Relationship with radiological size/stage and pathological size/stage for renal cell carcinoma

Tıpta Uzmanlık TeziRenal hücreli karsinom sınıflamasında boyut önemli bir faktördür. Cerrahiyi planlamak ve prognozu değerlendirmek açısından radyolojik tetkiklerin patolojik boyut ve evreyi öngörmesi önemlidir. Çalışmamızda Trakya Üniversitesi Tıp Fakültesi Üroloji Kliniği'nde, Taksim Eğitim ve Araştırma Hastanesi Üroloji Kliniği'nde ve Kartal Dr. Lütfü Kırdar Eğitim ve Araştırma Hastanesi Üroloji Kliniği'nde radikal nefrektomi veya nefron koruyucu cerrahi yapılmış patolojileri renal hücreli karsinom olarak değerlendirilen 405 hasta çalışmaya dahil edilmiştir. Çalışmanın sonucunda hastaların ortalama tümör boyutları bilgisayarlı tomografi ile 6,.77±3.,3, magnetik rezonans ile 6.,29±3.,35, patoloji sonucuyla ise 6.,778±3.,32 olarak bulunmuştur. Patolojik tümör boyutu ile bilgisayarlı tomografi tümör boyutu ve magnetik rezonans tümör boyutu arasında anlamlı (kappa: 0,650 / p=0,000) (kappa: 0,765 / p=0,000) uyumluluk gösterilmiştir. Bunun yanında evre değerlendirildiğinde radyolojik evre ile patolojik evre arasında anlamlı uyumluluk gösterilmiştir. Evre artıkça uyumun belirgin olarak düştüğü gözlenmiştir. Ayrıca Fuhrman grade' i yüksek hastalarda tümör boyutunun anlamlı olarak büyük olduğu gösterilmiştir. Ancak Fuhrman grade 1 ve 2 olan hastalarda tümör boyutu açısından anlamlı farklılık gözlenmemiştir. Fuhrman grade' i yüksek hastalarda tümör evresinin anlamlı olarak yüksek olduğu gösterilmiştir. Ancak Fuhrman grade 1 ve 2 olan hastalarda tümör evresi açısından anlamlı farklılık gözlenmemiştir.AbstractDimension is an important factor for renal cell carcinoma staging. To plan the type of surgery and considering prognosis, radiologic eximination's estimation of pathologic dimension and staging is important. In our study, radical nefrectomy or nefron sparing surgery was made in Taksim Research and Training Hospital Urology Clinic and Kartal Dr. Lütfü Kırdar Research and Training Hospital Urology Clinic and 405 patients were included in the study whose patology results were evaluated as renal cell carcinoma . At the end of the study , the mean computerized tomography tumor size was found as 6,.77±3.,3, the mean magnetic resonance tumor size was found as 6.,29±3.35 and the mean pathological tumor size was found as 6,.778±3.,32. Significant correlation was shown between computerized tomography tumor size and magnetic resonance tumor size with pathological tumor size (kappa: 0,650 / p=0,000) (kappa: 0,765 / p=0,000). In addition, there was a significant correlation between radiological stage and pathological stage. But it is observed that as the stage increases, the correlation decreases significantly. Also patients who had higher Fuhrman grade tumors had significant higher tumor size. However, in patients with Fuhrman grade 1 and 2, no significant difference was observed in tumor size. Patients who had higher Fuhrman grade tumors had significant higher tumor stage. However, in patients with Fuhrman grade 1 and 2, no significant difference was observed in tumor stage

Predictive and prognostic impact of preoperative complete blood count based systemic inflammatory markers in testicular cancer

Purpose: To determine the utility of preoperative complete blood count (CBC) based systemic inflammatory markers in the prediction of testicular cancer and its prognosis. Material and Methods: Between 2008-2017 the data of all testicular tumor patients undergoing radical orchiectomy were retrospectively analyzed. Patient baseseline characteristics (age, tumor stage, tumor markers, etc.) and results of routine preoperative blood tests including mean platelet volume (MPV), red cell distribution width (RDW), lymphocyte ratio (LR) and neutrophil ratio (NR) were retrieved. In addition, neutrophil to lymphocyte ratio (NLR) was calculated. Results: Mean age of the tumor and control group was 36.0 +/- 15 and 30.50 +/- 11 years, respectively. Mean RDW, NR and NLR were significantly higher in the tumor group with p values<0.001; whereas LR and MPV were significantly higher in the control group (p<0.001). Receiver Operating Characteristic (ROC) analyses of LR, NR, RDW, MPV, and NLR are shown in Table-3. The cut off values for RDW and NR were found as 13,7 (Area under the curve (AUC): 0.687, sensitivity = 42.2%, specificity = 84.8%) and 55.3 (AUC:0.693, sensitivity 72.2%, specificity 62%), respectively. Area under the curve for NLR in tumor group was 0.711, with a threshold value of 1.78 and sensitivity=81.8% and specificity= 55.4% (AUC:0.711/sig<0.001) that together with RDW exhibited the best differential diagnosis potential which could be used as an adjuvant tool in the prediction of testicular tumor and its prognosis. Conclusion: Several systemic inflammatory markers, which are obtained by routinely performed cost-effective blood tests, could demonstrate incremental predictive and prognostic information adjuvant to preoperativly achieved testiscular tumor markers

Comparison Of Micro-Computerized Tomography And Cone-Beam Computerized Tomography In The Detection Of Accessory Canals In Primary Molars

Purpose This study was performed to compare the accuracy of micro-computed tomography (CT) and cone-beam computed tomography (CBCT) in detecting accessory canals in primary molars. Materials and Methods Forty-one extracted human primary first and second molars were embedded in wax blocks and scanned using micro-CT and CBCT. After the images were taken, the samples were processed using a clearing technique and examined under a stereomicroscope in order to establish the gold standard for this study. The specimens were classified into three groups: maxillary molars, mandibular molars with three canals, and mandibular molars with four canals. Differences between the gold standard and the observations made using the imaging methods were calculated using Spearman's rho correlation coefficient test. Results The presence of accessory canals in micro-CT images of maxillary and mandibular root canals showed a statistically significant correlation with the stereomicroscopic images used as a gold standard. No statistically significant correlation was found between the CBCT findings and the stereomicroscopic images. Conclusion Although micro-CT is not suitable for clinical use, it provides more detailed information about minor anatomical structures. However, CBCT is convenient for clinical use but may not be capable of adequately analyzing the internal anatomy of primary teeth.PubMedScopu