The role of Endocan as a Prognostic Biomarker in community-acquired pneumonia.

OBJECTIVE: The aim of this study was to determine the importance of using endocan as a biomarker in deciding the setting of treatment and predicting prognosis in patients with community-acquired pneumonia (CAP). METHODS: This prospective, case-control study was conducted at Okmeydani Training and Research Hospital between November 20, 2016 to March 20th 2017. Blood samples were obtained from 63 patients who were admitted to internal medicine clinic due to CAP and 25 volunteers without active infection. Serum samples were centrifuged at 1000G for 15 minutes and stored at -20ºC. Samples were analyzed using human ESM1 (endocan) (Lot No: AK0017MAR0830) (Elabscience, Texas, USA) kit with Robonik (Mumbai, India) ELISA Plate Reader and Washer. Demographic and clinical data of the patients were recorded. CURB-65, qSOFA and Pneumonia Severity Index (PSI) scores were calculated. Primary endpoint of the study was 30-days mortality. RESULTS: Mean serum endocan levels of the study group and the control group were 30.99±3.3 pg/ml and 246.5±49.95pg/ml, respectively. The difference between groups was statistically significant (p<0.005). 30-days mortality rate was 12.7% with eight patients, three of which died subsequently in the ICU. When patients were classified according to PSI and CURB-65 scores, endocan levels of PSI class ≥4 and CURB-65 ≥2 individuals were found to be significantly different than the control group. ROC analysis showed that serum endocan levels less than 64.96pg/ml has 85.2% sensitivity and 83.3% specificity for PSI class ≥4 and 82.4% sensitivity and 55.6% specificity for CURB-65 score ≥2. CONCLUSION: Serum endocan levels are significantly lower in patients with community-acquired pneumonia than the control group.

Total Lesion Glycolysis Obtained by FDG PET/CT in Diagnosing Solitary Pulmonary Nodules.

OBJECTIVE: To evaluate the diagnostic performance of total lesion glycolysis (TLG) obtained by 18F-FDG PET/ CT to differentiate malignant solitary pulmonary nodules (SPNs) from benign ones. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Nuclear Medicine, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey, from January 2018 to April 2022. METHODOLOGY: Eighty patients, who were found to have SPNs and underwent PET/CT imaging, were enrolled in this retrospective study. Parameters of PET-CT such as metabolic, volumetric, and metabolovolumetric were assessed concerning diagnostic value. Moreover, maximum standard uptake value (SUVmax) and TLG were combined and compared to improve diagnostic accuracy. RESULTS: The number of the detected benign and malignant SPNs was 38 and 42, respectively. Compared to the benign lesions, the malignant nodules presented significantly higher values in terms of SUVmax, TLG, and the volumes of metabolic tumour (MTV) and CT. Considering all parameters, the highest area under the curve (AUC) was occupied by TLG and SUVmax. The values for the sensitivity, specificity, and accuracy of SUVmax, TLG, and SUVmax combined with TLG were as follows respectively: 97.6%, 63.2%, and 81.2%; 85.7%, 92.1%, and 88.7%; and 85.7%, 94.7%, and 90%. CONCLUSION: The conventional value of SUVmax does not yield satisfactory results in order to separate the malignant nodules from the benign ones. The SUVmax value could be more valuable if it is used with TLG measurement in diagnosing SPNs. KEY WORDS: 18F-FDG PET/CT, SUVmax, TLG, Pulmonary nodule.

Real-world outcomes of pazopanib in metastatic soft tissue sarcoma: a retrospective Turkish oncology group (TOG) study.

AIM: Description of patient characteristics, effectiveness and safety in Turkish patients treated with pazopanib for metastatic soft tissue sarcoma (STS). PATIENTS AND METHODS: This multicenter study is based on retrospective review of hospital medical records of patients (≥ 18 years) treated with pazopanib for non-adipocytic metastatic STS at 37 Oncology clinics across Turkey. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS) and overall survival (OS) were evaluated with further analysis of data on the three most common histological subtypes (leiomyosarcoma [LMS], undifferentiated pleomorphic sarcoma [UPS], synovial sarcoma [SS]) in the cohort. RESULTS: Data of 552 adults (57.6% women, median age: 52 years) were analyzed. DCR and ORR were 43.1% and 30.8%, respectively. Median PFS was 6.7 months and OS was 13.8 months. For LMS, UPS and SS, median PFSs were 6.1, 5.9 and 7.53 months and median OSs were 15.03, 12.87 and 12.27 months, respectively. ECOG ≥ 2 was associated with poor PFS and OS. Liver metastasis was only a factor for progression. Second-line use of pazopanib (vs. front-line) was associated with better PFS, its use beyond third line predicted worse OS. Adverse events (AE) occurred in 82.7% of patients. Most common AEs were fatigue (58.3%) and anorexia (52.3%) which were graded as ≥ 3 in 8.2% and 7.4% of patients, respectively. CONCLUSION: Pazopanib is effective and well-tolerated in treatment of non-adipocytic metastatic STS. Its earlier use (at second-line), good performance status may result in better outcomes. Worldwide scientific collaborations are important to gain knowledge on rarer STS subtypes by conducting studies in larger patient populations.