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Saka, Burcu

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Burcu

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Saka

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Saka, Burcu

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2021 - 20236

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    Evaluation and pathologic classification of choledochal cysts clinicopathologic analysis of 84 cases from the west
    (Lippincott Williams & Wilkins, 2021) Hacıhasanoğlu, Ezgi; Muraki, Takashi; Pehlivanoğlu, Burçin; Memiş, Bahar; Mittal, Pardeep; Polito, Humbert; Everett, Rhonda; Sarmiento, Juan; Kooby, David; Maithel, Shishir K.; Baştürk, Olca; Reid, Michelle D.; N/A; Meriçöz, Çisel Aydın; Saka, Burcu; Erkan, Murat Mert; Adsay, Nazmi Volkan; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; School of Medicine; 162418; 222921; 214689; 286248
    Choledochal cyst (CC) is believed to be a mostly Asian disorder. As a clinically defined entity, its pathologic correlates are poorly characterized. Eighty-four resected CCs from the West were reanalyzed. After applying established Japanese criteria, 9/66 with available imaging were disqualified and 10/39 with preoperative cyst typing had to be recategorized. None had been diagnosed with, or evaluated for, pancreatobiliary maljunction, but on retrospective analysis of radiologic images, 12/66 were found to have pancreatobiliary maljunction. The clinical findings were: F/M=5.7; mean age, 48; most (77%) presented with abdominal pain; mean size, 2.9 cm; choledocholithiasis 11%. Gross/histologic examination revealed 3 distinct pathology-based categories: (I) Cystic dilatation of native ducts (81%). (II) Double bile duct (13%), almost all of which were found in women (10/11); all were diagnosed by pathologic examination, and not preoperative diagnosis. (III) Gastrointestinal (GI) duplication type (6%). Microscopic findings of the entire cohort included mucosal-predominant lymphoplasmacytic inflammation (50%), follicular cholangitis (7%), mucosal hyperplasia (43%; 13% with papillae), intestinal metaplasia (10%), BilIN-like hyperplasia (17%), erosion/ulceration (13%), and severe dysplasia-mimicking atypia including "detachment atypia" and micropapillary degeneration (11%). Carcinomatous changes were seen in 14 cases (17%) (high-grade dysplasia/carcinoma in situ in 7, intraductal papillary neoplasm 1, and invasive carcinoma 6); and 13/14 of these occurred in pathologic category I, all with cyst size >1 cm. In conclusion, diagnostic imaging guidelines used in Asia are not routinely used (but should be adopted) in the West. Pathologically, cases designated as CC are classifiable in 3 groups: category 1 (dilated native duct type), more prone to carcinomatous change; category 2, double-duct phenomenon (all but 1 being female in this study); and category 3, GI-type duplication. Overall, 17% of CCs show carcinomatous change (50% of them invasive). CC specimens should be carefully examined with this classification and submitted entirely for assessment of at-risk mucosa and cancerous transformation.
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    Effects of Whey protein, Omega-3 fatty acid and Roux-En-Y gastric bypass on body weight, biochemical parameters and organ functions in an obese rat model: experimental research
    (Springer, 2023) Mert-Biberoğlu, Fatma; Erdem, Nihal Zekiye; Özdenkaya, Yaşar; Özdemir, Ekrem Musa; Saka, Burcu; Faculty Member; School of Medicine; Koç University Hospital; 222921
    Purpose: Extreme obesity (EO) is one of the biggest public health problems in the world and has grown considerably over the years. The aim of the study is to examine the effect of Roux-en-Y gastric bypass (RYGB), whey protein (WP), and omega-3 polyunsaturated fatty acid (PUFA) supplementation applied to EO rats on weight loss, histopathological changes in internal organs and biochemical alterations. Materials and Methods: Wistar albino female rats (n = 28) were used in the study and randomly divided into four groups. All rats were made obese by adding high fructose corn syrup (HFCS) to their drinking water. After the EO, WP and omega-3 PUFA supplementation was given and RYGB process was applied. At the end of the study, glucose, total cholesterol, HDL, VLDL, AST, ALT and uric acid changes and liver, kidney and pancreatic tissues were evaluated histopathologically. Results: WP and omega-3 PUFA supplementation decreased body weight (p > 0.05). Omega-3 PUFA and RYGB caused a decrease in total cholesterol (p < 0.05), WP decreased HDL (p < 0.05), WP and omega-3 PUFA caused an increase in ALT (p < 0.05). WP has been shown to have greater curative effects in rat liver and kidney tissues. It has been determined that RYGB causes necrosis in the liver and HFCS causes inflammation in the kidney. Conclusion: In the study; the positive effects of WP, omega-3 PUFA and bariatric surgery on obesity and dyslipidemia have been demonstrated. With this result, it was determined that WP, omega-3 PUFA supplementation and bariatric surgery were not superior to each other. Graphical abstract: [Figure not available: see fulltext.]
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    Infiltration pattern predicts metastasis and progression better than the T-stage and grade in pancreatic neuroendocrine tumors: a proposal for a novel infiltration-based morphologic grading
    (Elsevier, 2022) Reid, Michelle D.; Bağcı, Pelin; Balcı, Serdar; Pehlivanoğlu, Burçin; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Birceanu, Adelina; Xue, Yue; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Taşkın, Orhun Çığ; Armutlu, Ayşe; Demirtaş, Deniz; Saka, Burcu; Erkan, Murat Mert; Kapran, Yersu; Baygül, Arzu Eden; Adsay, Nazmi Volkan; Faculty Member; Teaching Faculty; Undergraduate Student; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; 166686; 133567; 371572; 222921; 214689; 168101; 272290; 286248
    The advancing edge profile is a powerful determinant of tumor behavior in many organs. In this study, a grading system assessing the tumor-host interface was developed and tested in 181 pancreatic neuroendocrine tumors (PanNETs), 63 of which were <=2 cm. Three tumor slides representative of the spectrum (least, medium, and most) of invasiveness at the advancing edge of the tumor were selected, and then each slide was scored as follows. Well-demarcated/encapsulated, 1 point; Mildly irregular borders and/or minimal infiltration into adjacent tissue, 2 points; Infiltrative edges with several clusters beyond the main tumor but still relatively close, and/or satellite demarcated nodules, 3 points; No demarcation, several cellular clusters away from the tumor, 4 points; Exuberantly infiltrative pattern, scirrhous growth, dissecting the normal parenchymal elements, 5 points. The sum of the rankings on the three slides was obtained. Cases with scores of 3-6 were defined as "non/minimally infiltrative" (NI; n = 77), 7-9 as "moderately infiltrative" (MI; n = 68), and 10-15 as "highly infiltrative" (HI; n = 36). In addition to showing a statistically significant correlation with all the established signs of aggressiveness (grade, size, T-stage), this grading system was found to be the most significant predictor of adverse outcomes (metastasis, progression, and death) on multivariate analysis, more strongly than T-stage, while Ki-67 index did not stand the multivariate test. As importantly, cases <=2 cm were also stratified by this grading system rendering it applicable also to this group that is currently placed in "watchful waiting" protocols. In conclusion, the proposed grading system has a strong, independent prognostic value and therefore should be considered for integration into routine pathology practice after being evaluated in validation studies with larger series.
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    Hepatic cysts reappraisal of the classification, terminology, differential diagnosis, and clinicopathologic characteristics in 258 cases
    (Lippincott Williams and Wilkins (LWW), 2022) Quigley, Brian; Choi, Hegyong; Basturk, Olca; Akkas, Gizem; Pehlivanoglu, Burcin; Memis, Bahar; Jang, Kee-Taek; Erkan, Mert; Erkan, Burcu; Balci, Serdar; Bagci, Pelin; Farris, Alton B.; Kooby, David A.; Martin, Diego; Kalb, Bobby; Maithel, Shishir K.; Sarmiento, Juan; Reid, Michelle D.; N/A; Armutlu, Ayşe; Erkan, Burcu; Saka, Burcu; Adsay, Nazmi Volkan; Teaching Faculty; Doctor; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 133567; N/A; 222921; 286248
    The literature on liver cysts is highly conflicting, mostly owing to definitional variations. Two hundred and fifty-eight >= 1 cm cysts evaluated pathologically using updated criteria were classifiable as: I. Ductal plate malformation related (63%); that is, cystic bile duct hamartoma or not otherwise specified-type benign biliary cyst (35 with polycystic liver disease). These were female predominant (F/M=2.4), large (10 cm), often multifocal with degenerative/inflammatory changes and frequently misclassified as "hepatobiliary cystadenoma." II. Neoplastic (13%); 27 (10.5%) had ovarian-type stroma (OTS) and qualified as mucinous cystic neoplasm (MCN) per World Health Organization (WHO). These were female, solitary, mean age 52, mean size 11 cm, and 2 were associated with carcinoma (1 in situ and 1 microinvasive). There were 3 intraductal papillary neoplasms, 1 intraductal oncocytic papillary neoplasm, 1 cystic cholangiocarcinoma, and 2 cystic metastasis. III. Infectious/inflammatory (12%). These included 23 hydatid cysts (including 2 Echinococcus alveolaris both misdiagnosed preoperatively as cancer), nonspecific inflammatory cysts (abscesses, inflammatory cysts: 3.4%). IV. Congenital (7%). Mostly small (<3 cm); choledochal cyst (5%), foregut cyst (2%). V. Miscellaneous (4%). In conclusion, hepatic cysts occur predominantly in women (3/1), are mostly (90%) non-neoplastic, and seldom (<2%) malignant. Cystic bile duct hamartomas and their relative not otherwise specified-type benign biliary cysts are frequently multifocal and often misdiagnosed as "cystadenoma/carcinoma." Defined by OTS, MCNs (the true "hepatobiliary cystadenoma/carcinoma") are solitary, constitute only 10.5% of hepatic cysts, and have a significantly different profile than the impression in the literature in that essentially all are perimenopausal females, and rarely associated with carcinoma (7%). Since MCNs can only be diagnosed by demonstration of OTS through complete microscopic examination, it is advisable to avoid the term "cystadenoma/cystadenocarcinoma" solely based on radiologic examination, and the following simplified terminology would be preferable in preoperative evaluation to avoid conflicts with the final pathologic diagnosis: (1) noncomplex (favor benign), (2) complex (in 3 subsets, as favor benign, cannot rule out malignancy, or favor malignancy), (3) malignant features.
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    Ki67 of >=10% identifies an aggressive Group of PanNETs and lends support to emerging protocols in oncology literature utilizing this cut-off for closer follow-up and chemotherapy candidates
    (Elsevier, 2022) Eren, Ozgur; Bagci, Pelin; Balci, Serdar; Sokmensuer, Cenk; Leblebici, Can Berk; Xue, Yue; Reid, Michelle; Luchini, Claudio; Scarpa, Aldo; Basturk, Olca; N/A; Saka, Burcu; Taşkın, Orhun Çığ; Kapran, Yersu; Adsay, Nazmi Volkan; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; 222921; 166686; 168101; 286248
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    Centrally-necrotic/hyalinizing demarcated (CND) carcinomas of the pancreas: a clinico-pathologically distinct group with divergent metaplastic patterns and high-grade characteristics
    (Elsevier, 2022) Bagci, Pelin; Altinmakas, Emre; Pehlivanoglu, Burcin; Bozkurtlar, Emine; Reid, Michelle; Cheng, Jeanette; Luchini, Claudio; Scarpa, Aldo; Basturk, Olca; N/A; Cengiz, Duygu; Saka, Burcu; Bozkurt, Emre; Armutlu, Ayşe; Meriçöz, Çisel Aydın; Alper, Emrah; Tellioğlu, Gürkan; Gürses, Bengi; Adsay, Nazmi Volkan; Other; Faculty Member; Doctor; Teaching Faculty; Teaching Faculty; Faculty Member; Faculty Member; Faculty Member; Faculty Member; School of Medicine; School of Medicine; N/A; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; 296729; 222921; N/A; 133567; 162418; 220444; 230736; 113169; 286248
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