Person: ÇELİKEL, ÇİĞDEM
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ÇELİKEL
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ÇİĞDEM
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Publication Open Access Myeloperoxidase and calprotectin; Any role as non-invasive markers for the prediction of inflammation and fibrosis in non-alcoholic steatohepatitis?(AVES, 2020-10-30) ÇELİKEL, ÇİĞDEM; Bicakci, Ercan; Demirtas, Coskun Ozer; Celikel, Cigdem; Haklar, Goncagul; Duman, Deniz GuneyBackground/Aims: Specific serum markers reflecting hepatic inflammation and fibrosis are required to tailor the treatment strategies in non-alcoholic steatohepatitis (NASH). We aimed to investigate the roles of myeloperoxidase (MPO) and calprotectin in predicting the hepatic inflammation status and disease severity in NASH. Materials and Methods: A total of 48 patients with biopsy-proven NASH and 25 healthy volunteers with normal weight were prospectively enroiled Serum MPO and calprotectin levels were compared between the NASH and control groups. Hepatic MPO and calprotectin expressions were compared in terms of histologic non-alcoholic fatty liver disease activity scores (NAS) (low NAS [<= 4] vs. high NAS [>5]) and fibrosis stage (insignificant [F0-1]/significant [F2-4]). Results: Serum MPO and calprotectin levels were not significantly different between the NASH and control groups. In the subgroup analysis, hepatic MPG expression was significantly increased in patients with NASH with significant fibrosis than in those with insignificant fibrosis (F2-4: 7.04 +/- 3.61 vs. F0-1: 4.83 +/- 2.42, p=0.01). We found no difference between the groups with low and high NAS with regard to serum MPG and calprotectin levels and hepatic MPG and calprotectin expressions. Conclusion: This study demonstrated that hepatic MPG expression can reflect advanced fibrosis in NASH. However, when serum MPO and calprotectin levels were evaluated as potential serum markers, both did not associate with hepatic inflammation status and fibrosis stage in NASH. Therefore, our study results preclude their use as serum markers for hepatic inflammation in NASH.Publication Metadata only Gastrointestinal nöroendokrin tümör patolojisi(Türkiye Klinikleri Özel Sayı, 2020-01-01) ÇELİKEL, ÇİĞDEM; ÇELİKEL Ç.Publication Metadata only Gastrointestinal kanal patolojisinde tuzaklar(Kongre Kitabevi, 2022-01-01) ÇELİKEL, ÇİĞDEM; BOZKURT, SÜHEYLA; ÇELİKEL Ç., GÜLLÜOĞLU M., BOZKURT S., DOĞANAVŞARGİL YAKUT B., SAKA B., GÖKSEL S., YAMAN B.Publication Metadata only COVID-19 gastrointestinal kanal ve karaciğer patolojisi(Türkiye Klinikleri Özel Sayı, 2020-01-01) ÇELİKEL, ÇİĞDEM; ÇELİKEL Ç.Publication Metadata only COVID-19 İmmunopatogenezi: güncel bilgiler ve olası hasar mekanizmaları(Türkiye Klinikleri Özel Sayı, 2020-01-01) ÇELİKEL, ÇİĞDEM; ŞAHİN ÖZKAN H., ÇELİKEL Ç.Publication Open Access Evaluation of mucosal status in the follow-up of pediatric patients with celiac disease: the role of serology(2022-09-01) AY, NADİYE PINAR; ERTEM ŞAHİNOĞLU, DENİZ; ÇELİKEL, ÇİĞDEM; Sengul O. K., Akkelle B. S., Ay P., Volkan B., Tutar E., Celikel Ç., Ertem D.Recent guidelines suggest non-biopsy serology-based approach for the diagnosis of celiac disease; however, there is no evidence-based data regarding noninvasive follow-up of mucosal healing. The aim of this study is to investigate the efficacy of serology in reflecting mucosal status in the follow-up of pediatric patients with celiac disease. This is a validation study conducted at a university hospital. Patients who had biopsy proven celiac disease (Marsh III) at diagnosis, and had been followed-up for at least 12 months, were prospectively evaluated with duodenal biopsies. tTG-IgA and EMA tests were performed on the day of endoscopy. One hundred four patients with a mean age of 7.4 +/- 4.02 years were included in the study. The sensitivity and specificity of tTG-IgA were 85.2% and 61% respectively, with a high negative predictive value (NPV) of 92.2% but a very low positive predictive value (PPV) of 43.4%. We found that a cutoff value of 68.5 U/mL for tTG-IgA had a sensitivity, specificity of 85.2% and 85.7% respectively. The AUC was 0.891. The sensitivity and specificity of EMA was 77.8% and 87% respectively, with a high NPV of 91.8% but low PPV of 67.7%.Publication Metadata only Hepatocellular adenomas in the Turkish population: reclassification according to updated World Health Organization criteria(WILEY, 2021) ÇELİKEL, ÇİĞDEM; Deniz, Kemal; Umetsu, Sarah E.; Ferrell, Linda; Yilmaz, Funda; Gulluoglu, Mine; Sagol, Ozgul; Dogusoy, Gulen B.; Kirimlioglu, Hale; Turhan, Nesrin; Doran, Figen; Kepil, Nuray; Celikel, Cigdem A.; Nart, Deniz; Ozguven, Banu Y.; Ceyran, Bahar; Karadag, Nese; Kir, Gozde; Erden, Esra; Yilmaz, Guldal; Akyol, GulenAims Hepatocellular adenoma (HCA) is an uncommon liver neoplasm, and studies of HCA subtypes have been primarily limited to France, the USA, and Japan. The aim of this study was to describe the clinicopathological features of HCA subtypes in Turkey. Methods and results The resection specimens of 59 cases diagnosed as 'hepatocellular adenoma' collected from 15 institutions were reviewed to confirm the diagnosis and to classify them according to the current World Health Organization 2019 classification. Immunostaining for glutamine synthetase, liver fatty acid-binding protein, C-reactive protein, beta-catenin and reticulin was performed. Of the 59 cases, 48 (81%) were diagnosed as HCA. We identified 24 (50%) hepatocyte nuclear factor 1 alpha (HNF1 alpha)-inactivated HCAs, five (10%) inflammatory HCAs, 15 (32%) beta-catenin-activated HCAs, three (6%) beta-catenin-activated inflammatory HCAs, and one (2%) unclassified HCA. HCA patients were predominantly female (female/male ratio of 5:1); they had a median age of 34 years and a median tumour diameter of 60 mm. In the beta-catenin-activated HCA group, nine cases (19%) showed cytoarchitectural atypia, and were also referred to as atypical hepatocellular neoplasms. In the beta-catenin-activated HCA group, three cases (6%) showed focal areas supportive of transition to HCA. The original diagnosis of HCA was changed to well-differentiated hepatocellular carcinoma in nine cases and to focal nodular hyperplasia in two cases. Conclusion In our series, the major HCA subtype was HNF1 alpha-inactivated HCA. We found a low incidence of inflammatory-type HCA. Our data also showed that beta-catenin-activated hepatocellular neoplasms, including cases with atypical histology, constituted a relatively high proportion of the cases. These findings are in contrast to those of most other studies of HCA subtypes.Publication Open Access Prognostic significance of metastatic lymph node ratio in gastric cancer: a Western-center analysis(2023-08-01) UPRAK, TEVFİK KIVILCIM; AKIN, MUHAMMED İKBAL; ÇELİKEL, ÇİĞDEM; YEGEN, ŞEVKET CUMHUR; ERGENÇ, MUHAMMER; Ergenç M., Uprak T. K., Akın M. İ., Hekimoğlu E. E., Çelikel Ç., Yegen Ş. C.BackgroundTumor-node-metastasis (TNM) staging is the central gastric cancer (GC) staging system, but it has some disadvantages. However, the lymph node ratio (LNR) can be used regardless of the type of lymphadenectomy and is considered an important prognostic factor. This study aimed to evaluate the relationship between LNR and survival in patients who underwent curative GC surgery.MethodsAll patients who underwent radical gastric surgery between January 2014 and June 2022 were retrospectively evaluated. Clinicopathological features of tumors, TNM stage, and survival rates were analyzed. LNR was defined as the ratio between metastatic lymph nodes and total lymph nodes removed. The LNR groups were classified as follows: LNR0 = 0, 0.01 < LNR1 ≤ 0.1, 0.1 < LNR2 ≤ 0.25 and LNR3 > 0.25. Tumor characteristics and overall survival (OS) of the patients were compared between LNR groups.ResultsAfter exclusion, 333 patients were analyzed. The mean age was 62 ± 14years. According to the LNR classification, no difference was found between groups regarding age and sex. However, TNM stage III disease was significantly more common in LNR3 patients. Most patients (43.2%,n = 144) were in the LNR3 group. In terms of tumor characteristics (lymphatic, vascular, and perineural invasion), the LNR3 group had significantly poorer prognostic factors. The Cox regression model defined LNR3, TNM stage II—III disease, and advanced age as independent risk factors for survival. Patients with LNR3 demonstrated the lowest 5-year OS rate (35.7%) (estimated mean survival was 30 ± 1.9months) compared to LNR 0–1–2.ConclusionOur study showed that a high LNR was significantly associated with poor OS in patients who underwent curative gastrectomy. LNR can be used as an independent prognostic predictor in GC patients.Publication Open Access Diagnosis and treatment of autoimmune hepatitis: Questions, answers, and illustrative cases: endorsed by autoimmune liver diseases special interest group, Turkish association for the study of liver(2023-11-01) ÇELİKEL, ÇİĞDEM; Özaslan E., Günşar F., ÇİFCİBAŞI ÖRMECİ A., Hatemi İ., Efe C., AKYOL G., Turhan N., Barbet F. Y., SAĞOL Ö., Ataizi Çelikel Ç., et al.Autoimmune hepatitis (AIH) is a rare, immune-mediated liver disease. It has a heterogeneous nature with varied clinical presentations. The management of patients with AIH is challenging in many ways. The main difficulties are inexperience due to the rarity of the disease, diagnostic confusion in controversial areas such as variant/overlap cases, acute presentations, the presence of non-alcoholic fatty liver disease or drug-induced liver injury features, and the long and complex course of treatment. Here, we provide a clear, concise, and visualized review regarding the diagnosis and treatment of AIH, including illustrative cases.Publication Open Access Prognostic significance of mucinous histology in metastatic colorectal cancer patients treated with regorafenib(2023-01-01) ARIKAN, RUKİYE; DEMİRCAN, NAZIM CAN; YAŞAR, ALPER; SEVER, NADİYE; ÇELİKEL, ÇİĞDEM; SARI, MURAT; KÖSTEK, OSMAN; BAYOĞLU, İBRAHİM VEDAT; ARIKAN R., Üstün H. S., Demircan N. C., Işik S., Telli T. A., Yaşar A., Çelebi A., Majidova N., Sever N., ÇELİKEL Ç., et al.Objective: Prognostic factors for regorafenib therapy have not been fully defined. Mucinous adenocarcinoma (MAC) is a dis-tinct subtype of colorectal cancer (CRC). We investigated the significance of mucinous histology in patients treated with regorafenib for metastatic CRC (mCRC). Material and Methods: In this retrospective study, patients were stratified according to the presence of mucinous histology; >1% extracellular mucin was defined as mucinous component adenocarcinoma (MCAC), and containing no mucin was defined as non-MAC. The prognostic significance of mucinous histology for progression-free survival (PFS) and overall survival (OS) was evaluated by univariate and multivariate analyses. Results: A total of 103 patients were included, including 20 (19.4%) patients with MCAC and 83 (80.6%) patients with non-MAC. The median follow-up time was 8.6 months (range 1.8-31.6 months). The median PFS was lower in cases with MCAC than those with non-MAC (3.2 months vs. 3.6 months, respectively, p=0.01). Median OS was lower in MCAC patients than in non-MAC patients (4.3 months vs. 9.6 months, respectively, p=0.008). In multivariate analyses, mucinous histology was an independent risk factor [haz-ard ratio (HR): 2.2, p=0.003] for PFS and Eastern Cooperative Oncology Group-Performance Status (HR: 2.2, p=0.01), cancer antigen 19-9 (HR: 1.7, p=0.03), and mucinous histology (HR: 1.9, p=0.02) were independent risk factors for OS. Conclusion: This study revealed the prognostic value of mucinous histology in mCRC patients treated with regorafenib. Consideration of histologic features may be helpful in se-lecting patients for regorafenib therapy.