2020-12-11T00:00:00Z, Köker, İbrahim Hakkı, Ünver, Nurcan, Malya, Fatma Ümit, Uysal, Ömer, Keskin, Elmas Biberci, Şentürk, Hakan, MALYA, FATMA ÜMİT, UYSAL, ÖMER, BİBERCİ KESKİN, ELMAS, ŞENTÜRK, HAKAN

Background/aims: The role of cyst fluid carcinoembryonic antigen (CEA) level in differentiating mucinous pancreatic cystic lesions (PCLs) is controversial. We investigated the role of cyst fluid CEA in differentiating low-risk (LR)-intraductal papillary mucinous neoplasms (IPMNs) from high-risk (HR)-IPMNs and LR-mucinous cystic neoplasms (MCNs). Methods: This was a retrospective study of 466 patients with PCLs who underwent endoscopic ultrasound-guided fine-needleaspiration over a 7-year period. On histology, low-grade dysplasia and intermediate-grade dysplasia were considered LR, whereas high-grade dysplasia and invasive carcinoma were considered HR. Results: Data on cyst fluid CEA levels were available for 50/102 mucinous PCLs with definitive diagnoses. The median CEA (range) levels were significantly higher in HR cysts than in LR cysts (2,624 [0.5-266,510] ng/mL vs. 100 [16.8-53,445]ng/mL, p=0.0012). The area under the receiver operating characteristic curve (AUROC) was 0.930 (95% confidence interval [CI], 0.5-0.8; p<0.001) for differentiating LR-IPMNs from LR-MCNs. The AUROC was 0.921 (95% CI, 0.823-1.000; p<0.001) for differentiating LR-IPMNs from HR-IPMNs. Both had a CEA cutoff level of >100ng/mL, with a negative predictive value (NPV) of 100%. Conclusion: Cyst fluid CEA levels significantly vary between LR-IPMNs, LR-MCNs, and HR-IPMNs. A CEA cutoff level of >100ng/mL had a 100% NPV in differentiating LR-IPMNs from LR-MCNs and HR-IPMNs.

2021-06-01T00:00:00Z, Güler, Beril, Adilli, Adila, Uysal, Ömer, GÜLER, BERIL, ERDOĞAN, EZGİ BAŞAK, UYSAL, ÖMER

Aim: Lymphoma staging is important from the prognostic and therapeutic point of view and bone marrow biopsy performed for this purpose makes up a large part of current hematopathology practice. PET-CT is the currently preferred method to evaluate bone marrow involvement by lymphoproliferative disorders as it is non-invasive and practical. The aim of this study was to compare trephine biopsy and PET-CT results as regards determining bone marrow involvement in various lymphoma subtypes. Materials and Methods: A total number of 198 bone marrow biopsies and 185 PET-CT images of cases consisting of various lymphoma subtypes were included in the study. The results of both methods evaluated for bone marrow infiltration were grouped as positive, negative, and suspicious to compare consistency. Statistical agreement was calculated with the kappa coefficient. The sensitivity, specificity, and the positive and negative predictive values were calculated as the diagnostic test measures. Results: Twenty-six cases (15.8%) had lymphoma involvement in trephine biopsies and 36 cases (21.2%) had positive findings for lymphoma involvement of the bone marrow on PET-CT. The two methods had weak statistical agreement (κ= 0.21). Biopsy and PETCT results were similar in 132 cases (71.20%). PET-CT showed false negative results in 11 cases in which infiltration was observed with biopsy. Twenty-six cases that were negative for lymphoma involvement on biopsy were accepted as positive on PET-CT and 16 of these cases were classical Hodgkin-s lymphoma. One case with suspicious bone marrow biopsy was positive on PET-CT, while four cases with suspicious PET-CT results were positive on biopsy. Conclusion: The results showed that both of the methods have advantages and disadvantages as regards lymphoma staging. However, histopathology is globally accepted as the gold standard for a definite diagnosis. We believe that the complementary use of the two methods is more beneficial for correct guidance during clinical practice.

2022-01-01T00:00:00Z, DÜNDAR, TOLGA TURAN, Cetinkaya, Ezra, YURTSEVER, İSMAİL, Uysal, Ömer, Aralaşmak, Ayşe, DÜNDAR, TOLGA TURAN, ÇETİNKAYA, EZRA, YURTSEVER, İSMAİL, UYSAL, ÖMER

Purpose: To search for the utility of DCE-MRP to differentiate between posttreatment enhancement (PT) and tumoral enhancement (TM) in high-grade glial tumors. Materials and methods: Thirty-four patients with glioma (11 grade 3; 23 grade 4) were enrolled. Enhancement in the vicinity of the resection cavity demonstrated by DCE-MRP was taken into consideration. Based on the follow-up scans, reoperation or biopsy results, the enhancement type was categorized as PT or TM. Measurements were performed at the enhancing area near the resection cavity (ERC), nearby (NNA) and contralateral nonenhancing areas (CLNA). Perfusion parameters of the ERC were also subtracted from NNA and CLNA. Intragroup comparison (paired sample t-test) and intergroup comparison (Student's t-test) were made. Results: There were 7 PTs and 27 TMs. In the PT, the subtracted values of Ve and IAUC from the CLNA and NNA and the subtracted value of Kep from NNA were statistically different. In TM, all metrics were significantly different comparing the CLNA and NNA. Comparing PT with TM, Ktrans, IAUC, Kep, and subtracted values of Ktrans and IAUC from both NNA and CLNA were significantly different. Conclusions: In PT, only Ktrans values did not reveal any difference comparing NNA and CLNA. To differentiate PT from TM, Ktrans, Kep, IAUC, and subtracted values of Ktrans and IAUC from NNA and CLNA can be used. These findings are in concordance with literature.