Evaluation of risk factors associated with pancreatic adenocarcinoma in Black Sea region, Turkey

Aim: To evaluate the risk factors in patients with pancreatic adenocarcinoma in Turkey's Black Sea region and to determine groups at high risk for pancreatic cancer. Methods: 106 newly diagnosed pancreatic adenocarcinoma patients living in Black Sea region of Turkey who applied to our clinic between January 2015 and December 2016 were included in this study. In the same period a control group was formed with 92 patients of similar age. Both groups were asked to fill out a form that questioned the pancreatic cancer risk factors. Data were analyzed. Results: Pancreatic cancer risk was 3.5 times higher in people over 65 years of age. Patients with deficient level of serum vitamin D level (<20 ng/ml) had 10.2 times more risk of pancreatic cancer than patients with normal level of Vitamin D (≥30 ng/ml). While newly diagnosed type 2 diabetics had 19.5 times higher risk of pancreatic cancer, long term type 2 diabetics had 1.2 times higher risk than normal individuals. Those with pancreatic cancer in family had 4.3 times higher risk than those who did not. It was observed that people with rhesus (Rh) antigen negative blood group has 70% less risk of pancreatic cancer. Conclusion: Determination of pancreatic cancer risk factors, organization of imaging and screening programs for high-risk people can provide early diagnosis of the disease and prolong survival

Indoor and outdoor radon measurements at lung cancer patients' homes in the dwellings of Rize Province in Turkey

Akbulut Ozen, Songul/0000-0001-8025-2141WOS: 000432993200012PubMed: 28577063In this study, indoor and outdoor radon (Rn-222) surveys were carried out in the summer and winter seasons in homes of one hundred lung cancer patients in the year 2013-2014. the aim was to investigate the relationship between radon and cancer patients. Lung cancer patients completed a questionnaire concerning their living environment, various physical parameters and living habits. Pearson correlation and t tests revealed no meaningful results between radon concentrations, on one hand, and environmental and personal living habits, on the other hand. Consequently, the BEIR VI model was adapted and Rn-222 exposure was estimated to be responsible for about 12% of the lung cancer incidences in the winter season and around 5% in the summer season in the Rize Province. However, due to the limited number of data and numerous parameters that could lead to lung cancer, the estimations done with the model should be taken very lightly. the annual effective doses due to inhalation of indoor and outdoor Rn-222 were estimated to be, respectively, 1.43 and 0.94 mSv y(-1). the indoor and outdoor annual effective doses were, respectively, close and below the world annual effective dose (1.3 mSv y(-1)). At the district level, the indoor annual effective dose equivalent in the A degrees yidere district was 4.52 mSv y(-1), which was 3.5 times greater than the world average. the number of patients in the majority of the houses in this district was more than one.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [112S652]; Recep Tayyip Erdogan University Academic Research Projects UnitRecep Tayyip Erdogan University [2013.102.01.3]This work was supported by the Scientific and Technological Research Council of Turkey (TUBITAK) with project number 112S652 and by the Recep Tayyip Erdogan University Academic Research Projects Unit with project number 2013.102.01.3. the authors would like to thank Prof. Dr. Orhan Karsli from Recep Tayyip Erdog. an University, Department of Geological Engineering, for the geological map of Rize

Does a Close Surgical Margin for Ductal Carcinoma In Situ Associated with Invasive Breast Carcinoma Affect Breast Cancer Recurrence?

Purpose: Our aim was to determine if a close surgical margin (<2 mm, but no ink on tumor) for ductal carcinoma in situ (DCIS) associated with invasive breast cancer (IBC) leads to an increased rate of ipsilateral breast tumor recurrence (IBTR). Patients and Methods: Six hundred and twenty-eight patients with T1-2 IBC who underwent breast conserving therapy (BCT) and had no ink on tumor between 2009 and 2017 in our institution were included in the study. Age, tumor size, axillary lymph node status, resection margin status of DCIS as closer than 2 mm or ≥2 mm, DCIS as present or absent, extensive intraductal component as yes or no were investigated. All patients were followed-up for IBTR. Results: The median age was 50 years (range, 29–82), and median tumor size was 25 mm (range, 5–50). Median follow-up time was 56 months (range, 12–114). Of the 628 IBC patients, 440 (70%) were found to be associated with DCIS. Of the 440 patients with DCIS, 119 (27%) had a close margin (<2 mm) and 321 (73%) had a margin ≥2 mm for DCIS. Among 440 IBC patients associated with DCIS, there were three local recurrences. One developed in a patient who had a close surgical margin for DCIS, and in the other two patients, surgical margins were ≥2 mm. Conclusions: No ink on tumor is an adequate margin for IBC associated with DCIS in patients who undergo BCT and it is not associated with increased IBTR

Management of the Axilla in T1-2 Breast Cancer Patients with Macrometastatic Sentinel Node Involvement Who Underwent Breast-Conserving Therapy

Purpose: The aims of our study were to determine the incidence of axillary recurrence and arm morbidity in T1-2 invasive breast cancer patients with macrometastases on the sentinel lymph node (SLN) who underwent breast-conserving therapy (BCT), with or without axillary lymph node dissection (ALND). Methods: One hundred and nine T1-2 invasive breast cancer patients with macrometastases on the SLN who underwent BCT in our institution were included in the study. Patients with 1–2 positive SLN and without extra nodal extension (ENE) on the SLN did not undergo ALND (SLN-only group) and patients with ENE or patients who had >2 metastatic nodes underwent level I, II ALND (ALND group). The SLN-only group received radiotherapy to three axillary levels, the supraclavicular fossa, and ± mammaria interna. ALND group received radiotherapy to axillary level III, the supraclavicular fossa, and ± mammaria interna. The incidence of axillary recurrence and arm morbidity were investigated. Results: Of the 109 patients, 18 patients with >2 metastatic SLNs and 10 with ENE on the SLN underwent ALND and 81 patients underwent SLN only. Median follow-up time was 37 months (3–77). There was no axillary recurrence in SLN-only group. However, in the ALND group 1 patient had developed axillary metastasis. There were 2 objective lymphoedema and 3 arm-shoulder restriction cases in the SLN-only group, and 2 and 3 in the ALND group, respectively. Conclusions: Axillary dissection could safely be omitted in patients with 1–2 macrometastatic SLN and without ENE who undergo BCT and axillary radiotherapy

Evaluation of the relationship between Ki67 expression level and neoadjuvant treatment response and prognosis in breast cancer based on the Neo-Bioscore staging system

Abstract Background Neoadjuvant chemotherapy (NAC) is widely used in the treatment of primary breast cancer. Different staging systems have been developed to evaluate the residual tumor after NAC and classify patients into different prognostic groups. Ki67, a proliferation marker, has been shown to be useful in predicting treatment response and prognosis. We aimed to investigate the prognostic importance Neo-Bioscore stage and pretreatment and posttreatment Ki67 levels in breast cancer patients who received NAC and correlations between Neo-Bioscore stage and pretreatment and posttreatment Ki67 levels. Methods A total of 176 invasive breast carcinoma patients who underwent NAC were included in the study. Ki67 levels were evaluated by immunohistochemical methods in Trucut biopsy and surgical excision specimens. Patients were classified into prognostic groups using the Neo-Bioscore staging system. Results Patients with high pretreatment Ki67 score were more likely to be in the higher Neo-Bioscore risk group (p < 0.001). Patients with a high posttreatment Ki67 score were more likely to be in the higher Neo-Bioscore prognostic risk group (p < 0.001). Overall survival (OS) and disease-free survival (DFS) were shorter in patients with high posttreatment Ki67 scores and in patients in the higher Neo-Bioscore risk group. We also determined a cutoff 37% for pathological complete response. Conclusion Neo-Bioscore staging system is found to be important in predicting survival. The posttreatment Ki67 level is more important than pretreatment Ki67 level in predicting survival

A First Report of Synchronous Intracapsular and Extracapsular Hepatic Adenoma

Although the gallbladder is the most common site of ectopic liver, it has been reported in many other organs, such as kidney, adrenal glands, pancreas, omentum, stomach, esophagus, mediastinum, lungs, and heart. Hepatocytes in an ectopic liver behave like normal hepatocytes; furthermore, they can be associated with the same pathological findings as those in the main liver. Ectopic liver in the gallbladder can undergo fatty change, hemosiderosis, cholestasis, cirrhosis, hemangioma, focal nodular hyperplasia, adenoma, and even carcinogenesis. The incidence of extracapsular hepatic adenoma is not known, but only two cases have been reported. Here, we provide the first case report of synchronous multiple intracapsular and extracapsular hepatic adenomas. A 60-year-old woman with multiple hepatic adenomas and one 7 × 5 × 5 cm ectopic hepatic adenoma attached to the gallbladder fundus complicated with abdominal pain is presented

Assessing posterior ocular structures in beta-thalassemia minor

Purpose The aim of this study was to investigate the effect of beta-thalassemia minor on choroidal, macular, and peripapillary retinal nerve fiber layer thickness