/low CD8 and FOXP3 expressions. Moreover, metastatic axillary lymph node(s) was associated with negative/low FOXP3 expression in TS. CD8, FOXP3, CD163, SP142 and SP263 expressions were positively correlated with each other, except a mild discordance caused by CD163 in ITA. Although PD-L1 status with both SP142 and SP263 antibodies were concordant in the majority of cases, 33.3% and 13.7% of the cases showed SP142-negative/SP263-positive pattern in TC and IC respectively. In conclusion, we suggest that composition, density and localization of the immune cells and the check point molecules are important prognostic parameters in TNBC. Immunohistochemistry can be used as an accessible and less expensive tool to demonstrate TIME.
  • Publication
    Metastazı taklit eden brown tümörler: Paratiroid sintigrafisi ve PET/BT bulguları
    (2022-05-01) KESİM, SELİN; TUROĞLU, HALİL TURGUT; UĞURLU, MUSTAFA ÜMİT; ÖZGÜVEN, SALİH; ENGÜR, CEREN ÖZGE; FİLİZOĞLU, NUH; ÖNEŞ, TUNÇ; ERDİL, TANJU YUSUF; BALABAN GENÇ, ZEYNEP CEREN; Kesim S., Turoğlu H. T., Uğurlu M. Ü., Özgüven S., Engür C. Ö., Filizoğlu N., Niftaliyeva K., Kıssa T. N., Balaban Genç Z. C., Öksüzoğlu K., et al.
    Amaç: Kronik böbrek yetmezliğinde sürekli ve aşırı üriner kalsiyum atılımı, serum kalsiyum seviyelerini düşürerek parathormon düzeyinde artışa neden olur. Serum kalsiyum seviyelerini normal sınırlar içinde tutmak için kompansatuvar olarak oluşan hızlı osteoklastik kemik döngüsü brown tümörlerin oluşmasına neden olabilir. Bu olgu sunumunda, sekonder hiperparatiroidiye ikincil multipl brown tümörleri olan olgunun dual faz Tc-99m metoksiizobutilizonitril (MIBI) paratiroid sintigrafisi ve florodeoksiglukoz (F-18 FDG) pozitron emisyon tomografisi/bilgisayarlı tomografide (PET/BT) bulguları sunulmaktadır. Yöntem: Son dönem böbrek yetmezliği ile takip edilen, diyaliz bağımlı, serum fosfat, alkalen fosfataz ve paratiroid hormon seviyesi yüksek iken, serum kalsiyum seviyesi düşük olan, 57 yaşındaki kadın hastaya sekonder hiperparatiroidi etiyolojisi araştırılması amacıyla dual faz Tc99m MIBI paratiroid sintigrafisi yapıldı. Paratiroid sintigrafisi ile toraks BT görüntülemesinde kemik metastazlarını taklit eden osteolitik lezyonlarraporlanan olguya primer malignite araştırılması amacıyla F-18 FDG PET/BT görüntülemesi yapıldı. Bulgular: Tc-99m MIBI paratiroid sintigrafisinde erken ve geç fazda sağ ve sol alt paratiroid lojunda izlenen nodüler lezyonlarda multiglandüler paratiroid patolojisi ile uyumlu olarak değerlendirilen artmış aktivite tutulumu izlendi. Ek olarak, SPECT/CT (Tek foton emisyon bilgisayarlı tomografi) görüntülerinde sağ 4. ve 7. kosta anterolateralinde artmış MIBI tutulumu gösteren ekspansil osteolitik lezyonlar dikkati çekti (Şekil 1). Tanımlanan ekspansil lezyonların metastaz olma olasılığı açısından F-18 FDG PET/BT tetkikine refere edilen olguda; PET/BT görüntülemesinde aksiyel ve apendiküler iskelette yaygın yoğun hipermetabolik litik/yer yer ekspansil karakterde multipl lezyonlar izlendi. Ayrıca tiroid glandı her iki lob alt pol komşuluğunda yoğun hipermetabolik heterojen dansiteli nodüler lezyonlar saptandı (Şekil 2). Paratiroidektomi operasyonu yapılan hastada biyopsi sonucu paratiroid hiperplazisi ile uyumlu olarak raporlandı. Sonuç: Brown tümörler, neoplastik olmayan, hipervasküler kemik tümörleri olup hiperparatiroidizmin ciddi bir komplikasyonudur. Bu osteolitik lezyonların ayırıcı tanısısında dev hücreli onarım granülomu, metastaz, multipl myelom-plasmositom ve görüntüleme yöntemleriyle veya histolojik olarak ayırt edilemeyen dev hücreli kemik tümörü bulunur. Bununla birlikte, hastanın biyokimyasal profili tanı koymaya yardımcı olabilir. Brown tümörlerin kemik sintigrafisinde ve MIBI sintigrafisinde saptanabileceği gösterilmiştir. Ayrıca PET/BT tetkikinde osteoklast-benzeri dev hücreler ile makrafojlardaki artmış glukoz metabolizması sebebiyle FDG tutulumu gösterebilmektedir. Ayrıca, brown tümörlerin hiperparatiroidizm tedavisini takiben FDG afinitelerini kaybettiği bildirilmiştir. Kronik böbrek hastalığı ve hiperparatiroidi anamnezi olan olgularda; metastaz şüpheli osteolitik lezyonlar değerlendirilirken ayırıcı tanıda Brown tümörler göz önünde bulundurulmalıdır. Anahtar Kelimeler: Hiperparatiroidi, brown tümör, Tc-99m MIBI paratiroid sintigrafisi, SPECT/BT, F-18 FDG PET/BT
  • PublicationOpen Access
    Effect of the pandemic on surgical procedures in a tertiary care hospital: A retrospective review
    (2022-09-01) SAÇAK, BÜLENT; KESİMER, MEHMET DENİZ; ŞAHİN, BAHADIR; UĞURLU, MUSTAFA ÜMİT; SAKAR, MUSTAFA; YUMUŞAKHUYLU, ALİ CEMAL; Ozkan M. C. , SAÇAK B., KESİMER M. D. , ŞAHİN B., UĞURLU M. Ü. , Sirzai E. Y. , SAKAR M., Aykut A., Cicek I., YUMUŞAKHUYLU A. C.
    Objective: The aim of this study was to examine the impact of performing surgeries with necessary precautions and to evaluate demographic characteristics of operated patients during novel coronavirus-2019 (COVID-19) pandemic and the infection rates during hospitalization and within 14 days after surgery.
  • Publication
    Meme kanserinde neoadjuvan kemoterapi sonrası es-zamani: Rekonstrüksiyon güvenli midir? 5 yıllık tek merkez onkolojik sonuçlar
    (2022-09-18) UĞURLU, MUSTAFA ÜMİT; AKMERCAN, AHMET; SAÇAK, BÜLENT; AKDENİZ DOĞAN, ZEYNEP DENİZ; KAYA, HANDAN; BUĞDAYCI, ONUR; GÜLLÜOĞLU, MAHMUT BAHADIR; UĞURLU M. Ü., AKMERCAN A., SAÇAK B., AKDENİZ DOĞAN Z. D., HAYTAOĞLU A. A., KAYA H., BUĞDAYCI O., AKIN TELLİ T., ÖZGEN Z., GÜLLÜOĞLU M. B.
  • PublicationOpen Access
    Changes in 18F-FDG-PET/CT tumor metabolism are not consistent with pathologic complete response in hormone-positive breast cancer
    (2017-09-01) DEDE, FUAT; KAYA, HANDAN; UĞURLU, MUSTAFA ÜMİT; Kaya S., Aktas B., Tanrikulu E., ÖZTÜRK M. S., DEDE F., KAYA H., Ugurlu U., Ozgen Z., Koca S., Halil S., et al.
    © 2017 Zerbinis Publications. All rights reserved.Purpose: Current evaluation of response to neoadjuvant chemotherapy (NAC) shows that it could achieve pathological complete response (pCR). The purpose of this study was to assess the consistency of maximum uptake values (SUVmax) changes and pCR in hormone-positive locally advanced breast cancer (LABC). Methods: Ninety hormone-positive LABC patients treated at Marmara University Medical Oncology Clinic, Istanbul, Turkey, between 2009 and 2015 were retrospectively studied. All eligible patients (n=51) received NAC (4-8 cycles) and were evaluated for pCR. 18F-fluorodeoxyglucose positron emission tomography/ computed tomography (18F-FDG-PET/CT) scan was performed before and after the completion of NAC. The relative changes of SUVmax both in the primary tumor and the axilla were assessed for consistency with pCR. Results: The patient median age was 46 years (range 26-76). The patients 13.7% achieved pCR. Values of >50% (n=40) and 75% SUVmax changes could achieve pCR of 20%. Interestingly, most patients with complete metabolic response did not achieve pCR (81%). The difference of the Ki67 levels before and after NAC, tumor localization, HER-2 positivity, menopausal status, grade of differentiation, lymphovascular and perineural invasion were not associated with pCR. Conclusion: SUVmax changes in later cycles of NAC as commonly practised in oncology clinics were not consistent with pCR (p=1.0). Complete metabolic response may not be associated with pCR in hormone-positive LABC. However, almost 80% of patients had >50% decrease in SUVmax and may still have a chance for conservative surgery and less postoperative morbidity. Therefore, 18F-FDG-PET/CT may still have a role to evaluate the tumor response with a need of larger studies and analysis for cost-effectiveness.
  • PublicationOpen Access
    Efficacy of topical clobetasol propionate in the treatment of idiopathic granulomatous mastitis
    (MARMARA UNIV, FAC MEDICINE, 2018-10-31) CÖMERT ÖZER, ELİF; Yazici Ozgen, Zuleyha; Comert, Elif; Ugurlu, Mustafa Umit
    Objectives: To evaluate the efficacy of topical clobetasol propionate 0.05% pomade in the treatment of idiopathic granulomatous mastitis. Patients and Methods: Twenty-one idiopathic granulomatous mastitis patients' clinical and histopathological fmdings were retrospectively reviewed. Those patients excluded from other etiologies were categorized as idiopathic granulomatous mastitis and treated with topical clobetasol propionate 0.05% pomade as an initial treatment. Results: All 21 patients with a fmal diagnosis of idiopathic granulomatous mastitis were women with the average age of 36.2+/-5.2 years. Of the 21 patients; erythema, induration and pain problems of 6 (28.5%) patients totally resolved without recurrence in 3 months follow-up period. Erythema, induration and pain problems of 7 (33.5%) patients were minimalized and stay stable in 3 months follow-up period. The symptoms of 8 (38%) did not change under topical clobetasol propionate treatment. None of the patients developed side or adverse effects due to topical steroid treatment and 6 of 18 patients with non-steroidal anti-inflammatory drugs (NSAIDs) complained of gastric pain. Conclusion:Topical steroid treatment is a safe treatment option for idiopathic granulomatous mastitis patients before systemic steroid and immunosuppressive treatments and also surgery.
  • Publication
    Response Assessment With Molecular Characterization of Circulating Tumor Cells and Plasma MicroRNA Profiling in Patients With Locally Advanced Breast Cancer During Neoadjuvant Chemotherapy
    (CIG MEDIA GROUP, LP, 2020) ERZİK, CAN; Akkiprik, Mustafa; Koca, Sinan; Ugurlu, M. Umit; Ekren, Ruchan; Eyuboglu, Irem Peker; Alan, Ozkan; Erzik, Can; Amuran, Gokce Gullu; Telli, Tugba Akin; Gulluoglu, M. Bahadir; Sezerman, Ugur; Yumuk, Perran Fulden
    Peripheral blood samples from 36 patients with locally advanced breast cancer who had undergone neoadjuvant chemotherapy were collected for circulating tumor cell (CTC) and plasma microRNA (miR) analysis. Pretreatment CTC and ALDH1 positivity (P = .0245) correlated, with miR-146b-5p and miR-199a-5p accompanied by CTC positivity. CTC and miR profiling of serial samples during neoadjuvant chemotherapy appears to be a very useful in predicting cure and clinical course. Background: Cells detaching from the primary tumor site are metastasis initiator cells, and the detection of CTC, known as liquid biopsy, is an important test of biomarkers of cancer progression. We investigated the molecular characterization of circulating tumor cells (CTCs), profiled the plasma microRNA (miR) content, and analyzed the relationship with the clinical outcomes by sampling the peripheral blood from patients with locally advanced breast cancer before and after neoadjuvant chemotherapy. Patients and Methods: Markers of breast cancer, epithelial-mesenchymal transition (EMT), drug resistance, and stem cells were used for CTC isolation and characterization. Plasma miR profiles were obtained from selected patients with CTC positivity determined using next-generation sequencing. Resutts: The proportion of CTC, EMT, and stem cell marker positivity was 16.7%, 8.3%, and 25% before and 18.2%, 15.2%, and 9.1% after treatment, respectively. A significant correlation was found between the pretreatment CTCs and ALDH1 positivity (P= .0245). These CTCs with stemness properties were observed in most hormone receptor-positive, human epidermal growth factor receptor 2 -negative cases and were also present with a high incidence in cases of early metastasis. miR-146b-5p and miR-199a-5p, which are involved in metastasis, invasion, and EMT, were accompanied by CTC positivity, and miR-4646-3p was associated with the development of early metastasis. Conclusions: Molecular characterization of CTCs and miR profiling of serial samples from patients with locally advanced breast cancer during neoadjuvant chemotherapy appears to be a very useful in predicting cure and clinical course and might be a key to developing new targeted therapies. (C) 2020 Elsevier Inc. All rights reserved.
  • PublicationOpen Access
    BRAFV600E Immunohistochemistry in Papillary Thyroid Carcinomas: Relationship Between Clinical and Morphological Parameters
    (FEDERATION TURKISH PATHOLOGY SOC, 2019) UĞURLU, MUSTAFA ÜMİT; Kombak, Faruk Erdem; Ozkan, Naziye; Ugurlu, Mustafa Umit; Kaya, Handan
    Objective: To investigate the association of the BRAFV600E mutation with papillary thyroid carcinoma using clinical, morphological and prognostic parameters. We also intend to assess the utility of the BRAFV600E immunohistochemistry and compare it with BRAF polymerase chain reaction (RT-PCR). Material and Method: We applied BRAFV600E immunohistochemistry in a cohort of 107 papillary carcinomas, 19 adenomas and 13 normal thyroid tissues that was chosen retrospectively between 2011 and 2015. Statistical analysis was based on semiquantitative immunohistochemistry findings. We also applied BRAF RT-PCR in a subgroup of 14 papillary carcinomas, 13 metastatic lymph nodes and 4 adenomas that was chosen randomly. Results: In regard to the comparison of BRAFV600E immunohistochemistry and BRAF RT-PCR, a 3+ nuclear and cytoplasmic immunoexpression was considered 'positive The BRAFV600E mutation was most frequently observed in classic variant cases. No mutation was detected in follicular variant cases. The mutational status of the primary tumour and the lymph node metastasis was consistent. A significant relationship of the BRAFV600E mutation was found with prognostic factors such as higher pT stage, classic variant, lymphatic invasion, perineural invasion, lower mitotic index, lack of tumour capsule, intrathyroidal spread and extrathyroidal extension. Conclusion: Immunohistochemistry, using the VE1 clone, is a reliable technique for detection of the BRAFV600E mutation. Our results with immunohistochemistry are consistent with a previous effort. In our study, despite the correlation between some pathological prognostic parameters and the BRAFV600E mutation; poor prognosis was found to be irrelevant overall. Morphological parameters seem to be keener than the BRAFV600E mutation. Nevertheless, different series display different results, possibly due to environmental factors. Considering this and the proven success of targeted therapies against the BRAFV600E mutation a thorough assessment would be important.
  • PublicationOpen Access
    Regional Clinical and Biochemical Differences among Patients with Primary Hyperparathyroidism
    (GALENOS YAYINCILIK, 2017-01-15) GÜLLÜOĞLU, MAHMUT BAHADIR; Makay, Ozer; Ozcinar, Beyza; Simsek, Turgay; Arici, Cumhur; Gungor, Bulent; Ozbas, Serdar; Akca, Tamer; Emre, Ali Ugur; Cakmak, Guldeniz Karadeniz; Akcay, Mufide; Unal, Bulent; Girgin, Mustafa; Girgin, Sadullah; Gorgulu, Semih; Sezer, Atakan; Karatas, Adem; Ozemir, Ibrahim Ali; Aksakal, Nihat; Erel, Serap; Ugurlu, M. Umit; Filiz, Ali Ilker; Atalay, Can; Uzunkoy, Ali; Deveci, Ugur; Kotan, Cetin; Icoz, Gokhan; Kurt, Yavuz; Kebudi, Abut; Canturk, N. Zafer; Erbil, Yesim; Pandev, Rumen; Gulluoglu, Bahadir M.
    Background: Environmental habitat may play a role in clinical disparities of primary hyperparathyroidism (pHPT) patients. Aims: To compare preoperative clinical symptoms and associated conditions and surgical findings in patients with pHPT, living in different geographical regions from the Black Sea, Mediterranean and Anatolia regions. Study Design: Retrospective, clinical-based multicentric study of 694 patients with pHPT. Methods: Patients from 23 centers and 8 different geographical regions were included. Data related to baseline demographics, clinical, pathologic and treatment characteristics of 8 regions were collected and included age, gender, residential data, symptoms, history of fracture, existence of brown tumor, serum total Ca and p levels, serum parathormone (PTH) levels, serum 25-OH vitamin D levels, bone mineral density, size of the resected abnormal parathyroid gland(s), histology, as well as the presence of ectopia, presence of dual adenoma, and multiple endocrine neoplasia (MEN)- or familial-related disease. Results: The median age was 54. Asymptomatic patient rate was 25%. The median PTH level was 232 pg/mL and serum total Ca was 11.4 mg/dL. Eighty-seven percent of patients had an adenoma and 90% of these had a single adenoma. Hyperplasia was detected in 79 patients and cancer in 9 patients. The median adenoma size was 16 mm. Significant parameters differing between regions were preoperative symptoms, serum Ca and p levels, and adenoma size. All patients from South-East Anatolia were symptomatic, while the lowest p values were reported from East Anatolia and the largest adenoma size, as well as highest Ca levels, were from Bulgaria. Conclusion: Habitat conditions vary between geographical regions. This affects the clinicopathological features of patients with pHPT.