Does smoking change expression patterns of the tumor suppressor and DNA repair genes in the prostate gland?

OBJECTIVES: Somatic mutations can be present in clonally expanded cell populations in nonmalignant tissues, which are detectable at tissue-level resolution. Some of the mutational changes may arise due to smoking. We aimed to find out changes in carcinogenic gene expressions related to smoking in nonmalignant prostate gland epithelia. MATERIALS AND METHODS: The patients who came to the Department of Urology at Abant Izzet Baysal University Medical Faculty from December 2006 to December 2009 for prostate biopsy were questioned for cigarette smoking. The patients were divided into 2 groups, namely, smokers and nonsmokers. Paraffin sections were stained immunohistochemically with p53, PTEN, p16INK4a, MSH2, CHK2, RB, and E-cadherin. RESULTS: Smoking was the main independent factor that had an effect on the immunohistochemical expressions for p53, p16, and PTEN (P = 0.007, P = 0.036, P = 0.015, respectively). Age and inflammation had no statistically significant effects on gene expressions. No difference was found between smokers and nonsmokers for immunohistochemical expressions of E-cadherin, MSH2, RB, and CHK2. CONCLUSIONS: Smoking-related carcinogens can alter the expressions of some suppressor genes in a prostate tissue, and these alterations can be determined immunohistochemically. Alterations in these genes in prostate gland epithelia could possibly increase the risk for prostate carcinoma.

Pattern of primary tumors and tumor-like lesions of bone in children: retrospective survey of biopsy results.

BACKGROUND: Although primary bone tumors are relatively uncommon, they constitute the most important tumors in patients less than 20 years. We aimed to determine the frequencies of primary bone tumors and tumor-like lesions of bone and the anatomical sites of their occurrence. METHODS: A retrospective review of histopathology reports of all bone specimens received in a private pathology laboratory in Istanbul between 2009 and 2015. RESULTS: A total of 57 patients (aged 5 to 18 years) with a mean of 13.12 years were studied. Thirty five patients (61.4%) were males and 22 (38.6%) were females. Fifty five (94.4%) of the tumors were benign. Osteochondroma was the commonest tumor accounting for 31 cases (54.3%) followed by osteoid osteoma, 9 cases (15.7%). Chondrosarcoma observed in two patients and Ewing sarcoma in one patient as malignant tumors. Of the 57 bone tumors 13 (22.8%) occurred in the upper extremities, while 44 (77.2%) were in the lower extremities. Proximal humerus was the most commonly involved site in upper extremity tumors, with osteochondromas representing the most frequent type of tumor (4 patients; 7%). In the lower extremities again osteochondromas were the most common type of tumor (8 cases, 14%), with the femur being the most common site of involvement (18 patients, 31.5%). Of the patients with tumor-like lesions; four patients had fibrous dysplasia, 4 patients had non-ossified fibromas, 4 patients had simple bone cysts and 3 had aneurismal bone cyst. CONCLUSION: This study showed that primary bone tumors were mainly benign, settled predominantly in the lower extremities mostly in the femur with a male preponderance. Osteochondroma was the most common benign bone tumor. We didn't observed osteosarcoma, which is the most frequent malignant bone tumor.

Diagnostic value of fine needle aspiration biopsy in non-thyroidal head and neck lesions: a retrospective study of 866 aspiration materials.

AIM: We aimed to investigate the diagnostic value of fine needle aspiration biopsy (FNAB) and compared our FNAB results of non-thyroidal head and neck lesions with excisional biopsy results. MATERIALS AND METHODS: A total of 866 aspiration material taken from different parts of head and neck region out of thyroid were evaluated at Haydarpasa Numune Training and Research Hospital Pathology Laboratory, between January 2002 and May 2013 and 248 of which has histopathologic response were included in the study. Patients depending on origin of the masses were divided into three categories as; salivary gland, lymph nodes and soft tissue/cystic lesions. The sensitivity, specificity, diagnostic accuracy values of fine needle aspiration biopsies have been investigated for all the series and individually for each category. FINDINGS: Diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive values of non-thyroidal head and neck masses were respectively; For all of the series; 94.6%, 97.9%, 96.7%, 95.9%, 97.2%, Salivary gland: 88.9%, 100%, 98.8%, 100%, 98.7%, Lymph nodes: 94.7%, 89.3%, 92.9%, 94.7%, 89.2%, Soft tissue/cystic lesions: 100%, 100%, 100%, 100%, 100%. For all of the series; there were 4 false negative (FN) cases; and 3 false positive (FP) cases. CONCLUSION: FNAB in the diagnosis of head and neck masses; it is an easy, cheap and usefull procedure.

Visfatin concentrations in patients with endometrial cancer.

OBJECTIVE: Visfatin is one of the most recent proteins shown to be highly expressed in adipose tissue. The purpose of this study was to determine visfatin levels in patients with endometrial cancer (EC). METHODS: A total of 90 patients (46 EC patients and 44 healthy controls) were included in the study. Fasting venous blood samples were collected from all patients. Serum visfatin levels were measured by an enzyme-linked immunosorbent assay (ELISA). The correlation between serum visfatin levels and clinicopathologic variables were determined. RESULTS: Serum visfatin levels were found to be higher in patients with EC (p < 0.001). Visfatin concentrations were positively correlated with age (p = 0.002, r = 0.323), body mass index (BMI) (p = 0.001, r = 0.354), fasting insulin (p = 0.002, r = 0.326), total cholesterol (TC) (p = 0.006, r = 0.285), triglyceride (TG) (p < 0.001, r = 0.364) levels and homeostasis model-resistance index (HOMA-IR) (p = 0.007, r = 0.281) of patients. By using classification and regression trees (C&RT) method, we found that visfatin predicted patients with EC 100% and controls 81.8%. CONCLUSION: Visfatin was the most important risk factor for occurrence of EC other than, age, BMI, Diabetes Mellitus and other biochemical factors like HDL, LDL, TG, TC. Clearly, there are largely unknown aspects of visfatin pathophysiology in EC and require further study.

Evaluation of peripheral lymphadenopathy with excisional biopsy: six-year experience.

BACKGROUND: Lymphadenopathy (LAP) may be the first symptom of many diseases. We aimed to investigate peripheral LAP results taken by excisional biopsy. METHODS: Histopathological examination of 185 lymph node biopsy specimens were evaluated between January 2009 and April 2015 in Istanbul Private Ekin Pathology Laboratory, retrospectively. RESULTS: The average age of patients ranged from 1 to 86 was 41.01 ± 20.62 years. 87 of were female, 98 of male. 62 (33.5%) of excisional biopsy materials were benign lesions and 123 (66.5%) of malignant. Benign lesions were consisted of reactive hyperplasia, cat-scratch disease, toxoplasmosis, necrotizing/non-necrotizing granulomatous. Of these patients, 40 had nodes with reactive hyperplasia (15 female/25 male, mean age: 27.35 y), 14 had necrotizing granulomatous disease (9 female/5 male, mean age: 39.86 y), 2 non-necrotizing granulomatous disease (1 female/1 male mean age: 43 y), 4 had cat-scratch disease (1 female/3 male mean age: 54.25 y), 1 toxoplasmosis (26 y, female), 1 Kikuchi disease (25 y, female). In the evaluation of malign lesions; 38 were Hodgkin lymphoma (HL) (20.5%, 17 female/21 male, mean age: 34.89 y) 77 had non-Hodgkin lymphoma (NHL) (41.6%, 37 female/40 male, mean age: 52.26 y), 8 metastasis (4.3%, 5 female/3 male, mean age: 53.5 y). Reactive LAP observed most common in cervical region, NHL in axillary-abdomen-inguinal-mediastinum and HL in the supraclavicular region. CONCLUSION: Excisional biopsy can be applied safely with minimal morbidity and mortality and a gold standard diagnostic method for LAP. Although LAP is mostly related with benign lesions, malignancy should be kept in mind in differential diagnosis.

TNM and Modified Dukes staging along with the demographic characteristics of patients with colorectal carcinoma.

AIM: Colon adenocarcinoma, is the most common cancer in gastrointesinal system (GIS). The whole world is an important cause of morbidity and mortality. TNM and modified Dukes classification which has great importance in the diagnosis and treatment of Colorectal cancer (CRC). TNM and Modified Dukes classification results of histopathological examination and the demographic characteristics of patients and their relation were investigated. MATERIALS AND METHODS: Lower gastrointestinal operation results of 85 patients were examined accepted to clinical Pathology between January 1997-November 2013. Colon cancer had been diagnosed at 85 patients with pathology materials and staging was done according to the TNM and Modified Duke classification. The demographic characteristics of patients, differentiation grade, lymph node involvement, serous involvement were evaluated retrospectively. RESULTS: In this study 37 patients (43.52%) were men and 48 (56.47%) were women. Ages of patients were between 19 and 87 with a mean age of 57.31 ± 15.31. Lymph node, differentiation, serosa involvement, Modified Dukes and TNM classification was assessed according to sex and age. TNM classification by sex was not statistically significant (p > 0.05). There was no statistically significant relationship between age and differentiation (p = 0.085). Value of differentiation increased towards from 1 to 3 inversely proportional to age. So young patients defined as well-differentiated at the conclusion. Negative relationship was evaluated between age and TNM Class variables. As a result, the relationship between age and TNM was not significant (p > 0.05). However, with increasing age the degree of staging was also found to increase. TNM classification was associated with the differentiation and it was significant (p = 0.043). CONCLUSION: Colon cancer, when contracted at an early stage, it is suitable for surgery and curative treatment can be done with minimal morbidity and mortality. However, some of the patients have advanced disease at diagnosis and their 5-year survival rate is only 8%. Every year there is prolongation of overall survival of colon cancer. It is so common cancer type so that determination of prognostic factors, disease staging and treatment strategy which affects survival is significant.

The analysis of 8-year data (2002-2010) of the tumor cases based on the pathology records of Abant Izzet Baysal University medical faculty department.

AIM: Cancer is one of the most significant health problems throughout the world. An important aspect of measures against cancer is to determinate the extension and prevalence of the cancer. Understanding characteristics and behavior of cancer is the key issue in providing preventive steps and developing proper strategies in the concept of early diagnosis and treatment. The objective of this study was to determine the regional cancer incidence and cancer types based on the pathology records of Department of Pathology, Medical School, Abant Izzet Baysal University. Secondly. The aim was to discuss the properties of these cases with other similar reports both from Turkey and the world. MATERIALS AND METHODS: All pathology records of the cases were evaluated who diagnosed at The Department of Pathology, Medical School, Abant Izzet Baysal University between December 20, 2002 and December 31, 2010. The results were classified according to year, age, sex and organ systems. Statistical analyses were carried out using Open Office version 3.1 and PSPP 0.7.2. The duplication of data was particularly prevented by excluding the multiple records in the case of more than one biopsies of the same cancer in the same patient. RESULTS: Totally 18654 pathology records were analyzed. The ratio of positive cases was 24.18% (4510/18654) of including all benign and malignant tumors. Among them 1984 (43.99%) were male and 2526 (56.01%) were female. On the other hand, malignant tumors constituted 33.35 % (1504/18654) of all cases and the percentage of male and female patients were 67.81 % (1020/1504) and 32.19 % (484/1504) respectively. The occurrence of malignant tumors was mostly seen between 60 and 69 age group, while the predominant age period was between 50 and 59 when considering both benign and malignant patients. Male patients had cancers mostly after 60 age group and the predominant period was between 60 and 69 ages. Considering the female patients only, they had more cancers between 10 and 60 age group than males, and the most prevalent period was between 40 and 49 years. The prevalence of both benign and malignant tumors with respect to their origin were skin( 30.15%), female genital tract (21.57%) and gastrointestinal system (12.92%). Considering only the malignant tumors, the distribution was as skin (21.07%), male genital tract (17.82%) and gastrointestinal tract (14.96%). On the other hand, the order of cancers was skin (31.29%), gastrointestinal tract (17.69%), male genital tract (14.81%) in male patients, while it was as female genital tract (38.50%), skin (29.30%), gastrointestinal tract (9.20%) for the female patients. CONCLUSION: Due to our datas, our results are similar to the results in Turkey and the World. The reason of the lower incidence of some tumors such as lung tumors which are much higher in Turkey and the world may depend on technical inadequacy due to our faculty's being a newly established one.

Diagnostic and prognostic roles of DOG1 and Ki-67, in GIST patients with localized or advanced/metastatic disease.

AIM: Gastrointestinal stromal tumor is the most common mesenchymal neoplasia in the gastrointestinal tract and has a broad spectrum of pathological patterns and also clinical features changing from benign to malignant. Although the well-characterized parameters to predict the outcome have been the size and the mitotic index of the tumor in the patients with early-staged disease, bulky recurrent or metastatic tumor, resistance to medical treatment and mutation analysis are the prognostic factors for advanced stage-GIST. The aim of this study is to investigate new and more practical tissue markers, such as DOG1 and Ki-67 to specify the GIST diagnosis and also to predict the outcome in GIST patients with both localized and advanced staged disease. METHODS: For the last 14 years, from 1999 to 2013, 111 patients with a histopathological GIST diagnosis from the hospital files were enrolled to the study. In their parafin-embedded tissue samples, DOG1 and Ki-67 expressions were evaluated with immunohistochemisty by two independent pathologists from Cukurova University Medical Faculty. Patients were divided into two groups, the patients with localized disease treated by surgery and the patients with advanced/metastatic disease. DOG1 and Ki-67 expressions were corelated with other diagnostic and prognostic histopathological markers and also the clinical outcome in these two group of patients. RESULTS: The specificity and the sensitivity of DOG1 in GIST diagnosis was found 94 and 43%, respectively. DOG1 expression was especially important in the diagnosis of c-kit negative cases. Although Ki-67 was not found a statistically significant prognostic factor for overall survival, it was strongly corelated with mitotic index which is a well-known standart prognostic factor for localized disease. DISCUSSION: DOG1 seems to be an important diagnostic tool for clinically suspected GIST diagnosis in both advanced or early staged patients whose tumours are c-kit expression negative. On the other hand, Ki-67 can be a stronger candidate for prognostic factor instead of mitotic index to identify the proliferative cells out of mitotic phase but this statement needs be prospectively validated on studies with large number of patients.

Thymoma type B1 arising in a giant supradiaphragmatic thymolipoma.

Thymolipomas are uncommon tumors of the anterior mediastinum. They may extend into, but rarely stem from, the chest cavity. Furthermore, thymoma arising in a thymolipoma is extremely rare. We report a unique case of thymoma type B1 that originated form a giant thymolipoma located in the chest cavity, which was resected by a lateral thoracotomy in a 23-year-old woman. To our knowledge, this is the first reported case of thymoma type B1 arising within a giant thymolipoma.

Evaluation of results of lower gastrointestinal endoscopic biopsi.

AIM: The endoscopic examination is widely used and also the the gold standard in lower gastrointestinal system (LGIS) in the diagnosis and treatment of mucosal pathology. Colon and rectum often hosts premalignant lesions and relatively easily accessible organs. Therefore, colorectal cancer (CRC) is a early detectable disease. And to prevent the development of CRC and to capture at early stage the screening tests such as screening endoscopy are used. In our study was aimed to evaluate the biopsy results of the lower gastrointestinal endoscopy. MATERIALS AND METHODS: The lower gastrointestinal endoscopy (LGE) biopsy results of 135 cases and demographic characteristics of the patients were evaluated retrospectively who admitted to Department of Pathology between January 2013-November 2013. RESULTS: 135 patients enrolled in the study, 89 (65.92%) of male and 46 (34.07%) were female. The age of patients were between 15 and 82 with a mean age of 53.00 ± 14.6. 85 of 135 cases (62.96%) were colitis, 3 (2.22%) were hyperplastic polyps, 22 (16.30%) were tubular adenoma, 15 (11.11%) of them tubulovillous adenoma, 1 (0%, 74) of submucosal lipoma, 9 (6.67%) patients were diagnosed with cancer. All of the cancer cases were in adenocarcinoma histology, one of developing from villous adenoma, one of them from tübülovillous adenoma. Cases of adenomas were included to only cancer groups because there is no duplication of data. CONCLUSION: Colonoscopy in the detection of both benign and malignant LGIS pathologies is the gold standard method. The upper and lower gastrointestinal endoscopy(LGE) must be remembered as a reliable method in the population, with a low complication rate and high diagnosis rate and when there is clinical necessity gastrointestinal endoscopy should not be avoided as planned.