Label-Free Surface Enhanced Raman Spectroscopy for Cancer Detection.

Blood is a vital reservoir housing numerous disease-related metabolites and cellular components. Thus, it is also of interest for cancer diagnosis. Surface-enhanced Raman spectroscopy (SERS) is widely used for molecular detection due to its very high sensitivity and multiplexing properties. Its real potential for cancer diagnosis is not yet clear. In this study, using silver nanoparticles (AgNPs) as substrates, a number of experimental parameters and scenarios were tested to disclose the potential for this technique for cancer diagnosis. The discrimination of serum samples from cancer patients, healthy individuals and patients with chronic diseases was successfully demonstrated with over 90% diagnostic accuracies. Moreover, the SERS spectra of the blood serum samples obtained from cancer patients before and after tumor removal were compared. It was found that the spectral pattern for serum from cancer patients evolved into the spectral pattern observed with serum from healthy individuals after the removal of tumors. The data strongly suggests that the technique has a tremendous potential for cancer detection and screening bringing the possibility of early detection onto the table.

Radiomics Features Based on MRI-ADC Maps of Patients with Breast Cancer: Relationship with Lesion Size, Features Stability, and Model Accuracy.

Objective: To predict breast cancer molecular subtypes with neural networks based on magnetic resonance imaging apparent diffusion coefficient (ADC) radiomics and to detect the relation of lesion size with the stability of radiomics features. Methods: This retrospective study included 221 consecutive patients (224 lesions) with breast cancer imaged between January 2015 and January 2020. Three sample size configurations were identified based on tumor size (experiment 1: all cases, experiment 2: >1 cm3, and experiment 3: >2 cm3). The tumors were segmented by three observers based on diffusion-weighted imaging-registered ADC maps, and the volumetric agreement of these segmentations was evaluated using the Dice coefficient. Stability of radiomics features (n=851) was evaluated with intraclass correlation coefficient (ICC, >0.75) and coefficient of variation (CoV, <0.15). Feature selection was made with variance inflation factor (VIF, <10) and least absolute shrinkage and selection operator regression. Outcomes were identified as molecular subtypes (Luminal A, Luminal B, HER2-enriched, triple-negative). Neural network performance was presented as an area under the curve and accuracies. Results: Of the 851 radiomics features, 611 had ICC >0.75, and 37 remained stable in the first experiment, 49 in the second, and 59 in the third based on CoV and VIF analysis. High accuracy was demonstrated by the Luminal B, HER2-enriched, and triple-negative models in the first experiment (>80%), all models in the second experiment, and HER2-enriched and triple-negative models in the third experiment. Conclusions: A positive stability is indicated by an increased lesion size related to radiomics features. Neural networks may predict moleculer subtypes of breast cancers over 1 cm3 with high accuracy.

Multivariable Diagnostic Prediction Model to Detect Hormone Secretion Profile From T2W MRI Radiomics with Artificial Neural Networks in Pituitary Adenomas.

Objective: This study aims to develop neural networks to detect hormone secretion profiles in the pituitary adenomas based on T2 weighted magnetic resonance imaging (MRI) radiomics. Methods: This retrospective model-development study included a cohort of patients with pituitary adenomas (n=130) from January 2015 to January 2020 in one tertiary center. The mean age was 46.49±13.69 years, and 76/130 (58.46%) were women. Three observers segmented lesions on coronal T2 weighted MRI, and an interrater agreement was evaluated using the Dice coefficient. Predictors were determined as radiomics features (n=851). Feature selection was based on intraclass correlation coefficient, coefficient variance, variance inflation factor, and LASSO regression analysis. Outcomes were identified as 7 hormone secretion profiles [non-functioning pituitary adenoma, growth hormone-secreting adenomas, prolactinomas, adrenocorticotropic hormone-secreting adenomas, pluri-hormonal secreting adenomas (PHA), follicle-stimulating hormone and luteinizing hormone-secreting adenomas, and thyroid-stimulating hormone adenomas]. A multivariable diagnostic prediction model was developed with artificial neural networks (ANN) for 7 outcomes. ANN performance was presented as an area under the receiver operating characteristic curve (AUC) and accepted as successful if the AUC was >0.85 and p-value was <0.01. Results: The performance of the ANN distinguishing prolactinomas from other adenomas was validated (AUC=0.95, p<0.001, sensitivity: 91%, and specificity: 98%). The model distinguishing PHA had the lowest AUC (AUC=0.74 and p<0.001). The AUC values for the other five ANN were >0.85 and p values were <0.001. Conclusions: This study was successful in training neural networks that could differentiate the hormone secretion profile of pituitary adenomas.

Radiological approach to basilar invagination type B: Reliability and accuracy.

OBJECTIVES: This study aims to determine the reliability of the radiological tests used in the diagnosis of basilar invagination (BI). METHODS: Patients diagnosed with type B basilar invagination, who had both magnetic resonance (MR) and computed tomography (CT) imaging between January 2014 and November 2019 were included in this retrospective reliability study. In this study, distance from odontoid apex to Chamberlain's line (OA-CL) was accepted as a reference method for the diagnosis. Forty-two BI cases and 79 controls were included. Three radiologists with different levels of experience individually evaluated OA-CL, Boogard's angle (BoA), clivo-axial angle (CXA), clivo-dens angle (CDA), and clivo-palate angle (CPA) on midsagittal CT and MR images. Statistical analysis was made with the intraclass correlation coefficient (ICC), t-test, and receiver operating characteristic (ROC) curve. RESULTS: The ICC for CT and MR were; 0.977-0.973 (OA-CL), 0.912-0.882 (BoA), 0.845-0.846 (CXA), 0.862-0.864 (CDA), and 0.762-0.747 (CPA) respectively (P < 0.001). The areas under the ROC curve were 0.977 (BoA), 0.832 (CXA), 0.852 (CDA), and 0.719 (CPA) (P < 0.001). The cut-off measures were ≥137.84° (BoA), ≤149.25° (CXA), ≤129.58° (CDA), and ≤61.83° (CPA). The diagnostic accuracies were 0.954 (BoA), 0.664 (CXA), 0.704 (CDA), 0.438 (CPA) (P < 0.001). CONCLUSIONS: OA-CL and BoA express excellent inter-rater agreement than CXA, CDA, and CPA, which are limited due to morphological variations and head spatial position. BoA is the second most reliable diagnostic test. CXA, CDA, should only be used for complementary information. CPA was found inadequate for the diagnosis of BI..

Comprehensive Analysis of Factors Affecting Cochlear Size: A Systematic Review and Meta-analysis.

OBJECTIVES: To determine the cochlea's average size in humans and evaluate the relationships between certain covariates and cochlear size. METHODS: A systematic search on articles on cochlear size and published in English was conducted using Cochrane, PubMed, Web of Science, and Scopus databases up to September 15, 2020. Data were pooled using random-effects with three models. The effect of demographic, clinical, and measurement-related parameters was specifically analyzed. Meta-regression and subgroup analyses were conducted. The overall effect estimation was made for outcomes. RESULTS: The meta-analysis included 4,708 cochleae from 56 studies. The overall length of the organ of Corti was 32.94 mm (95% confidence interval [CI]: 32.51-33.38). The first and second models revealed that age, gender, country, continent, measurement method (direct, indirect), measured structure ("A" value, cochlear lateral wall), origin (in vivo, in vitro), and type (histology specimens, plastic casts, imaging) of the cochlear material did not affect the cochlear size. However, study populations (general population, patients with a cochlear implant, and patients with congenital sensorineural hearing loss [CSNHL]) were found to affect the outcomes. Compared to the other populations, patients with CSNHL had shorter cochleae. Therefore, we developed a third model and found that the general population and patients with cochlear implants did not differ in cochlear size. CONCLUSION: This meta-analysis investigated the factors that could affect the cochlear size and found that patients with CSNHL had significantly shorter cochleae, whereas other covariates had no significant effect. Laryngoscope, 132:188-197, 2022.

The Relation Between the Metopic Suture Persistence and Frontal Sinus Volume and Olfactory Fossa Depth: A Reliability Study with Semiautomatic Volume Measurement.

Objective: This study aims to investigate the relationship of the persistence of metopic suture (PMS), frontal sinus volume (FSV), and olfactory fossa depth (OFD). Methods: Tomography scans of 1,603 patients aged 18-65 years were evaluated for the presence of PMS. In the study, 74 PMS cases and 74 controls were included. The appearance of each individual's frontal sinus was classified as aplasia, hypoplasia, or normal. Two observers independently measured the lateral lamella length (LLL), OFD, and FSV. Interobserver agreement was evaluated with the intraclass correlation coefficient (ICC) and Cohen's kappa coefficient (κ). Results: The prevalence of PMS was found to be 4.99% [95% confidence interval (CI): 4.03-6.17]. The PMS group had five times higher hypoplasia/aplasia than the controls (52.70%, 95% CI: 41.48-63.66 and 10.81%, 95% CI: 5.58-19.91, respectively; p<0.001). An "almost perfect" agreement was detected among observers for the frontal sinus appearance classification: κ=0.807, p<0.001. The ICC of continuous measurements for OFD, LLL, and FSV, respectively, presented "excellent" reliability: 0.956, 0.958, and 0.981, with p<0.001 for each. LLL was shorter, OFD was shallower, and FSV was smaller in the PMS group than the control group (p<0.001). There was a moderate positive correlation between OFD, LLL, and FSV (r=0.306, r=0.302). Conclusions: This study interprets that the presence of PMS is related frontal sinus development and volume. With PMS, a smaller FS, shorter lateral lamella, and shallower olfactory fossa may be expected.

Is Cochlear Length Related to Congenital Sensorineural Hearing Loss: Preliminary Data.

OBJECTIVES: This study used the data from patients with congenital sensorineural hearing loss (CSNHL) and those with normal hearing to measure and compare the length of the cochlea with high-resolution computed tomography (HRCT). MATERIALS AND METHODS: HRCT images of patients who were diagnosed with CSNHL and were candidates for cochlear implantation were evaluated retrospectively. Sixty-three ears of 33 patients were included in the study. The control group comprised 66 ears of 33 individuals. The measurements were conducted by an experienced radiologist, using three-dimensional curved multiplanar reconstruction. All the measurements were performed thrice, and the average was calculated. RESULTS: The data were distributed normally. The lengths of the cochlear components for the CSNHL and control groups were as follows: basal turn 21.66±1.01 (21.30-22.02) and 22.57±0.68 (22.32-22.81) mm, middle turn 11.58±0.69 (11.34-11.83) and 12.39±0.46 (12.23-12.56) mm, and apical turn 6.45±0.92 (6.12-6.77) and 7.12±0.65 (6.89-7.35) mm, respectively. The mean cochlear lateral wall (LW) length was significantly shorter in the CSNHL patients [39.71±1.32 (39.25-40.18) mm] than in the controls [42.09±1.17 (41.67-42.51) mm], (p<0.001). The intra-rater reliability was 0.878 (confidence interval 95%: 0.841-0.908 p<0.001). The cut-off value was 40.81 mm (sensitivity: 0.91, specificity: 0.94, and accuracy: 0.90). CONCLUSION: There were microanatomic dissimilarities between the length of the cochlea in subjects from the CSNHL group and those from the control group.

Role of iliac crest tangent in correct numbering of lumbosacral transitional vertebrae

Background/aim: The iliac crest tangent (ICT) has recently emerged as a reliable landmark to correctly number the lumbosacral transitional vertebrae (LSTV). We retrospectively evaluated the reproducibility and accuracy of the ICT as a landmark in subjects without disc degeneration. Materials and methods: Fifty-eight patients with LSTV [19 female, 41 (26­52) years] and 55 controls without LSTV [23 female, 40 (26­55) years] who had undergone spinal computed tomography were included. The ICT was drawn on the coronal images, with the cursor in the sagittal view set to the posterior ⅓ of the vertebral body located one level above the LSTV. When more than 1.25 vertebral body was counted below the ICT, the LSTV was considered as S1, otherwise it was considered as L5. The gold standard was counting the vertebrae craniocaudally. Results: The interobserver agreement was good for determining ICT level (Cohen's kappa = 0.78, P < 0.001). The rate of correct numbering by ICT in the LSTV group was significantly less than in the controls (43.1% vs. 96.4%, respectively, P < 0.001). Patients with sacralization had a significantly lower correct numbering rate than patients with lumbarization (33.3% vs. 63.2%, respectively, P = 0.03). Conclusion: ICT does not seem to be a reliable landmark for correct numbering of LSTV in patients with no intervertebral disc degeneration.

Clinical evaluation of negative-pressure wound therapy in the management of electrical burns.

BACKGROUND: In this study, we aimed to evaluate the clinical efficacy and safety of negative-pressure wound therapy (NPWT) in the treatment of the patients with electrical burns. METHODS: This study was retrospectively performed using a database placed prospectively in the burn center of our hospital. All consecutive patients with electrical burns treated using NPWT at our center between August 2008 and December 2012 were included. The treatment results in our study were grouped as successful or unsuccessful considering the treatment objectives in accordance with therapy indications. RESULTS: In total, 39 patients were included in our study; of them, 36 (92.3%) were men. The average age was 34.9±9.8 years (range, 17-63 years). The majority of the patients in our study (92.3%) had been exposed to high voltage electricity. The mean total burned body surface area (TBSA) was 19.3±9.8 (range, 4-44). Six patients (15.4%) had TBSAs ≥30%, 31 (79.5%) had third degree burns, and 8 (20.5%) had fourth degree burns. In our study, indications of NPWT included bone and/or tendon exposed deep wounds that are not suitable for early grafting or flap applications owing to the lack of supporting tissue in 27 (69.2%) patients, graft fixation in 8 (20.5%) patients, and secondary grafting following graft loss in 4 (10.3%) patients. The general success rate of NPWT was 90.7% according to indications and treatment objectives in our study. CONCLUSION: In the light of our results, NPWT may contribute to the present conventional treatments used in severe electrical burns.

Evaluation of the patients with colorectal cancer undergoing emergent curative surgery.

BACKGROUND: The aim of our study is to evaluate perioperative and mid-term oncologic outcomes of the patients with colorectal cancer, who underwent emergent curative surgery. METHODS: The study included all patients with colorectal cancer, who underwent surgery for curative intent between 1 January 2012 and 31 December 2014 in General Surgery Department of Kartal Training and Research Hospital. The patients were divided into two groups according to the type of admission (emergent or elective). The data of the patients were retrospectively collected with chart review. Demographic characteristics of the patients, ASA scores, emergent indications and surgical interventions, postoperative complications, pathological findings, oncological therapy, and follow-up findings were investigated. RESULTS: Fifty-one and 209 patients were evaluated in both groups, respectively. Rate of right sided and sigmoid/recto-sigmoid tumors were significantly higher in emergent group. Ostomy rate, early morbidity, ICU need, transfusion, and mortality rates in emergent group were significantly higher than elective group. Average length of hospital stay in emergent group was also significantly longer in elective group (11.2 ± 3.2 vs. 8.4 ± 2.4 days). The patients in emergent group had a much lower survival rate than those in elective group. CONCLUSION: In our study, emergency presentation of colorectal cancer was found associated with increased morbidity, a longer length of stay, increased in-hospital mortality, advanced pathologic stage and worsened long term survival in even same stages.

Effect of local bleomycin sulfate application on seroma formation in a rat mastectomy and axillary lymph node dissection model.

Seroma formation is one of the most common complications following breast cancer surgery. It may lead to delay of adjuvant therapies and increasement of therapy costs. Bleomycin sulfate is a sclerosing antibiotic with antineoplastic efficacy. It is locally used in the treatment of pleural effusion. The present study aimed to investigate seroma-reducing effect of local bleomycin application after mastectomy. Sixteen female Wistar Albino rats were used in this study. The rats were divided into two equal groups. Under general anesthesia all rats underwent unilateral mastectomy as definition by Harada. Serum physiologic was applied to animals in Group 1 (control group) and bleomycin to Group 2. Mastectomized localization was explored on the 10th day postoperatively. Seroma and tissue samples were obtained from axilla and thoracic wall for histopathological examination. The amount of seroma was significantly lower in the bleomycin group as compared to the control group (P=0.002). Fibrosis, PNL infiltration and the number of fibroblasts were significantly higher in the bleomycin group. No difference was identified between the groups in terms of angiogenesis, edema, congestion, and monocyte, lymphocyte and macrophage infiltration. Local bleomycin sulfate application might be a therapeutic option in patients with seroma formation, as well as in the patients with malignant pleural effusion. Nonetheless, further studies that compare the efficacy and adverse effects (benefit-to-harm ratio) of bleomycin sulfate are needed.

A prospective comparative study to assess the contribution of radioisotope tracer method to dye-only method in the detection of sentinel lymph node in breast cancer.

BACKGROUND: Metastasis in the axillary lymph nodes is the most important known prognostic factor for breast cancer. We aimed to investigate the contribution of the radioisotope tracer method to the dye-only method by performing sentinel lymph node biopsy on the same patient group during a single surgical session. METHODS: Forty-two patients who underwent operations in our clinic from February 2010 to October 2011 and with masses of <5 cm and clinically and radiologicallly negative axilla (T1-2 N0) were prospectively included in this study. After paraffin examination results were obtained, the numbers and metastatic states of the lymph nodes that were unidentifiable during surgery (although they were stained) but were detected by a gamma probe, lymph nodes that were only stained, lymph nodes that were only radioactive (hot), and lymph nodes that were both stained and radioactive (stained-hot) were determined in all patients. In patients who underwent axillary lymph node dissection, the total numbers of lymph nodes removed and their metastatic states were determined separately. RESULTS: At least one blue-stained sentinel lymph node was identified in all patients during the blue-stained lymph node detection stage. The average number of sentinel nodes removed at this stage was 2.1 ± 1.1. In the second surgical stage (the stage in which nodes with axillary counts were investigated with the gamma probe) in these 41 patients, at least one additional hot node was removed, or at least one of the nodes that was removed because it was blue was also hot. In addition to the lymph nodes removed in the dye stage, 34 hot lymph nodes were excised from 21 patients. Overall, the average number of hot lymph nodes removed was 2.9 ± 1.5. In all patients, subsequent frozen sections and histopathological examinations were 100% concordant with the sentinel lymph nodes that were removed; the stained sentinel lymph nodes that were removed first did not affect the decision to perform axillary dissection. CONCLUSION: The results of our study indicate that performing sentinel lymph node biopsy with dye only is sufficient and as effective as the combined method.

Effects of local phenytoin on seroma formation after mastectomy and axillary lymph node dissection: an experimental study on mice.

BACKGROUND: Seroma formation is the most common complication after breast cancer surgery. It is an important complication since it prolongs therapy duration, increases cost, and negatively affects patient psychology. Currently, there is no widely accepted method that prevents seroma formation. We tried to investigate impact of local phenytoin application on seroma formation following an experimental mastectomy model created in rats. METHODS: Two groups including eight rats in each were randomized. Saline injection was applied in the first group, whereas 1% phenytoin was locally used in the second group. Ten days after the surgery, seroma formation and wound-healing processes were evaluated using histopathological and biochemical examinations. RESULTS: Phenytoin significantly decreased seroma formation. Fibrosis was significantly increased and angiogenesis was significantly reduced in the phenytoin group (P < 0.05). Increased levels of macrophage and lymphocyte infiltration was detected in the control group (P < 0.05). No difference was detected between the groups in terms of necrosis, edema, congestion, and PNL (Polymorphonuclear leucocyte) and fibroblast infiltration. CONCLUSIONS: Seroma formation-reducing effect of phenytoin might have occurred over its anti-inflammatory, anti-angiogenetic, and fibrosis augmenting effects.

Is there any role of thrombin activatable fibrinolysis inhibitor in the development of a hypercoagulable state in gastric cancer.

BACKGROUND: The purpose of this study was to investigate plasma levels of thrombin activatable fibrinolysis inhibitor (TAFI) and TAFI's relationship with coagulation markers (prothrombin fragment 1 + 2) in gastric cancer patients. METHODS: Thirty-three patients with gastric adenocarcinoma and 29 healthy control subjects were prospectively enrolled in the study. Patients who had a history of secondary malignancy, thrombosis related disease, oral contraceptive use, diabetes mellitus, chronic renal failure or similar chronic metabolic disease were excluded from the study. A fasting blood sample was drawn from patients to determine the plasma levels of TAFI and Prothrombin Fragment 1 + 2 (F 1 + 2). In addition, data on patient age, sex, body mass index (BMI) and stage of disease were recorded. The same parameters, except stage of disease, were also recorded for the control group. Subsequently, we assessed the difference in the levels of TAFI and F 1 + 2 between the patient and control groups. Moreover, we investigated the relation of TAFI and F 1 + 2 levels with age, sex, BMI and stage of disease in the gastric cancer group. RESULTS: There were no statistical differences in any demographic variables (age, gender and BMI) between the groups (Table 1). The mean plasma TAFI levels of the gastric cancer group (69.4 ± 33.1) and control group (73.3 ± 27.5) were statistically similar (P = 0.62). The mean plasma F 1 + 2 level in the gastric cancer group was significantly higher than for those in the control group (549.7 ± 325.3 vs 151.9 ± 67.1, respectively; P < 0.001). In the gastric cancer group, none of the demographic variables (age, gender and BMI) were correlated with either TAFI or F 1 + 2 levels. Also, no significant associations were found between the stage of the cancer and either TAFI or F 1 + 2 levels. CONCLUSION: In our study, TAFI levels of gastric cancer patients were similar to healthy subjects. The results of our study suggest that TAFI does not play a role in pathogenesis of the hypercoagulable state in gastric cancer patients.

Intra-abdominal use of phosphodiesterase type 4 inhibitor in postoperative adhesion prevention: an experimental study on mice.

OBJECTIVE: The study was designed to assess the value of intraperitoneal use of rolipram for adhesion prevention and to compare the results with placebo and a sodium hyaluronate/carboxymethylcellulose absorbable barrier (Seprafilm), in a murine cecal abrasion model. DESIGNS: Twenty-four Balb/c mice were subjects of this study. Intra-abdominal adhesions were created with a multiple-abrasion model consisting of meticulous abrasion of the cecum and small-bowel segments with strokes of a dental toothbrush. Animals in groups R (n = 8) received 1 mL of rolipram intraperitoneally. Seprafilm was placed over the viscera under the incision in group S animals (n = 8). Group C animals (n = 8) were reserved as control and received nothing. Animals were killed on day 22. MAIN OUTCOME MEASURES: The adhesions were evaluated with 2 different observational scoring systems, the Majuzi System and the Linsky Scale. After completion of observational evaluation, the cecum and small bowel of the animals were excised and sent to the pathology laboratory for histopathologic examination. The extent of inflammatory response, the extent of the fibrotic reaction, the extent of the necrosis and abscess formation, and the extent of foreign body reaction were histologically evaluated. RESULTS: The mean Majuzi System scores of groups R and S were similar to each other and significantly less than control group. Also, all scores of the Linsky Scale in group R were similar to those in group S, and significantly less than those in the control group. Histologically, the mean score of inflammatory response in group R was less than both those in group C and group S. The mean score of fibrotic reaction in group R was significantly less than those in the control group. CONCLUSION: These results indicate that rolipram may be an effective material in prevention of postoperative intra-abdominal adhesions, but it is obvious that further studies are needed to validate the results of this limited initial study.

Acute pancreatitis associated with hypertriglyceridemia: a life-threatening complication.

Acute pancreatitis is rare cause in pregnancy and gallstones are clearly the most common cause of pancreatitis during pregnancy. Only a small percentage of women with acute pancreatitis are associated with hypertriglyceridemia and it is most often noted during the last two trimesters of pregnancy. Hypertriglyceridemia is a rare cause of pancreatitis in pregnant women and complication such as pancreatitis carries a higher risk of mortality for both the mother and the fetus. Our purpose was to report our experience with acute pancreatitis as a lethal complication of hypertriglyceridemia during the third trimester of pregnancy.

The association of serum adiponectin levels with histopathological variables in gastric cancer patients.

Adiponectin is a peptide hormone secreted from the adipose tissue, affecting the proliferation and insulin sensitivity in different cell types. The levels of adiponectin have been found to be decreased in hyperinsulinemia and insulin resistant states, such as obesity. The previous studies have suggested that plasma adiponectin levels are decreased in patients with endometrial and breast cancer. In our study, the relationship among serum adiponectin levels, demographic features and histopathological variables was evaluated in gastric cancer patients. Forty consecutive patients with gastric cancer who underwent gastrectomy with standard lymph node dissection were included and 43 healthy controls were included in this study. The serum levels of glucose, insulin, C-peptide, HbA1c and adiponectin were measured in both groups. We analyzed the correlation among these parameters and patients' demographic features, such as age, gender, body mass index (BMI) and histopathological variables such as tumor localization, stage, nodal status, histological grade, vascular and lymphatic invasion. The mean age was 60.05+9.72 in patients, while it was 38.6+12.73 in controls. The mean serum adiponectin levels were 12.62+7.9 and 10.07+6.72 ng/ml, respectively, in groups. There was no different in terms of adiponectin, C-peptide, HOMA-R level in both groups. On the other hand, BMI, glucose and insulin levels were significantly different in gastric cancer patients in comparison with the controls. There was no correlation among the levels of adiponectin, BMI, insulin and c-peptide levels in patient group (P>0.05). The adiponectin levels of woman were significantly lower than male patients (P=0.002). No relations were detected among tumor stage, tumor localization, nodal status, lymphatic and vascular invasion, and the levels of serum adiponectin (P>0.05). Interestingly, a positive correlation was found between tumor grade and plasma adiponectin levels (r=0.372; P=0.018). Our results suggest that plasma adiponectin levels were similar in both patients with gastric cancer and the controls. In addition, no correlation was found between adiponectin levels and demographic features and histopathological variables of patients. But, in undifferentiated tumors, plasma adiponectin level was significantly higher than well-differentiated grade tumors.

Neoadjuvant chemotherapy for locally advanced breast cancer: a single center experience.

Neoadjuvant chemotherapy (NAC) is one of the treatment options for patients with locally advanced breast cancer (LABC). Preoperative chemotherapy potentially may reduce the extent of the surgery and offers the opportunity to assess the chemosensitivity of the tumor in vivo. Herein, we evaluated the results of NAC in Turkish LABC patients. We retrospectively analyzed 73 LABC patients. Anthracycline/taxane-based chemotherapy regimens were administered. Patients were stratified according to age, menopausal status, type of surgery, response to the treatment, histopathological properties, and survival. After 3-6 cycles of chemotherapy, patients were re-staged radiologically and surgery was performed in operable patients. Adjuvant chemotherapy was administered as needed. The median age was 45 (29-93) at the time of diagnosis. Sixteen percentage of patients were younger than 35 years of age and 45.2% were premenopausal. Median follow-up time was 20.2 months. Sixty-seven out of 73 patients responded to therapy (89%). Breast conserving surgery was possible in the 15% of the patients. In histopathological analysis, lymph node invasion was detected in 85%. The estrogen (ER) and progesterone (PR) receptor were positive in 78.1% and c-erb-B2 was positive in 17.5% of patients. The median disease-free survival (DFS) was 44 months (SE: 9; %95 CI: 27.1-60.8), overall survival (OS) was not reached at the time of analysis. Three-year DFS and OS were 58% and 91.9%, respectively. In a multivariate Cox regression analyses; no demographic or pathologic prognostic parameter predicted overall survival. In recent years, NAC in breast cancer has become a viable treatment option for patients with LABC. NAC is not commonly applied in Turkey. The response rate to NAC in Turkish breast cancer patients is encouragingly high. Broader efforts should be made to evaluate breast cancer patients preoperatively at tumor boards for proper treatment sequence.