Yasemin Kemal | Bahcesehir University (original) (raw)

Papers by Yasemin Kemal

Clinical Chemistry and Laboratory Medicine, 2015

Background: Red cell distribution width (RDW) is a routinely examined parameter with the complete... more Background: Red cell distribution width (RDW) is a routinely examined parameter with the complete blood count. In recent studies, RDW levels have been associated with cardiovascular, liver and renal diseases and solid tumors. The aim of this study was to evaluate the alterations of RDW levels in benign and malignant causes of postmenopausal bleeding and to investigate the association of RDW levels with clinicopathological parameters of endometrial cancer (EC) patients. Methods: A retrospective study was made of a total of 884 females who were admitted to hospital for postmenopausal bleeding between May 2009 and December 2013. After inclusion and exclusion criteria were applied, 222 patients remained. Complete blood count data was obtained from the recorded computerized database. After pathological evaluation, the patients were divided into two groups, benign and malignant (EC). Results: The EC group (n = 113) had significantly higher RDW levels compared to the benign group (14.78 ± 2.02 vs. 13.88 ± 1.05; p = 0.000). Grade II and above EC patients had higher levels of RDW than Grade I patients (15.2 ± 2.3 vs. 14.1 ± 1.00; p = 0.005). Correlation analyses also revealed a negative correlation between RDW and hemoglobin levels (p = 0.000), RDW and mean corpuscular volume (p = 0.000), RDW and lymphocyte count (p = 0.035) but a positive correlation between RDW and platelet to lymphocyte ratio (p = 0.030). Conclusions: The results of the current study revealed the potential predicitve role of RDW in patients with postmenopausal bleeding. Significant associations were also determined between RDW and clinicopathological characteristics in EC patients.

Molecular and Clinical Oncology, Mar 2, 2015

Thyroid extracts were first used to treat patients with metastatic breast cancer over a century a... more Thyroid extracts were first used to treat patients with metastatic breast cancer over a century ago. Since then, a number of studies have investigated the association between thyroid disorders and breast cancer. The presence of antibodies to thyroid peroxidase (TPOab) was recently reported to be associated with improved outcome in these patients. The aim of the present study was to evaluate the association between TPOab positivity and clinicopathological characteristics in breast cancer patients. The study included 318 newly diagnosed cases of breast cancer treated at

PubMed, Jun 1, 2014

Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. R... more Gastrointestinal stromal tumors (GISTs) are uncommon tumors of the gastrointestinal (GI) tract. Regorafenib is a new multikinase inhibitor and is approved for the treatment of GISTs in patients who develop resistance to imatinib and sunitinib. The most common drug-related adverse events with regorafenib are hypertension, hand-foot skin reactions, and diarrhea. Grade IV hypertensive side effect has never been reported after a single dose. In this report, we present a case of Grade IV hypertensive side effect (hypertensive crisis and seizure) after a single dose of regorafenib. A 54-year-old male normotensive GIST patient was admitted to the emergency department with seizure and encephalopathy after the first dosage of regorafenib. His blood pressure was 240/140 mmHg upon admission. After intensive treatment with nitrate and nitroprusside, his blood pressure returned to normal levels in five days. Regorafenib was discontinued, and he did not experience hypertension again. This paper reports the first case of Grade IV hypertension after the first dosage of regorafenib. We can suggest that hypertension is an idiosyncratic side effect unrelated to the dosage.

Türk Patoloji Dergisi, 2021

Objective: Medullary thyroid carcinoma (MTC) is a rare tumor originating from parafollicular C ce... more Objective: Medullary thyroid carcinoma (MTC) is a rare tumor originating from parafollicular C cells. It has more aggressive biologic behavior than differentiated thyroid carcinomas, and it is insensitive to treatment with radioactive iodine. Vandetanib and cabozantinib are the newly approved tyrosine kinase inhibitors in advanced stages, but novel effective systemic therapeutics could be crucial and needed for the clinical management of these patients. We aimed to evaluate the Programmed death-ligand 1 (PD-L1) expression, which is a novel immunotherapy target, in our MTC cohort, and determine whether it has an association with clinical and pathological features. Material and Method: This retrospective study involved 41 cases of MTC with a median follow-up of 54 months. PD-L1 monoclonal antibody (SP263 clone) was investigated immunohistochemically. Complete and/or partial membranous staining pattern in more than 1% of tumor cells was considered positive. The correlations of PD-L1 expression with clinicopathologic and prognostic features were analyzed. Results: PD-L1 positivity was detected in 5 (12.2%) of 41 tumors. The extent of PD-L1 staining was low (<5%) for all tumors. There was no clinicopathologic and prognostic relevance regarding PD-L1 expression in our MTC patients. Conclusion: Although PD-L1 expression could be a potential biomarker to predict the prognosis of various cancers and response to checkpoint inhibitors, we did not find any significant correlation between PD-L1 expression and clinicopathologic features in our cases. Studies with larger patient numbers are still required to perform a more comprehensive analysis.

Mean platelet volume could be a useful biomarker for monitoring epithelial ovarian cancer

Journal of Obstetrics and Gynaecology, May 15, 2014

New studies show that inflammatory markers and blood cells may be related to epithelial ovarian c... more New studies show that inflammatory markers and blood cells may be related to epithelial ovarian cancer (EOC). We aimed to examine whether mean platelet volume would be a useful marker for EOC patients to predict tumour burden and prognosis, and investigate the difference in MPV values between EOC patients and healthy controls. We retrospectively investigated 113 ovarian cancer patients who underwent surgery between January 2008 and July 2012 and 90 healthy subjects. MPV levels were significantly higher in preoperative EOC patients compared with healthy subjects (8.26 fl vs 7.71 fl; p = 0.004). Also NLR and PLR values were significantly higher in EOC patients (NLR, 3.48 vs 2.37; p = 0.000; PLR, 241 vs 148; p = 0.000). Surgical tumour resection resulted in a significant decrease in MPV levels (8.26 fl vs 7.61 fl; p = 0.001). NLR values also decreased after tumour resection significantly similar to CA125 (NLR, 3.48 vs 2.49; p = 0.000). Our data suggests that MPV could be a promising and easily available biomarker for monitoring EOC patients.

Quality of life in colorectal cancer patients during chemotherapy in the era of monoclonal antibody therapies

PubMed, May 27, 2015

Purpose: Colorectal cancer (CRC) survivors are currently living longer due to better therapies bu... more Purpose: Colorectal cancer (CRC) survivors are currently living longer due to better therapies but they also need to maintain their quality of life (QoL). QoL is increasingly being used as primary outcome measure in clinical studies. This study was designed to gain knowledge about QoL during chemotherapy across different lines and different regimens. Methods: The study comprised 101 CRC out patients receiving chemotherapy who completed the EORTC QLQ-C30 questionnaire. The Shapiro-Wilk, Kruskal-Wallis, and Mann-Whitney U tests were used for statistical analyses. Results: The demographics of the patients were evaluated for QoL. Prior surgery, prior radiotherapy, working status, stage, comorbidity and sex had no effect on global health status in CRC patients, although some other demographics such as education, monthly income, age and type of chemotherapy regimen did have an effect on global health status. Role functioning was worse in older than in younger ones (p<0.05). Adjuvant chemotherapy did not affect the QoL scores negatively but palliative chemotherapy negatively affected the cognitive function, appetite loss and nausea/vomiting scores (p<0.05). According to chemotherapy regimen, the best QoL was observed with adjuvant FUFA regimen. In the palliative setting FOLFOX/Bevacizumab was associated with the best QoL scores whereas FOLFIRI/Cetuximab were associated with the worst QoL scores. Conclusions: Palliative chemotherapy maintained QoL irrespective of the chemotherapy line in metastatic CRC (mCRC) patients. Some demographics affect QoL and different chemotherapy regimens showed different QoL scores.

Experimental Oncology, Sep 22, 2015

Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgk... more Aim: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extranodal non-Hodgkin's lymphoma (NHL). We aimed to analyse the clinicopathological characteristics and outcomes of our PTL cases. Materials and Methods: A review was made of the medical records of 339 NHL patients who were treated in the Medical Oncology Department between January 2005 and December 2013. Results: 8 PTL patients were identified from the 339 NHL patients. The average age of the patients was 67.7 ± 7.9 years (range 53-79 years). The mean follow-up time was 24.8 months (range 7-98 months). Inguinal orchiectomy was performed as a diagnostic and initial therapy and all the patients underwent 4-6 cycles of chemoimmunotherapy consisting of cyclophosphamide, doxorubicin, vincristine and prednisone plus rituximab. 4 of 8 patients received intrathecal prophylactic chemotherapy and 6 of 8 patients continued contralateral testis irradiation. Relapse occured in only 1 patient in central nervous system after 6 months who had not received intrathecal prophylaxis. No contralateral testis relapse was observed. Conclusions: Primary testicular NHL is an uncommon entity and we evaluated 8 patients; with one relapse in central nervous system and no relapse in the contralateral testis.

Asian Pacific Journal of Cancer Prevention, Mar 30, 2014

Background: Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diag... more Background: Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a major obstacle to improving lung cancer outcomes. Recently, elevated preoperative or pretreatment neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) detected in peripheral blood were identified as independent prognostic factors associated with poor survival with various cancers, including colon cancer, esophageal cancer, gastric cancer and breast cancer. Objective: The aim of this study was to examine whether MPV, NLR and PLR could be useful inflammatory markers to differentiate lung cancer patients from healthy controls. An investigation was also made of the relationship between these markers and other prognostic factors and histopathological subgroups. Materials and Methods: Retrospectively eighty-one lung cancer patients and 81 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chronic infection, hepatic disorder and other cancer were excluded from the study. The preoperative or pretreatment blood count data was obtained from the recorded computerized database. Results: NLR and PLR values were significantly higher in the LC patients compared to the healthy subjects.(NLR: 4.42 vs 2.45 p=0.001, PLR: 245.1 vs 148.2 p=0.002) MPV values were similar in both groups (7.7 vs 7.8). No statistically significant relationship was determined between these markers (MPV, NLR and PLR) and histopathological subgroups and TNM stages. Conclusions: NLR and PLR can be useful biomarkers in LC patients before treatment. Larger prospective studies are required to confirm these findings.

Oncology Letters, Feb 8, 2016

The present study aimed to analyze the clinical significance of epithelial membrane protein 1 (EM... more The present study aimed to analyze the clinical significance of epithelial membrane protein 1 (EMP1) expression in ovarian serous tumors. A total of 84 cases of ovarian serous tumor (50 patients with malignant ovarian serous tumors and 34 patients with borderline and benign serous tumors) were retrospectively analyzed. Differences in the expression levels of EMP1 between the malignant and non-malignant tumor groups were evaluated by immunohistochemical staining. In addition, the association between EMP1 expression and prognostic factors in malignant ovarian serous tumors was investigated. The expression levels of EMP1 were significantly reduced in all the 50 malignant ovarian serous tumors, compared with the 34 non-malignant ovarian serous tumors (P<0.000). Reduced expression of EMP1 was correlated with high grade (P=0.009) and stage (P<0.000) of malignant tumors. EMP1 expression was not observed to be correlated with any other investigated parameters, including surgery, type of operation and chemotherapy response (P>0.005). These results indicated that EMP1 may have a significant role as a negative regulator in ovarian serous tumors, and reduced EMP1 expression in serous tumors may be associated with increased disease severity.

Journal of Oncological Sciences, 2022

Coronavirus disease-2019 (COVID-19) is caused by a new and rapidly spreading CoV called severe ac... more Coronavirus disease-2019 (COVID-19) is caused by a new and rapidly spreading CoV called severe acute respiratory syndrome-CoV-2 (SARS-CoV-2). 1 The first case of a human with COVID-19 caused by SARS-CoV-2 was reported in Wuhan, China, in December 2019. Since then, 54,300,000 and 1,300,000 people have contracted COVID-19 and have died due to COVID-19, respectively. 2 The data available so far suggest that elderly people are more susceptible than the younger population to COVID-19 complications, particularly if they have comorbidities such as diabetes, cardiovascular disease, chronic kidney disease, chronic lung disease, and active cancer. 3 Some cancer therapies and some cancers themselves suppress the immune system. Immunosuppression can expose these patients to serious complications from infection, which can lead to treatment delays and unnecessary hospitalizations, negatively affecting disease prognosis. 4 Thus, patients with cancer are at an increased risk of COVID-19. A study conducted in China revealed that the risk of COVID-19 is 3.5 times higherin patients with cancer than in the normal population. 5 Furthermore, during the COVID-9 pandemic, the hospital admissions of patients with cancer significantly decreased, their diagnosis was delayed, and their treatment was affected due to insufficient health care resources for patients requiring regular evaluation in hospitals. Thus, the COVID-19 pandemic likely created or exacerbated mental health problems. 6,7

Acta Diabetologica, Aug 26, 2007

Thiazolidinediones (TZD) have become a powerful tool for lowering insulin resistance. The problem... more Thiazolidinediones (TZD) have become a powerful tool for lowering insulin resistance. The problem of cardiovascular adverse events including fluid retention and risk of heart failure should be well known and recognised. We aimed to evaluate the long-term effects of rosiglitazone on cardiac function and fluid dynamics. Forty-six type 2 diabetic patients were randomised to treatment with rosiglitazone or metformin or to a control group. There are no significant differences between the groups in the duration of diabetes, HbA1c, plasma brain natriuretic peptide (BNP) levels, body mass index and myocardial performance indexes (MPIs) before the treatment. After three and six months all these parameters were repeated. Rosiglitazone increased plasma BNP levels and worsened MPIs 3 months after the start of treatment. Also left ventricular end-systolic volume increased and weight gain was observed. But these results were statistically non-significant (all p>0.05). When we continued rosigli-tazone treatment to six months the increase in BNP levels became soft and statistically significant improvements were seen in MPIs (p<0.01). Also left ventricular end-systolic volume decreased significantly (p=0.004) and weight gain was stopped. In patients with type 2 diabetes, TZD treatment might have slight adverse effects on ventricular contractility and fluid dynamics at the beginning of the therapy. However, these changes seem to stabilise in the long term.

Asian Pacific Journal of Cancer Prevention, Aug 30, 2014

Objectives: Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of che... more Objectives: Advanced gastric cancer (AGC) patients have a poor prognosis. The best benefit of chemotherapy is usually achieved by first line setting. Very few studies have compared combination regimens. This study was designed to compare two combination regimens. Methods: Patients with advanced gastric cancer receiving first line chemotherapy were retrospectively collected, and divided into two groups, receiving DCF (docetaxel, cisplatin and fluorouracil) or ECF (epirubicin, cisplatin and fluorouracil) regimens. Data were collected for the retrospective analysis in a single center. Results: Eighty-six patients were eligible for analysis. Median overall survival (OS) was 10.0 months in the ECF group and 11.0 months in the DCF group (p=0.31). Median progression free survival (PFS) for ECF and DCF was equal at 6.0 months. Second line chemotherapy were administered in more than one third of patients. Both regimens had similar toxicity. Conclusions: This is the first study investigating the outcomes of gastric cancer chemotherapy in this region. ECF and DCF regimens have similar efficacy and a similar tolerability profile for first line treatment of advanced gastric cancer. The decision of the first line chemotherapy in advanced gastric cancer could be improved with patient selection according to clinical parameters and molecular markers.

Baş-Boyun Adenoid Kistik Karsinomları

Baseline lymphopenia as a prognostic marker for colorectal carcinoma

Journal of Clinical Oncology, May 20, 2012

e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemot... more e14107 Background: Baseline lymphopenia has been proved to be a marker for poor prognosis, chemotherapy-induced toxicity and increased risk of febrile neutropenia, trombocytopenia and anemia in advanced solid neoplasms. This study aims to evaluate the effect of pretreatment lymphopenia on prognosis and hematological toxicity in colorectal cancer patients who received first line systemic chemotherapy. Methods: Lymphocyte count was evaluated in 386 pretreated colorectal cancer patients who do not have a seconder malignancy, HIV infection, bone involvement and primary G-CSF prophylaxis. Overall survival, progression free survival and disease free survival were calculated from date of diagnosis to date of relapse, progression and death. Kaplan-Meier, chi-square and Student-t test were used. Results: Mean follow-up was 30 months (range 1-180 months). Mean age was 57.4±12.5 years. Of all patients, 160 (41 %) were women. Rectum ( 26.2 %) and transvers colon (4.7 %) were the most and the least common anatomic locations, respectively. Mean lymphocyte count before treatment was 1964/µl (170-7000/µl). There were no relationship between lymphopenia and age, sex, performans status, presence of initial metastasis, adjuvant or palliative chemotherapy and hematological toxicity (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Grade 3-4 hematological toxicity was found in 40 patients and was significantly higher in patients receiving bi- or tri-chemotherapy regimen (p:0.017). Among 208 patients with relapse or progression, 40 patients had lymphopenia (19.2 %). 1, 3 and 5-year OS were significantly lower in lymphopenic patients (p:0.033). DFS was longer in non-lymphopenic patients but this data didn’t have statistical significance (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Conclusions: This study support that lymphocyte number prior to chemotherapy may be a simple but useful prognostic and predictive marker in untreated colorectal cancer patients. Patients with lower pretreatment lymphopenia have lower OS when compared to others (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). This study has the highest colorectal cancer population in the literature.

Experimental Oncology, Dec 22, 2015

Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI... more Background: Breast cancer (BC) is the most common cancer among women. A high body-mass index (BMI) is related to increased incidence of BC with poorer prognosis. Aim: The aim of the study was to evaluate the association in patients with BC between BMI at the time of diagnosis and biological characteristics, according to the menopausal status. Materials and Methods: This retrospective study comprised a total of 318 women with BC. Clinicopathological differences between normal, overweight and obese patients according to menopausal status were evaluated. Results: Premenopausal women had a significantly lower BMI than postmenopausal patients (28.7 vs. 31.5, respectively; p = 0.00001). No statistically significant association was determined between BMI and clinicopathological characteristics in either the premenopausal or the postmenopausal group (all p values are > 0.05). Conclusions: There are many conflicting results in literature on this relationship. The results of this study showed that a high BMI is not associated with worse clinicopathological characteristics in a predominantly obese population. In current medical oncology practice, BC should be evaluated on an individual patient basis and the impact of obesity on BC prognosis seems to be difficult to estimate especially in an obese population.

Authorea (Authorea), Dec 21, 2022

Objectives: To analyze the value of neutrophil-to-lymphocyte ratio (NLR) and anemia on results in... more Objectives: To analyze the value of neutrophil-to-lymphocyte ratio (NLR) and anemia on results in patients with laryngeal squamous cell carcinomas (LSCC). Design and setting: The patients were categorized into 2 groups as low and high. The relationship between NLR and anemia overall survival (OS), disease-free survival (DFS), and local regional recurrence-free survival (LRRFS) was investigated. Participants: LSCC patients included. Results: OS and DFS were better in patients in low NLR group. In the multivariate analysis, high NLR was significant indicator of worse OS and DFS. Conclusions: NLR is a biomarker in LSCC.

Turkish journal of family medicine and primary care, Jun 20, 2021

Objective: The objective of this study was to determine the knowledge level of family physicians ... more Objective: The objective of this study was to determine the knowledge level of family physicians about skin cancer and their attitudes and behaviors about sun protection. Methods: The sample of this study was composed of 295 family physicians who worked in Samsun province and participated in in-service trainings organized by the Provincial Health Directorate in March 2019. A questionnaire form consisting of questions on sociodemographic characteristics, attitudes and behaviors about sun protection was applied to the participants. Result: A total of 295 family physicians, 64.7% male and 35.3% female, participated in the study. Most of the physicians (87.8%) expressed that they tried to protect from sunlight. Women (68.3%) used sunscreen lotions/creams more frequently than men (41.4%). Those who had 2 and more severe sunburns throughout their lifetime (51.5%) stated that they described themselves at higher risk than those who did not (36.2%) which was statistically significant (p<0.05). The reasons of the physicians for application to a dermatologist were: 47(15.9%) had asymmetrically shaped, irregularly structured moles larger than 5 mm, 37(12.5%) had suspected presence of moles, 11(3.7%) wanted whole body examination for moles, 20(6.8%) requested advice on daily skin care and prevention of skin aging. Conclusion: Awareness studies should be carried out on the harmful effects of the sun and early diagnosis of skin cancer especially for family physicians, healthcare professionals and other parts of the society. In addition, considering that visual evaluation has a role in the diagnosis of skin cancer, it will be useful for family physicians to inform their patients about the detrimental effects of the sun and self-skin examination.

Reliability and Validity of the Turkish Version of Mental Adjustment to Cancer Scale

Thyroid peroxidase antibodies in breast cancer

Journal of Clinical Oncology, May 20, 2014

e22211 Background: Since Beatson first described the use of thyroid extracts to treat patients wi... more e22211 Background: Since Beatson first described the use of thyroid extracts to treat patients with metastatic breast carcinoma more than a century ago, many studies have investigated the relations...