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    Celiac disease prevalence in patients with hydatid cyst
    (2017) Poyrazoglu, Omer Bilgehan; Donder, Yunus; Dulger, Ahmet Cumhur; Arikan, Turkmen Bahadir
    Aim: Hydatid cyst (HC), which is localized in the liver and lungs in most cases, has been associated with a variety of hematologic and biochemical manifestations. Celiac disease (CD) is a small-intestinal malabsorption syndrome caused by hypersensitivity to gluten in subjects who carry the HLA haplotypes HLA DQ2 and DQ8. This study has attempted to show the connection between CD and HC. Material and Methods: We prospectively analyzed data from 211 HC patients, 62 of whom had extrahepatic involvement of HC; in addition, we also classified the patients’ hydatid cysts by their radiologic features. All patients tested positive for HC by ELISA. Sera from the study population were also analyzed for IgA and IgG with ELISA using human recombinant tTG (AESKU. Diagnostics, Germany); the data were then analyzed statistically. Results: Twelve cases of seropositivity of TTG IgA were found among patients with HC. In the control group, the rate of TTG IgG seropositivity was only 2 out of 211 patients (~2%), which was lower than those with HC. In patients with HC, the mean WBC level was higher in patients with TTG IgA seropositivity compared with those without TTG IgA seropositivity. Younger ages were independently associated with TTG IgA seropositivity in the HC group. Conclusion: This study furthers the understanding of CD risk in HC. If confirmed by future studies, the study’s data will assist in developing optimal strategies for the detection of CD in patients with HC. Understanding the infectious factors involved in CD is important for identifying new approaches to the early detection of CD.
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    Evaluation of MUC-1, MUC-4, CDX-2 and OCT-1 expression profiles in gastric carcinomas and precancerous lesions
    (2019) Tetikkurt, Seza Umit; Ulu, Yuksel; Izol,Ugur; Donder, Yunus
    Aim: We investigated the diagnostic and prognostic utility of MUC-1, MUC-4, CDX2 and OCT-1 expression profiles in high-mortality gastric carcinomas and their precancerous lesions.Material and Methods: Areas in proximity of dysplasias and gastric carcinomas that were suspected of having intestinal metaplasia were stained with PAS / Alcian Blue at pH 2.5 and pH 0.5; Giemsa staining was applied for evaluation of presence of H. Pylori.Results: Presence of MUC-1 expression may exclude the diagnosis of low-grade dysplasia. MUC-1 and MUC-4 overexpression may be used for determination of groups at high risk of development of carcinomas, primarily in cases of high-grade dysplasia, while overexpression of MUC-1 in gastric carcinomas may be used as a favorable prognostic factor. Presence of CDX2 expression in various histological types of carcinomas gives rise to a suggestion that intestinal differentiation occurs in all histological types at least to some degree. OCT-1 plays a role in CDX2-mediated carcinogenesis and its regulation. Conclusion: In cases of dysplasia occurring with intestinal metaplasia, CDX2 was found to be expressed at a significantly higher degree (95.5%, p=0.011). Expression of CDX2 and OCT-1 was observed in all high-grade dysplasia cases, and was significantly higher in comparison to low-grade dysplasia cases (p=0.042; p=0.006, respectively). MUC-1 and MUC-4 expression significantly increased with each progressing stage of precancerous lesions in all lesions following low-grade dysplasia (p=0.0001; p=0.027, respectively). MUC-1 expression was the lowest (53.6%) in weak cohesive type carcinomas. Positive immunoreactivity with MUC-1 and CDX2 was higher in cases with a smaller number of metastatic lymph nodes compared to the cases with a larger number thereof.
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    Is lesser curvature resection for GIST can be associated with delayed gastric emptying?
    (2020) Donder, Yunus; Baykan, Mehmet; Sevim, Yusuf; Ertan, Tamer; Karagoz Eren, Saliha
    Aim: Patients who performed wedge resection of the lesser curvature of the stomach due to GIST were evaluated for delayed gastric emptying. Material and Methods: Thirty patients who underwent wedge gastric resection for GIST in stomach between 2009-2019 were evaluated retrospectively. In Seven patients it is located in lesser curvature. Results: Fifty-five patients were operated between 2009 and 2019 for GIST.In 7 patients, GIST was found to be located in the lesser curvature of the stomach. Of the 7 patients, 2 (%28) were male and 5 (%72) were female. Laparoscopy was performed in 4 patients and conventional procedure was performed in 3 patients. The average age was 56±10.5 (46-67) years in the conventional procedure group, and 61.5±10.4 (50-73) in the laparoscopic group. Average hospital stay was 4.67±1.5 (3-6) days for conventional procedure and, 2.75±0.9 (2-4) days for the laparoscopic group. Age and length of hospital stay were not different between the two groups (p=0.522 and p=0.094, respectively).All patients had normal radiological findings. Stool discharge was observed on postoperative day 3 at the latest. Conclusion: In conclusion, resection of lesser curvature (with laparoscopic or conventional procedure) GISTs with a tumor free surgical margin staying near to the gastric wall to prevent vagal nerve injury is feasible without gastric emptying problems.
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    A medical approach to the treatment of atraumatic spontaneous spleen ruptures
    (2017) Dogan, Serhat; Gundes, Ebubekir; Donder, Yunus; Gulcan, Huseyin; Baburoglu, Mehmet
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    Results of concurrent HER2 (CERB-B2) staining in the primary tumor and lymph node metastasis in advanced stage gastric carcinoma
    (2020) Akay, Ebru; Tekelioglu, Fatos; Karagoz Eren, Saliha; Donder, Yunus; Karaman, Hatice
    Aim: We hypothesized that tumor cells with metastatic capacity and nodal metastasis would exhibit prominent HER2 overexpression in gastric cancer for which intratumoral heterogeneity is highly variable. This study purposed to investigate the mismatch for HER2 immunohistochemical staining between the primary tumor cells and the metastatic cells in patients with advanced-stage gastric cancer.Material and Methods: A hundred and forty-four patients with advanced staged gastric cancer, and lymph node metastasis who underwent surgical resection were enrolled in this retrospective study. Primary tumor and lymph node metastasis underwent concurrent immunohistochemical staining for addressing the HER2 positivity. The concordance of HER2 positivity between the primary tumor samples and the lymph node metastases was investigated.Results: There was a significant difference in HER2 positivity rate among the well, moderate, and poorly differentiated carcinomas, which was primarily driven by the high HER2 overexpression in well-differentiated subgroup. HER2 positivity was highly frequent in stage 3 tumors, whereas HER2 was negative in the majority of the stage 4 tumors. Tumor size was also significantly larger in subjects without HER2 overexpression compared to those with HER overexpression [6 (IQR=4.88) cm vs. 5.25 (IQR=3.5) cm, p = 0.037]. Concordance of primary tumors and the metastatic lymph nodes regarding HER2 positive IHC staining were 93.7%. Conclusion: HER2 might be positive in lymph node metastasis samples even if the primary tumor is negative for HER2. We suggest that HER2 IHC staining of the lymph node metastasis should be considered if the primary tumor is signet ring cell carcinoma, moderately or poorly differentiated, and negative for HER2 in subjects with gastric carcinoma and lymph node metastasis.