Predictive Value of Preoperative De-Ritis Ratio at Tumor Staging in Testicular Germ Cell Tumors

Aim:The de-ritis ratio (DRR), which refers to the ratio of aspartate transaminase (AST) to alanine transaminase (ALT), is used in the assessment of several malignancies. Preoperative prediction of tumor anvasiveness remains an important issue. The aim of this study was to investigate the possible association between tumor progression and the DRR (AST/ALT).Methods:The medical records of 103 patients who underwent radical orchiectomy because of testicular cancer between January 2010 and January 2020 in a single tertiary center were retrospectively assessed in this cross-sectional study. Parameters including age, blood parameters including AST, ALT, beta-human chorionic gonadotropin (B-hCG), alpha-fetoprotein, lactate dehydrogenase (LDH), complete blood count, pathology results, treatment schemes, imaging results, preoperative and postoperative DRR (AST/ALT), and tumor stage were noted.Results:The mean age of the 103 patients was 34.9±10.45. The pathological T-stage was T1 for 26 (25.2%), T2 for 65 (63.1%), and T3 for 12 (11.6%). The mean follow-up of the patients was 31.44±10.32 (13-53) months. The risk of retroperitoneal lymph node involvement and metastasis at a DRR was calculated as 1.37 (area under the curve, 0.853 with a sensitivity of 90% and specificity of 89%; 95% confidence interval, 0.689-0.897). Preoperative B-hCG level and LDH were statistically significantly higher in the AST/ALT>1.37 group (p=0.002 and p=0.012). Thirty-five (30.4%) of patients with NSGHT had an AST/ALT>1.37. Seminoma was observed in 25.6% (n=21) of patients with AST/ALT>1.37 (p=0.107). The higher stage was significantly associated with an elevated DRR (p=0.019).Conclusion:The DRR appears to be a useful and cost-effective preoperative marker for predicting localized and non-localized disease in Tca at the time of diagnosis

Primary Leiomyosarcoma of the Adrenal Gland: A Case Report with Immunohistochemical Study and Literature Review

Primary adrenal leiomyosarcoma is extremely rare tumor. We report a case with adrenal leiomyosarcoma. Our case was a 48-year-old man who presented with lower urinary tract symptoms. Ultrasonography and magnetic resonance imaging revealed approximately 9 cm solid mass originating from right adrenal gland. He underwent right adrenalectomy. Pathology of the specimen showed histologic and immunohistochemical features of adrenal leiomyosarcoma

Clinical significance of serum and urinary HER2/neu protein levels in primary non-muscle invasive bladder cancer

Objective: We aimed to compare serum and urinary HER2/neu levels between healthy control group and patients with non-muscle invasive bladder cancer. Additionally, we evaluated relationship of HER2/neu levels with tumor stage, grade, recurrence and progression. Materials and Methods: Fourty-four patients with primary non-muscle invasive bladder tumors (Group 2) and 40 healthy control group (Group 1) were included the study. Blood and urinary samples were collected from all patients and HER2/neu levels were measured by ELISA method. Blood and urinary HER2/neu levels and additionally, ratio of urinary HER2/neu levels to urinary creatinine levels were recorded. Demographic data and tumor characteristics were recorded. Results: Mean serum HER2/neu levels were similar between two groups and statistically significant difference wasn't observed. Urinary HER2/neu levels were significantly higher in group 2 than group 1. Ratio of urinary HER2/neu to urinary creatinine was significantly higher in group 2 than group 1, (p=0,021). Serum and urinary HER2/ neu levels were not associated with tumor stage, grade, recurrence and progression while ratio of urinary HER2/neu to urinary creatinin levels were significantly higher in high-grade tumors. HER2/neu, the sensitivity of the test was found to be 20.5%, and the specificity was 97.5%, also for the urinary HER2/neu/urinary creatinine ratio, the sensitivity and specificity of the test were found to be 31.8% and 87.5%, respectively. Conclusions: Urinary HER2/neu and ratio of urinary creatinine urine were significantly higher in patients with bladder cancer compared to healthy subjects. Large series and controlled studies are needed for use as a tumor marker

Can we predict patients that will not benefit from invasive mechanical ventilation? A novel scoring system in intensive care: the IMV mortality prediction score (IMPRES)

KUCUK, Ahmet Oguzhan/0000-0002-6993-0519; Kirakli, Cenk/0000-0001-6013-7330; KUCUK, Mehtap PEHLIVANLAR/0000-0003-2247-4074; Aksoy, Iskender/0000-0002-4426-3342WOS: 000504051300010PubMed: 31655511Background/aim: The present study aimed to define the clinical and laboratory criteria for predicting patients that will not benefit from invasive mechanical ventilation (IMV) treatment and determine the prediction of mortality and prognosis of these critical ill patients. Materials and methods: The study was designed as an observational, multicenter, prospective, and cross-sectional clinical study. It was conducted by 75 researchers at 41 centers in intensive care units (ICUs) located in various geographical areas of Turkey. It included a total of 1463 ICU patients who were receiving invasive mechanical ventilation (IMV) treatment. A total of 158 parameters were examined via logistic regression analysis to identify independent risk factors for mortality; using these data, the IMV Mortality Prediction Score (IMPRES) scoring system was developed. Results: The following cut-off scores were used to indicate mortality risk: 8, very high risk. There was a 26.8% mortality rate among the 254 patients who had a total IMPRES score of lower than 2. The mortality rate was 93.3% for patients with total 1M PRES scores of greater than 8 (P < 0.001). Conclusion: The present study included a large number of patients from various geographical areas of the country who were admitted to various types of ICUs, had diverse diagnoses and comorbidities, were intubated with various indications in either urgent or elective settings, and were followed by physicians from various specialties. Therefore, our data are more general and can be applied to a broader population. This study devised a new scoring system for decision-making for critically ill patients as to whether they need to be intubated or not and presents a rapid and accurate prediction of mortality and prognosis prior to ICU admission using simple clinical data