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Although the prognostic significance of grade in endometrial cancer is well known, grade 2 cases have not been evaluated separately in most of the previous studies. In this study, we aim to investigate whether the oncologic outcomes of grade 2 endometrioid endometrial carcinomas trend towards grade 1 or 3 tumors. Patients' records and pathological reports were reviewed retrospectively and eligible patients with endometrioid endometrial carcinoma were determined and distributed into 3 groups according to their 1988 International Federation of Gynecology and Obstetrics (FIGO) grade. Groups' characteristics and oncologic outcomes were compared. Differences between grades were tested with z-test and adjusted by Bonferroni method. Kaplan-Meier method was performed for the survival analysis. In total, 776 patients of endometrioid endometrial carcinoma were included in this study. Mean follow-up time was 52 ± 14 months. Patients' mean age was 56.3 ± 10.8 years. Even though grade 2 endometrioid endometrial carcinomas were different from both grade 1 and 3 in terms of the pathological features, survival analyses demonstrated that their oncologic outcomes trended towards grade 1. The grade was determined as an independent prognostic factor for overall survival (OS). The interobserver reproducibility will be improved among pathologists by combining FIGO grade 1 and 2 endometrioid endometrial carcinomas, while prognosis prediction is not likely to be affected.

Objective Lung cancer displays heterogeneity both in the tumor itself and in its metastatic regions. One interesting behavior of the tumor is known as Skip N2 metastasis, which N2 lymph nodes contain tumor cells while N1 are clean. In this study, mRNA levels of epithelial mesenchymal transition (EMT) related genes in skip N2 and normal N2 involvements of non-small cell lung cancer tissues were investigated to evaluate the possible molecular background that may contribute to the pathogenesis of Skip N2 metastasis. Materials and methods Eighty-three surgically resected and paraffin embedded lymph node samples of lung cancer patients were analyzed in this study, which 40 of them were Skip N2. N2 tissues were sampled from 50% tumor containing areas and total RNA was extracted. mRNA levels for 18S, E-cadherin, Vimentin, ZEB1 and SLUG were analyzed via qPCR and E-cadherin and vimentin protein levels via immunohistochemistry (IHC). Bioinformatic analysis were adopted using online datasets to evaluate significantly co-expressed genes with SLUG in lung cancer tissue samples. Results Skip-N2 patients who had adenocarcinoma subtype had better survival rates. Comparative analysis of PCR results indicated that Skip N2 tumor tissues had increased E-Cadherin/Vimentin ratio and ZEB1 mRNA expression, and significantly decreased levels of SLUG. E-cadherin IHC staining were higher in Skip N2 and Vimentin were in Non-Skip N2. TP63 had a strong correlation with SLUG expression in the bioinformatics analyses. Conclusion The results indicate that, at molecular level, Skip N2 pathogenesis has different molecular background and regulation of SLUG expression may orchestrate the process., Highlights Skip N2 metastasis is related with better on-year survival rates in Lung AdenocarcinomaEMT regulator gene SLUG expression is suppressed in Skip N2 compared to Non-Skip N2 metastasis.Tumor metastatic site exhibit less Vimentin staining at Skip N2 lymph nodeBioinformatic analyzes show that one of the genes with the highest expression correlation with SLUG was TP63, suggesting that they may be acting together in this process.

PubMedID: 31076855 Purpose: The aim of this study was to evaluate prognostic importance of programmed death-1 (PD-1) and/ or programmed death-ligand 1 (PD-L1) expressions in type 2 endometrial cancer. Study design Formalin-fixed, paraffin-embedded tissue samples from 53 cases with type 2 endometrial cancer were analyzed. One-third of our cases had serous adenocarcinoma (32%), 11 had clear cell (21%) and 25 had mixed-type adenocarcinoma (47%). PD-1 and PD-L1 expressions in tumor tissue and microenvironment were detected by immunohistochemistry. Clinical and pathological characteristics including age, stage, initial symptom, surgical procedure, myometrial invasion, lymphovascular space invasion (LVSI), lymph node invasion, adjuvant therapy, and survival were reviewed. The Kaplan–Meier and Cox proportional hazards models were used to evaluate the prognostic factors. Results: PD-1 expression in tumor tissue and microenvironment was detected in 22 (42%) and 28 (53%) cases, respectively. PD-L1 expression was detected in tumor and microenvironment in 8 (15%) and in 15 cases (28%), respectively. Expression of PD-1 and PD-L1 expressions in tumor area was associated with shorter survival (p = 0.006 and 0.001, respectively) but PD-1 and PD-L1 expressions in microenvironment were not found to be related with survival. PD-1 (p = 0.006) and PD-L1 expressions (p = 0.001) in addition to LVSI (p = 0.005), myometrial invasion (p = 0.015), lymph node involvement (p = 0.019), and suboptimal cytoreduction (p = 0.042), were found to be associated with poor prognostic indicators. PD-1 and PD-L1 expressions in tumor and lymph node involvement were determined as independent prognostic factors. Conclusion: PD-1 and PD-L1 expressions in type 2 endometrial cancers were found to be poor prognostic indicators. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature. Çukurova Üniversitesi British Association for Psychopharmacology: TSA-2015–4843 Çukurova Üniversitesi Formalin-fixed, paraffin-embedded tissue samples from 53 cases with type 2 endometrial cancer who were operated and followed in our university clinic between January 1996 and December 2015 were analyzed. The patients who were operated in our clinic during this period but could not reach the paraffin blocks or were not followed up were not included in the study. Their pathologic diagnoses were established based on hysterectomy material evaluated by expert gynecological pathologists (E.K.B., D.G.) and the evaluation of the PD-1, PD-L1 staining was performed by one pathologist (E.K.B). This study was approved by Çukurova University, Faculty of Medicine, local ethical committee (2015.037.IRB.044) and was supported by the coordination unit of Scientific Research Projects (BAP–TSA-2015–4843) of Çukurova University. Funding This study was supported by the coordination unit of Scientific Research Projects (BAP-TSA-2015–4843) of Çukurova University.

PubMedID: 31739121 Objective: The aim of this study was to evaluate the clinical and prognostic importance of programmed death-1 (PD-1) and/ or programmed death-ligand 1 (PD-L1) in uterine carcinosarcoma (UCS). Study Design: Formalin-fixed, paraffin-embedded tissue samples from 59 cases with UCS were analyzed. PD-1 and PD-L1 expressions in tumor tissue and microenvironment were detected by immunohistochemistry. Clinical and pathological characteristics including age, stage, initial symptom, surgical approach, myometrial invasion, lymphovascular space invasion (LVSI), lymph node invasion, adjuvant therapy, and survival were evaluated. The Kaplan-Meier and Cox proportional hazards models were used to compare the outcomes and prognostic factors. Results: PD-1 expression in tumor tissue and microenvironment was detected in 15 (25 %) and 18 (30 %) cases, respectively. PD-L1 expression in tumor tissue and microenvironment was detected in 15 (25 %) and 12 cases (20 %), respectively. PD-L1 expression in tumor was associated with longer survival and median survival was 38 and 15 months in cases with and without PD-L1 expressions, respectively (p = 0.019). Lymphovascular space invasion (LVSI) (p = 0.014), myometrial invasion (p = 0.008) and PD-L1 expression were found to be prognostic for UCS's. PD-L1 expression was found to be an independent good prognostic factor with Cox regression analysis (OR 3.9; 95 % CI: 1.4–11.0) for overall survival. Conclusion: PD-1 and/or PD-L1 expression are important due to their expressions in one fourth of the cases with UCS and PD-1/PD-L1 blockade may be a new avenue in UCS. © 2019 British Association for Psychopharmacology: TSA-2015-4843 This study was supported by the coordination unit of Scientific Research Projects ( BAP- TSA-2015-4843 ) of Çukurova University.

Introduction/Background The prognostic significance of grade in the endometrial cancer is well known. However, grade 2 cases were not evaluated separately in most of the previous studies. In this study, we aimed to investigate whether the oncologic outcomes of grade 2 endometrioid endometrial carcinomas is trending to grade 1 or 3 tumors. Methodology Patients records and pathological reports were reviewed retrospectively and 776 patients of endometrioid endometrial carcinoma were distributed into 3 groups according to their 1988 FIGO grade. Groups9 characteristics and oncologic outcomes were compared. Difference between grades was tested with z-test and adjusted by Bonferroni method. Kaplan-Meier method were performed for the survival analysis. Results Mean follow-up time was 52 months. Patients9 mean age was 56.29±10.8 years. Five years OS, DFS rates were 95.1%, 83.3% and 91.6%, 79.1% for grade 1 and 2, respectively. These rates were not statistically different (OS: p=0.075, DFS: P=0.939). The statistically difference between grade groups in terms of OS and DFS was mainly noticed between grade 1 and 3 (OS: 75.6%, DFS: 60.3%) Even though, grade 2 endometrioid endometrial carcinomas were different from both grade 1 and 3 in terms of the pathological features, survival analyses demonstrated that their oncologic outcomes were trended to grade 1. Grade was determined as an independent prognostic factor for OS. Conclusion The interobserver reproducibility will be improved among pathologists by combining FIGO grade 1 and 2 endometrioid endometrial carcinomas, while prognosis prediction would not likely to be affected. Disclosure Nothing to disclose.

WOS: 000493372200002 PubMed ID: 31709947 Introduction: Mesothelioma is an aggressive tumour that originates in serous surfaces. The primary end point of this study was to invastigate the relationship of progression free survival (PFS) and overall survival (OS) with the c-Met, EGFR, PTEN, PDGFR-alpha, PI3K/AKT and mTOR expression levels in the tumour tissue of pleural and peritoneal mesothelioma cases. Materials and Methods: The study included 53 patients diagnosed with mesothelioma between 2005 and 2016. The cases were separated into 2 groups as pleural and peritoneal. The effects on OS and PFS were examined of the c-Met, EGFR, PTEN, PDGFR-alpha, PI3K/AKT and mTOR expression levels and also clinicopathological parameters and the treatments given. In the statistical analysis of the data obtained, IBM SPSS vn 20.0 software was used. Results: Of the 53 patients included in the study, 39 (73.6%) were diagnosed with pleural mesothelioma and 14 (26.4%) with peritoneal mesothelioma. According to the c-Met and mTOR expression, OS and PFS of the peritoneal cases with high expression (2+, 3+) was seen to be significantly better than that of the peritoneal cases with low expression (0, 1+) (p < 0.05). According to the PDGFR expression, OS and PFS of the pleural cases with low expression (0, 1+) was seen to be significantly better than that of the pleural cases with high expression (2+, 3+) (p < 0.05). Conclusion: The examination of c-MET, PDGFR-alpha and m-TOR expression in the in the tumor tissue of mesothelioma cases may be important in determining prognosis.

WOS: 000469053500001 PurposeThe aim of this study was to compare the clinical characteristics and outcomes of the cases with uterine high-grade endometrioid adenocarcinoma (HGEAC) and uterine carcinosarcoma (UCS).MethodsA total of 141 patients were included in this study. Of them, 61 cases had uterine HGEAC (group 1) and 80 had UCS (group 2). Both groups were compared in terms of clinical and pathological characteristics including age, stage, initial symptom, surgical approach, myometrial invasion, lymphovascular space invasion (LVSI), lymph node invasion, adjuvant therapy, and survival. The Kaplan-Meier and Cox proportional hazards models were used to compare the outcomes and prognostic factors.ResultsThere were no statistically significant differences between the groups with regard to age, nulliparity, menopausal status, and the main initial symptom. Both groups were similar in terms of stage, depth of myometrial invasion, and lymph node metastasis. Lymphadenectomy was performed in 74% and 91% of the cases in group 1 and group 2, respectively (p

Amaç: Prostat karsinomu (PK) önemli oranda ölümcül ve morbiditesi olan, sık görülen kanser türlerinden biridir. PK'nin etiyolojisi net değildir. Enflamatuvar yolaktaki sitokin ve mediatörler; kronik enflamasyon ve kanser arasındaki ilişkide, çeşitli basamaklarda rol oynamaktadır. Bu çalışmanın amacı, PK'li hastalarda siklooksijenaz-2 (COX), apopitozis ve anjiyogenezis arasında ilişki olup olmadığını belirlemektir.Gereç ve Yöntem: 2005-2010 yılları arasında, patolojik evresi pT2 olup radikal prostetektomi uygulanan 49 olgu, Çukurova Üniversitesi Tıp Fakültesi Patoloji arşivinden retrospektif olarak seçilmiştir. Histolojik slaytlar tanısal açıdan tekrar gözden geçirilmiş ve Gleason skorlama sistemine göre derecelendirilmiştir. Olgulara immünohistokimyasal olarak COX-2, vasküler endotelyal büyüme faktörü (VEBF), monoklonal antikor (M30), bcl-2 uygulanarak değerlendirilmiştir. Bulgular: Hastaların ortalama yaşı 63,8 idi. Yirmi bir hasta Gleason skor =7 olarak derecelendirildi. COX-2 ekspresyonu %81,6 hastada tespit edildi. COX-2 ekspresyonu bcl-2 ekspresyonu ile korele olarak bulunurken, VEBF ile COX-2 arasında korelasyon saptanmadı. Gleason skor ile M30 arasında negatif korelasyon saptandı. Ortalama yaşam ve COX-2 arasında negatif korelasyon saptandı. COX-2 ekspresyonu arttıkça sağkalım süresinin anlamlı olarak azaldığı saptandı.Sonuç: Çalışmamız PK karsinogenezisinde COX-2'nin anjiyogenezisi arttırmaktan çok apopitozisi inhibe ederek etki ettiğini düşündürmektedir. Bu sonuçların, tedavi stratejilerine yeni bakış açıları sunabileceği gibi, hastaların klinik takiplerinin sonuçlarını öngörmede faydalı olabileceğini düşünmekteyiz. Objective: Prostate carcinoma (PC) is one of the most commonly diagnosed cancer types with significant rates of mortality and morbidity. The etiology of PC is not clear. Cytokine and mediators at the inflammatory pathway plays role at the various steps of the relation between chronic inflammation and cancer. The objective of this study is to determine if there is relationship between cyclooxygenase-2 (COX) apoptosis and angiogenesis in patients with PC.Materials and Methods: Sample of 49 cases who were at pathologic stage pT2 and underwent radical prostatectomy, were selected retrospectively between 2005-2010, from the archives of Pathology Department of Çukurova University Faculty of Medicine. Histologic slides of each case were reviewed for the diagnostic reassessment and graded by the Gleason scoring system. COX-2, vascular endothelial growth factor (VEGF), monoclonal antibody (M30) and bcl-2 were immunohistochemically applied to the cases and they were evaluated.Results: The mean age of the patients were 63.8. Twenty-one cases had their Gleason score =7. COX-2 expression was detected in 81.6% of cases. While COX-2 expression was significantly correlated with bcl-2 expression, there was no correlation between VEGF and COX-2 expression. Gleason score was negatively correlated with M30. It was detected that as COX-2 expression increased mean survival time significantly decreased.Conclusion: This study makes us think that in the PC carcinogenesis COX2 inhibits apoptosis rather than promoting angiogenesis. These results may offer new insights for the treatment strategies, also they may be useful for the prediction of clinical outcomes.

Erdogan, Kivilcim Eren/0000-0002-4951-8703; kilic bagir, Emine/0000-0002-1447-1060; Celik, Betul/0000-0001-9731-9939; Tatli Dogan, Hayriye/0000-0003-4318-2775; Cakir, Asli/0000-0003-0128-6947 WOS: 000414649400006 PubMed: 28272675 Objective: There is no other screening program close to the success rate of PAP test. Cervical cytology constitutes a large workload so that quality control in cervical cytology is important for the quality assurance of pathology laboratories. Material and Method: In this study, we collected the cervical cytology results from all over Turkey and discussed the parameters influencing the quality of the PAP test. The study was conducted with Turkish gynaecopathology working group and 38 centers (totally 45 hospitals) agreed to contribute from 24 different cities. The study was designed to cover the cervical cytology results during 2013. The results were evaluated from the data based on an online questionnaire. Results: The total number of Epithelial Cell Abnormality was 18,020 and the global Epithelial Cell Abnormality rate was 5.08% in the total 354,725 smears and ranging between 0.3% to 16.64% among centers. The Atypical squamous cells/Squamous intraepithelial lesion ratios changed within the range of 0.21-13.94 with an average of 2.61. When the centers were asked whether they performed quality assurance studies, only 14 out of 28 centers, which shared the information, had such a control study and some quality parameters were better in these centers. Conclusion: There is an increase in the global Epithelial Cell Abnormality rate and there are great differences among centers. Quality control studies including the Atypical squamous cells/Squamous intraepithelial lesion ratio are important. Corrective and preventive action according to quality control parameters is a must. A cervical cytology subspecialist in every center can be utopic but a dedicated pathologist in the center is certainly needed.

PubMedID: 24841913 The objective of this study was to evaluate the reliability of an intraoperative frozen section during the endometrial carcinoma staging surgery procedure. The paraffin section reports of 291 cases with endometrial carcinoma were compared with intraoperative frozen section reports, which were diagnosed in the Pathology Department of Cukurova University, Medical Faculty between June 2006 and December 2012. The reports were reviewed for diagnostic accuracy of the frozen section in terms of histological subtype, grade, and myometrial invasion. Concordance values between frozen and paraffin section reports were 86, 84.3, and 91.6 % for histological subtype, grade, and myometrial invasion, respectively. When collectively evaluated, two (0.7 %) of 291 patients were inappropriately operated on due to frozen section reports. Intraoperative frozen section is a reliable guide for surgeons to evaluate the risk group of patients with endometrial cancer and prevent an unnecessary staging surgery operation. © 2014, Arányi Lajos Foundation.

e12584Background: Immune checkpoint ligand PD-L1 and transmembrane oncogenic protein MUC-1 are upragulated in TNBC and contribute aggressive behavior of this disease. It has been shown that pharmac...

Objectives: Although Hodgkin's lymphoma (HL) is one of the most curable cancers in adult patients, new targets have to be defined in cases resistant to traditional chemotherapy. The preferentially expressed antigen of melanoma (PRAME) is a cancer testis antigen and its expression is very scarce or absent in normal tissues. For this reason PRAME is a promising candidate for tumor immunotherapy. The aim of this study is to understand the correlation of PRAME expression with prognostic factors in HL, to determine the utility of PRAME as a targeted molecule for immunotherapy and to compare real-time polymerase chain reaction (real-time PCR) and immunohistochemistry (IHC) for the detection of PRAME. Methods: In 82 patients, PRAME was studied using real-time PCR and IHC. Data analyses were performed using statistical methods such as t test, Mann-Whitney U test, χ2 test, Kaplan-Meier method, log-rank test and Cox regression analysis. Results: PRAME was detected in 15 (18.3%) patients using IHC and in 8 (9.8%) patients using real-time PCR. A correlation was found between PRAME positivity and higher International Prognostic Score (p = 0.039). PRAME positivity detected using real-time PCR was found to be correlated with shorter disease-free survival (DFS) and overall survival (OS, p = 0.0005). Discussion: The demonstration of PRAME especially in histiocytes and Reed-Sternberg cells may provide guidance for immunotherapy. Although PRAME positivity increases the risk for death (3.56), independent risk factors that affected DFS and OS occurred in advanced age and high-risk groups. Conclusion: Although real-time PCR is sensitive in the detection of PRAME, IHC can be another useful method. Despite the need for studies conducted on larger patient samples, PRAME expression is considered as a poor prognostic parameter in HL.

PubMedID: 29798961 BACKGROUND: Chronic lymphocytic leukemia (CLL) is the most common type of leukemia among adults in Western populations. CLL has a wide range of clinical presentations and varied outcomes. For CLL, cytogenetic assessment is essential for estimating prognoses and determining the treatment of choice. The fluorescence in situ hybridization (FISH) technique is widely used for genetic assessment due to its high sensitivity. AIM: This study aimed to evaluate the frequencies of deletions of 13q14.3, 17p13.1, 11q22.3, and 13q34 and of trisomy 12 and to observe their effects on survival in 226 Turkish CLL patients using FISH analysis. RESULT AND CONCLUSION: The frequencies of abnormalities were 65.4% for del 13q14.3, 39.8% for del 17p13.1, 19% for del 11q22.3 (del ATM), and 15.9% for trisomy 12. No patients had a 13q34.3 aberration. Our results are partially consistent with literature findings. However, certain conflicts with prior results were observed, particularly with respect to the high prevalence of 17p13.1 deletions and the enhanced survival of patients with such deletions. These inconsistencies may represent population-based differences in the genetic epidemiology of CLL. © 2018 Indian Journal of Cancer | Pulished by Wolters Kluwer-Medknow.

Amaç: C-erbB-2 geni epidermal büyüme faktörü reseptörü ile homolog olan bir membran reseptör proteinini kodlar. Meme kanseri ve diğer kanserlerin bir prognostik faktörü olduğu belirlenmiştir. Prostat karsinomunda c-erbB-2 ekspresyonunun ve gen amplifikasyonunun prognostik rolü hâlâ tartışmalıdır. Bu çalışmada, primer ve metastatik prostat karsinomlarında c-erbB-2 aşırı ekspresyonunu ve gen amplifikasyonunu ve bunların tümörün evresi, yaş, ve sağkalım ile korelasyonlarını araştırdık. Materyal ve Metot: c-erbB-2 protein aşırı ekspresyonu 44 primer ve 15 metastatik prostat karsinomu olmak üzere 59 prostat karsinomunda immünohistokimya ve floresan in situ hibridizasyon analizleri kullanılarak incelendi. Bulgular: İki Gleason grade kategorisine ayrıldığı zaman, primer prostat karsinomu olgularında 20 düşük-grade ve 24 yüksek-grade olgu vardı. C-erbB-2 aşırı ekspresyonu, prostat karsinomlarında primer olanların %13.6’sında ve metastatik olanların %60’ında tespit edildi. Aşırı ekspresyon Gleason skoru (p=0.001) ve klinik sonuç ile ilişkiliydi ancak yaşla ilişkili değildi (p>0.05). Hiçbir olgu FISH ile HER-2 amplifikasyonu göstermedi. Sonuç: Bu çalışmada, c-erbB-2 proteini aşırı ekspresyonu yüksek grade ve ileri patolojik evre ile ilişkili idi. Ek olarak, metastatik prostat tümörü ile de ilişkiliydi. Bu bulgular, bu belirtecin bir potansiyel agresif klinik seyre ve metastaza işaret ettiğini desteklemektedir. Bu nedenle, bu belirteç tedavi planlaması için yararlı olabilir. Objective: The c-erbB-2 gene codes for a membrane receptor protein that is homologous to the epidermal growth factor receptor. It has been established as a prognostic factor in breast and other cancers. The prognostic role of c-erbB-2 expression and gene amplifcation in prostate carcinoma is still controversial. In this study, we searched for c-erbB-2 overexpression and gene amplifcation in primary and metastatic prostate carcinomas and their correlation with tumor grade, age, and survival. Material and Methods: c-erbB-2 protein overexpression was analyzed on 59 prostate carcinomas, including 44 primary and 15 metastatic prostate carcinomas, by immunohistochemistry and fuorescence in situ hybridization analysis. Results: When divided into two Gleason grade categories, there were 20 low-grade and 24 high-grade cases in the primary prostate carcinoma cases. C-erbB-2 overexpression was detected in 13.6% of primary and in 60% of metastatic prostate carcinomas. The overexpression was correlated with Gleason score (p=0.001) and clinical outcome but not with age (p>0.05). None of the cases showed HER-2 amplifcation by FISH. Conclusion: In this study, c-erbB-2 protein overexpression was associated with high grade and advanced pathological stage. Additionally, it was also associated with metastatic prostate tumors. These fndings support that this marker indicates a potentially aggressive clinical course and metastasis. Therefore, this marker may be helpful for planning therapy.

Background: Radiotherapy (RT) is used as an indispensable treatment approach for cancer therapy as an adjuvant or alone for definitive option. For early stage endometrial cancer, RT is applied after operation as an adjuvant. Primary cutaneous anaplastic large cell lymphoma (PCALCL) is a type of lymphoma which is seen rarely and has excellent prognosis with accurate treatment. It is another indication for RT. Developments in the diagnosis and the treatment of PCALCL have improved the disease prognosis and outcomes. Case Presentation: We present a case of a 55-years-old patient who had endometrial cancer and PCALCL, whose 9 years follow-up period was excellent with no recurrences and no metastasis. The outcome was achieved with the combination of surgery and RT. Conclusion: The presented case is important for long follow-up duration with no metastasis and/or no recurrences with single RT usage in both primary cancers. Single RT applications may be considered as an initial treatment option for surgically excised PCALCL with excellent outcome.

e19514 Background: PD1 and PD-L1 are new targets in cancer immunotherapy. PD1 protein is an immune check-point expressed in many tumours in response to inflammation and it has two ligands, PD-L1 an...