Serkan Degirmencioglu

Insertion/deletion polymorphism of the angiotensin I-converting enzyme gene in patients with breast cancer and effects on prognostic factors.

The aims of the present study were to investigate the distribution of the insertion/deletion (I/D) polymorphism of the angiotensin-converting enzyme (ACE) gene in breast cancer patients and the association between ACE genotypes and clinicopathologic features, as well as their effects on prognosis. We assessed the I/D polymophism of the ACE gene by using polymerase chain reaction from peripheral blood in breast cancer and healthy age-matched women. The clinicopathologic parameters of breast cancer patients were obtained from medical records. Of the 57 patients, 31 (54.4%) had DD, 24 (42.1%) had ID, and 2 (3.5%) had II genotypes. In control subjects, 33 (63.5%) had DD, 12 (23.1%) had ID, and 7 (13.4%) had II genotypes. The ID genotype was seen more commonly in breast cancer patients (p = .03). When the combination of ID and II genotypes was used as a reference group, the DD genotype was associated with negative hormone receptor status (p = .003), tumor size (p = .054), and lymph node involvement (p = .07) but not histologic high grade and c-erb B2 overexpression. These results suggest that the DD genotype may accompany poor prognostic factors and influence the tumor course.

Angiotensin-Converting Enzyme Gene Polymorphism Is Associated with Anemia in Non–Small-Cell Lung Cancer

The angiotensin-converting enzyme (ACE) plays an important role not only in the regulation of vascular homeostasis but also in stimulation of hematopoiesis. We aimed to evaluate the association between insertion/deletion (I/D) polymorphism of the ACE gene and anemia at the time of the diagnosis. We enrolled 75 patients with non–small-cell lung cancer (NSCLC) and 85 age- and sex-matched healthy control participants. The I/D polymorphism of ACE was identified by using polymerase chain reaction from peripheral blood samples. Statistical analyses were performed with SPSS for Windows. The distributions of the ACE genotypes and alleles are similar in patients and in healthy participants (P = 0.29 and P = 0.08, respectively). In patients with NSCLC, 34 (45.3%) had anemia; of whom 3 (8.8%) had genotype II, 24 (70.6%) had genotype ID, and 7 (20.6%) had genotype DD (P = 0.001). The patients with the II and ID genotypes had more frequent anemia at the time of the diagnosis (odds ratio = 6.02; P = 0.001). Our findings suggest that I/D polymorphism of the ACE gene may influence the development of anemia in patients with NSCLC.

Insulin-like growth factor I (Igf-1) gene polymorphism in patients with non-metastatic breast cancer

We aimed to assess the association between IGF-I gene (CA repeats) polymorphism in breast cancer patients and their clinicopathological features, as well as disease recurrence and survival. Seventy-six non-metastatic breast cancer patients were enrolled in the present study. The IGF-I (CA) repeats were studied with polymerase chain reaction by using proper primers belonging to these gene areas from DNA samples. Results show that the non 19- non 19 homozygote were more common in patients without lymph node involvement (p=0.04), with low histological grade (p=0.04), with positive hormone receptor status (p=0.01), and in patients without recurrence (p=0.06). These results suggest that the non 19-non 19 carriers have some favorable prognostic factors, and IGF-I gene polymorphism (CA repeats) may affect disease recurrence and overall survival.

Effects of Serum Leptin and Resistin Levels on Cancer Cachexia in Patients With Advanced-Stage Non–Small Cell Lung Cancer

Introduction: Cancer cachexia is one of the most frequent effects of malignancy, is often associated with poor prognosis, and may account for up to 20% of cancer deaths. The aim of our study was to evaluate the relationship of cancer cachexia and serum levels of resistin and leptin in patients with advanced non–small cell lung cancer. Methods: A total of 67 chemotherapy-naïve patients with advanced-stage non–small cell cancer and a control group containing 20 healthy individuals without a known chronic disease were enrolled in this study. All individuals in the control group were age and sex matched. Demographic, anthropometric, laboratory data and serum levels of adipokines were measured for 2 groups. Progression-free survival and overall survival were estimated using the Kaplan-Meier method. Survival among various factors was calculated using the log-rank test. Results: Patients presented significantly higher serum resistin (P = .0001) and lower serum leptin levels (P = .025) than the control group. Lower serum levels of leptin were correlated with overall survival (P = .011). Conclusions: Serum leptin and resistin levels play key role as proinflammatory cytokines in lung cancer and cancer cachexia; however, their use as diagnostic or prognostic markers is not possible yet, and further large-scale studies are required to confirm our findings.

Intracranial Dural Based Malign Mesenchymal Neoplasm: Case Report

Dural based sarcoma is a rare aggressive neoplasm arising from the multipotent primitive mesenchymal stem cells of the dura. A 61-year-old male patient presented with complaints of loss of visual acuity in his right eye for 1 week. Neuroimaging revealed a tumour located at the right temporal lobe. The mass was dural-based. Three years ago dural based lesion was seen. In that period radiological diagnosis was meningioma. Within three years, the lesion has grown and radiologically presumed meningioma view has been disappeared. After surgical resection of the mass pathological diagnosis of primary dural based sarcoma was made. As in soft tissue sarcomas, diagnosis is mainly based on light microscopy, while immunohistochemistry can improve accuracy of diagnosis. In this article we would like to highlight two things: one is dural sarcoma and meningioma cannot be distinguished radiologically, and the other is the patients three-year history

Effect of serum interleukin-1 receptor antagonist level on survival of patients with non-small cell lung cancer

Due to poor prognosis in advanced non-small cell lung cancer (NSCLC), new effective markers are required in the monitoring of the disease. The present study aimed to investigate the association between the serum IL-1 receptor antagonist (IL-1Ra) level, overall survival (OS), and treatment response in NSCLC, and to evaluate the usefulness of the serum IL-1Ra level as a prognostic marker for NSCLC. Eighty patients (72 men and 8 women) and 40 healthy volunteers (13 men and 27 women) were included in the present study. The median progression-free survival was 16 weeks for patients with high serum IL-1Ra levels, and 35 weeks for patients with low serum IL-1Ra levels (P=0.027). The median OS was 38 weeks in patients with a high serum IL-1Ra level, and 62 weeks in patients with a low serum IL-1Ra level (P=0.065). The results of the present study have demonstrated that there was a significant correlation between IL-1Ra levels and NSCLC progression and survival, although the correlation between IL-1Ra levels and the response to treatment was not statistically significant. Therefore, the pre-treatment IL-1Ra level has been identified as a putative prognostic factor for NSCLC.

Two rare diagnoses during chronic lymphocytic leukaemia follow-up: Kaposi's sarcoma and Merkel cell carcinoma.

Chronic lymphocytic leukaemia often has a clinical presentation characterised by increased neoplastic lymphocytes which are mostly mature looking due to B lymphocytes. Increased secondary cancer prevalence has been detected among patients with chronic lymphocytic leukaemia diagnosis. In this report, we present three chronic lymphocytic leukaemia patients who developed secondary rare cancers during their follow-up at our clinic. Case 1: A 54-year-old female patient was diagnosed with stage I chronic lymphocytic leukaemia in 2003 and was diagnosed with Merkel cell carcinoma in February 2013. Case 2: A 66-year-old male patient was diagnosed with stage II chronic lymphocytic leukaemia in 2009 and was diagnosed with Kaposi’s sarcoma in March 2013. Case 3: A 77-year-old male patient was diagnosed with stage I chronic lymphocytic leukaemia in 2006 and was diagnosed with Kaposi’s sarcoma in 2011. In conclusion, secondary cancers are observed in patients diagnosed with chronic lymphocytic leukaemia. Therefore, follow-up of chronic lymphocytic leukaemia requires additional attention in this context.

Effects of Serum Thyroid Stimulating Hormone Levels on Prognosis in Patients with Advanced Non-Small Cell Lung Cancer

New indicators and more effective treatments are required to monitor the disease in advanced non-small cell lungcancer (NSCLC) due to less favorable prognosis. The purpose of our study is to evaluate the effects of serum thyroid stimulating hormone (TSH) levels on prognosis and survival in NSCLC patients. Sixty seven patients (62 males and 5 females) and 20 healthy volunteers (16 males and 4 female) were included in the study. Demographic, laboratory data and serum TSH levels of these two groups were compared. Statistically significantly reduced serum TSH levels were detected in patient group versus control group (p=0.000). In our study, median survival time of patients with reduced TSH value was 225 days, while median survival time of patients with normal TSH value was 385 days; and the statistically difference was significant (p=0.03). These results indicate that TSH can be a physiological factor in both carcinogenesis and progression of the diseases

590PIMPACT OF PREOPERATIVE CHEMOTHERAPY AFTER NEOADJUVANT CHEMORADIATION ON TUMOR DOWN STAGING IN PATIENTS WITH LOCALLY ADVANCED RECTAL CANCER: A RETROSPECTIVE STUDY

ABSTRACT Aim: In this study, we compared two groups of patients: Group 1 was treated with neoadjuvant chemoradiotherapy (CRT) as standard therapy followed surgery 8 weeks period and Group 2 received both neoadjuvant CRT and preoperative chemotherapy (CT) during waiting 8 weeks period before surgery. We investigated the impact of using preoperative 5FU-based CT after neoadjuvant CRT on tumor size and nodal down staging up until surgery for rectal cancer with standardized total mesorectal excision. Methods: Of 132 patients with rectal cancer, 70 patients with radiologically T3-T4 and/or node positive disease were selected. ECOG performance status was ≤ 1 in all patients. Surgery was planned for 8 weeks after the end of CRT. Twenty patients (28.5%) received mFOLFOX-6 -at least 2 cycles- as preoperative CT until surgery after neoadjuvant CRT (Group 2). All patients were assessed by MRI and pathologic staging. All analyses were performed by using SPSS 17.0. In order to determine the clinicopathological parameters affected the tumor size (T) and nodal (N) down staging, logistic regression model was used. Results: Median age was 62 years; 44 (62.9%) were male. Of 70 patients, 55 (78.6%) patients had T3, 15 (21.4%) patients had T4. Of these, 28(40%) patients had N0 (18 had T3, 10 had T4), 42(60%) patients had N1 and N2. Twenty five patients (35.7%) had T downtaging and 29 (41.4%) had N down staging. The rate of T down staging was 26% (13pts) and 60% (12pts) in groups 1 and 2, respectively (p = 0.007). For patients receiving preoperative CT, N down staging rate was higher than the patients not receiving (55% vs. 36%, respectively). In logistic regression analysis, receiving preoperative CT (p = 0.01), higher level of LDH (p = 0.03) and perineural invasion (p = 0.06) affected T down staging rate. In group 2, 18 (90%) had no disease recurrences, but 21(42%) patients had disease recurrences in group 1. Preoperative mFOLFOX-6 was well tolerated until surgery. Also, there were no significant differences in toxicity or surgical complications in both groups. Conclusions: Our data suggest that using preoperative CT after neoadjuvant CRT is feasible and associated with an increased rate of T down staging in patients with locally advanced rectal cancer without any increase in surgical complications. This observation needs to be confirmed in larger prospective randomized studies. Disclosure: All authors have declared no conflicts of interest.