Person: UĞURLU, MUSTAFA ÜMİT
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UĞURLU
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MUSTAFA ÜMİT
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Publication Open 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.Publication Open 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 UmitObjectives: 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 Open 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, HandanObjective: 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.Publication Open 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.Publication Metadata only Neoadjuvan kemoterapi alan lokal ileri evre meme kanseri hastalarında dolaşımdaki tümör hücresi moleküler analizleri(2017-10-26) UĞURLU, MUSTAFA ÜMİT; ERZİK, CAN; PEKER EYÜBOĞLU, İREM; AKKİPRİK M., YUMUK P. F., UĞURLU M. Ü., KOCA S., ERZİK C., ALAN Ö., PEKER EYÜBOĞLU İ., GÜLLÜ AMURAN G., ÖZER S. A.Amaç: İzole edilen dolaşımdaki tümör hücrelerinin (CTC) analizi bir "sıvı biyopsi" olarak kanser tedavisinin ve prognozunun öngörülebilmesini sağlayan invaziv olmayan bir kişiye özel tıp uygulamasıdır. Bu çalışmanın amacı neoadjuvan kemoterapi alan lokal ileri evre meme kanserli hastalardan tedavi öncesi ve sonrası periferal kan örnekleri alınarak, CTC moleküler karakterizasyonunu yapmak ve tedaviye verilen yanıt ile ilişkisini ortaya koymaktır. Gereç-Yöntem: Çalışmaya 36 neoadjuvan kemoterapi alan lokal ileri evre meme kanserli hasta dahil edilmiş ve hastalardan tedavi öncesi ve sonrası 10 ml kan örnekleri alınmıştır. CTC izolasyonu, tanımlanması ve moleküler analizlerinde immuno-magnetik temelli AdnaTest kitleri kullanılmış, meme kanseri (GA733-2, Muc-1 ve Her-2, Aktin), EMT (PI3Kα, Akt-2, TWIST1) ve kök hücre (ALDH1) markerları incelenmiştir. Görüntüleme Agilent 2100 Bioanalyzer cihazı kulllanılarak DNA 1000 LabChip ile gerçekleştirilmiştir. CTC pozitifliği ve çalışılan markerlar ile tedaviye yanıt (patolojik tam cevap (PCR) ve rezidual hastalık) açısından anlamlılık, Fisher’s Exact test ile analiz edilmiştir. Bulgular: Otuzaltı hastanın 6'sında (%16,7) tedavi öncesinde CTC pozitifliği saptanmıştır. CTC pozitif olan 6 hastanın 4'ünde kök hücre markeri olan ALDH1 pozitifliği gözlenmiştir (p=0,0245) (Tablo 1). EMT markerlarından PI3Kα ise 3 hastada pozitif bulunmuştur. Hasta takipleri ve tedaviye verilen cevaplar izlenmeye devam etmektedir. Sonuç: Neoadjuvan kemoterapi alan lokal ileri evre meme kanseri hastalarında CTC pozitifliği ve kök hücre markerlarının analizi tedaviye verilecek olan cevabın ve hasta sağkalım oranlarının ön görülebilmesi için önemli bir yöntem olabilir. Çalışmalarımız bu kapsamda devam etmektedir.Publication Open Access Minimally invasive thyroid anaplastic carcinoma with long survival(TURKISH SURGICAL ASSOC, 2018-01-15) ERBARUT SEVEN, İPEK; Ugurlu, Mustafa Umit; Seven, Ipek Erbarut; Eren, Funda; Yegen, Cumhur; Gulluoglu, Bahadir MahmutAnaplastic thyroid carcinoma is a highly lethal malignancy. Previously, only five cases of a noninvasive form of anaplastic thyroid carcinoma with excellent prognosis were reported, We report a case of a 68-year-old man who presented with a 3,8 cm thyroid nodule diagnosed by fine needle aspiration biopsy as poorly differentiated spindled and epithelial malignant cells, Lobectomy and isthmusectomy were performed, and the final diagnosis was micro-invasive anaplastic thyroid carcinoma arising in a poorly differentiated carcinoma, The patient remains disease-free after six years, even after hemithyroidectomy and radiation treatment. Noninvasive/micromvasive anaplastic thyroid carcinoma appears to be a different disease entity from classical anaplastic thyroid carcinoma, with favorable prognosis and long disease-free survival.Publication Metadata only Role of Melatonin and Luzindole in Rat Mammary Cancer(TAYLOR & FRANCIS INC, 2012) YEGEN, BERRAK; Umit, Ugurlu M.; Berna, Terzioglu; Handan, Kaya; Ipek, Erbarut; Berrak, Yegen; Can, Erzik; Bahadir, Gulluoglu M.Background: Recent studies have analyzed the efficacy of various agents in experimental chemoprevention trials. In our study, the effects of melatonin (Mel) and its antagonist Luzindole (Luz) on Heme oxygenase-1 (HO-1) in a NMU (N-methyl-N-nitrosourea)-induced rat mammary carcinoma model are investigated. We aim to demonstrate the relationship between Mel and HO-1. Methods: Spraque-Dawley rats were treated with NMU at age 55 days to induce mammary carcinoma. Forty-eight rats were divided into four groups consisting of: (a) physiological saline group (PSG); (b) control group, NMU is given; (c) Mel group (500 mu g daily); (d) Mel antagonist Luz group (0.25 mg/kg/day i.p.). The animals were sacrificed; their serum and tissues were sampled for histopathologic evaluation, markers of endocrine derangement (serum prolactin, estradiol, and progesterone levels), apoptotic changes, DNA fragmentation, markers of oxidative stress and HO-1 immune expression were measured. Results: Most tumors developed in the Luz group (42%), followed by the control group (33%), and the Mel group (17%). The tumor latency was longer in Mel-treated group (control and Luz at week 17, Mel at week 21). The maximum tumor volume was also smaller in Mel group when compared to control and Luz groups (p < .05). In Mel group estradiol, progesterone, and prolactin levels were decreased compared to control group (p < .001; p < .01; and p < .01) and levels of apoptotic activity and DNA fragmentation ratio increased. Conclusions: The increment of HO-1 expression with Mel is described; possible underlying mechanisms of these effects await further investigations.Publication Metadata only Multiparametric breast MRI with 3T: Effectivity of combination of contrast enhanced MRI, DWI and 1H single voxel spectroscopy in differentiation of Breast tumors(ELSEVIER IRELAND LTD, 2016) KAYA, HANDAN; Aribal, Erkin; Asadov, Ruslan; Ramazan, Abdullah; Ugurlu, Mustafa Umit; Kaya, HandanObjectives: To evaluate the diagnostic accuracy of dynamic contrast enhanced breast MRI (DCE-MRI) combined with diffusion weighted imaging (DWI) and 1H single-voxel magnetic resonance spectroscopy (1HMRS) in differentiating malignant from benign breast lesions. Methods: One hundred twenty-nine patients with 138 lesions were included in the study. Multiparametric MRI of the breast was performed with a 3T unit. A DWI is followed by DCE-MRI and 1HMRS. All lesions were biopsied within one week after MRI. Histopathologic findings were accepted as the standard of reference. Probability of malignancy was assessed according to BI-RADS for DCE-MRI. ADC values were measured for DWI and choline peaks were assessed using a semi-quantitative method in 1HMRS. Two blinded radiologists evaluated findings in consensus. Diagnostic performance of DCE-MRI, DWI and 1HMRS alone or in combination for multiparametric imaging were statistically evaluated. Results: Histopathology revealed malignancy in 54.4% of lesions (75/138). DCE-MRI showed the highest AUC (0.978), sensitivity (97.33%) and specificity (88.89%) compared to DWI and 1HMRS. Sensitivity was 100% when a positive result from any one of three techniques was accepted as malignancy, albeit with a trade-off for 65.1% specificity. Highest specificity (98.4%) was attained when all three techniques were required to be positive, though with a lower sensitivity (82.7%) as trade-off. Logistic regression analysis confirmed significant association with DCE-MRI (p < 0.001) and 1H MRS (p = 0.009) but not with DWI (p = 0.127). There was one case of fat necrosis which was false positive in all three techniques. Conclusions: Multiparametric imaging with combination of DCE-MRI, DWI and 1HMRS does not improve, and may even reduce the diagnostic accuracy of breast MRI. Although, the specificity may be improved with a trade-off for lower sensitivity, we have not set a convenient algorithm for the combined use of these techniques. (C) 2016 Elsevier Ireland Ltd. All rights reserved.Publication Metadata only Neoadjuvan kemoterapi̇ veri̇len lokal İleri̇ evre meme kanserli̇ hastaların genel karekteri̇sti̇k özelli̇kleri̇ni̇n İncelenmesi̇(2015-04-21) UĞURLU, MUSTAFA ÜMİT; ÖZGEN, ZERRİN; DANE, FAYSAL; Kaya S., Tanrıkulu Şimşek E., Uğurlu M. Ü., Özgen Z., Köse H., Halil S., Beşiroğlu M., Koca S., Babacan N., Dane F., et al.Publication Open Access EXTRAUMBILICAL SINGLE-INCISION LAPAROSCOPIC CHOLECYSTECTOMY WITH STANDARD LAPAROSCOPIC INSTRUMENTS(SAGE PUBLICATIONS LTD, 2013-09) UĞURLU, MUSTAFA ÜMİT; Oruc, M. T.; Ugurlu, M. U.Background and Aim: Single-incision laparoscopic surgery is a rapidly progressing field as it combines some advantages such as cosmesis and less incisional pain. However, it also has some disadvantages such as limitation of movement and clashing of the hand instruments, which increase the complexity and technical challenges of the operation. In this study, we describe a pilot trial of single-incision laparoscopic cholecystectomy through a paramedian access site. Material and Methods: A total of 25 patients underwent single-incision laparoscopic cholecystectomy with this method. Acute cases with empyema and patients with history of previous abdominal surgery were excluded. Single-incision is established on the right upper quadrant, right latero-superior of the umbilicus, so that trocar sites and projection of the gallbladder on the abdominal wall are on the same vertical line. Standard laparoscopic instruments were placed into the abdominal cavity providing triangulation. Once the laparoscope, grasper, and dissector are in place, the overall procedures are similar to the standard laparoscopic cholecystectomy. Results: Single-incision laparoscopic cholecystectomy through an extraumbilical access site was successfully completed in all 25 patients without conversion to open surgery. Additional skin incisions and trocar access were required only in two patients. The mean operative time was 39.3 min (range: 20-75 min). The mean body mass index was 27.2. Postoperative course was uneventful in all patients. The mean postoperative hospital stay was shorter than 24 h, and all patients were discharged at first day postoperatively. No postoperative complications including seroma, wound infection, and trocar-site hernia were observed at 6-month follow-up. Conclusion: We described a new access site for single-incision laparoscopic cholecystectomy using standard laparoscopic instruments. We believe that this type of access site overcomes the technical difficulties of performing single-incision laparoscopic cholecystectomy, and it is a promising alternative method for the treatment of patients with symptomatic gallstone disease as a minimal invasive abdominal surgery.
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