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Öğe A proposal for improved t-staging of pancreatic ductal adenocarcinoma by using microscopic examination as the basis for determining the size and t-stage(Nature Publishing Group, 2020) Baştürk, Olca; Reid, Michelle; Balcı, Serdar; Erbarut Seven, İpek; Saka, Burcu; Pehlivanoğlu, Burçin; Memis, Bahar; Bağcı, Pelin; Adsay, Nazmi VolkanBackground: Stage remains as the most helpful prognosticator in pancreatic ductal adenocarcinoma (PDAC). However, accurate grossmeasurement of PDAC tumor size, the main stage parameter, is a well-known challenge due to its notoriously ill-defined nature. It hasbeen well documented that there are often satellite microtumor foci beyond the grossly appreciated tumor (PMID: 26832882), which in factmay represent intraparenchymal metastases. This becomes a bigger challenge if the gross room personnel are not experienced enough forthe subtleties of PDAC.Öğe A proposal for improved t-staging of pancreatic ductal adenocarcinoma by using microscopic examination as the basis for determining the size and t-stage(Nature Publishing Group, 2020) Baştürk, Olca; Reid, Michelle; Balcı, Serdar; Erbarut Seven, İpek; Saka, Burcu; Pehlivanoğlu, Burçin; Memis, Bahar; Bağcı, Pelin; Adsay, Nazmi VolkanBackground: Stage remains as the most helpful prognosticator in pancreatic ductal adenocarcinoma (PDAC). However, accurate grossmeasurement of PDAC tumor size, the main stage parameter, is a well-known challenge due to its notoriously ill-defined nature. It hasbeen well documented that there are often satellite microtumor foci beyond the grossly appreciated tumor (PMID: 26832882), which in factmay represent intraparenchymal metastases. This becomes a bigger challenge if the gross room personnel are not experienced enough forthe subtleties of PDAC.Öğe A retrospective evaluation of the epithelial changes/lesions and neoplasms of the Gallbladder in Turkey and a review of the existing sampling methods: A multicentre study(Federation of Turkish Pathology Societies, 2018) Esendağlı, Güldal; Akarca, Fahire Göknur; Balcı, Serdar; Argon, Asuman; Şengiz Erhan, Selma; Turhan, Nesrin; İnce Zengin, Neslihan; Hallaç Keser, Sevinç; Çelik, Betül; Bulut, Tangül; Abdullazade, Samir; Erden, Esra; Savaş, Berna; Bostan, Temmuz; Sağol, Özgül; Aysal Ağalar, Anıl; Kepil, Nuray; Karslıoğlu, Yıldırım; Günal, Armağan; Markoç, Fatma; Saka, Burcu; Özgün, Gonca; Özdamar, Şükrü Oğuz; Bahadır, Burak; Kaymaz, Esin; Işık, Emre; Ayhan, Semin; Tuncel, Deniz; Özgüven Yılmaz, Banu; Çelik, Sevinç; Karabacak, Tuba; Erbarut Seven, İpek; Ataizi Çelikel, Çiğdem; Gücin, Zuhal; Ekinci, Özgür; Akyol, GülenObjective: As there is continuing disagreement among the observers on the differential diagnosis between the epithelial changes/lesions and neoplasms of the gallbladder, this multicentre study was planned in order to assess the rate of the epithelial gallbladder lesions in Turkey and to propose microscopy and macroscopy protocols. Material and Method: With the participation of 22 institutions around Turkey that were included in the Hepato-Pancreato-Biliary Study Group, 89,324 cholecystectomy specimens sampled from 2003 to 2016 were retrospectively evaluated. The numbers of adenocarcinomas, dysplasias, intracholecystic neoplasms/adenomas, intestinal metaplasias and reactive atypia were identified with the review of pathology reports and the regional and countrywide incidence rates were presented in percentages. Results: Epithelial changes/lesions were reported in 6% of cholecystectomy materials. Of these epithelial lesions, 7% were reported as adenocarcinoma, 0.9% as high-grade dysplasia, 4% as low-grade dysplasia, 7.8% as reactive/regenerative atypia, 1.7% as neoplastic polyp, and 15.6% as intestinal metaplasia. The remaining lesions (63%) primarily included non-neoplastic polypoids/hyperplastic lesions and antral/pyloric metaplasia. There were also differences between pathology laboratories. Conclusion: The major causes of the difference in reporting these epithelial changes/lesions and neoplasms include the differences related to the institute’s oncological surgery frequency, sampling protocols, geographical dissimilarities, and differences in the diagnoses/interpretations of the pathologists. It seems that the diagnosis may change if new sections are taken from the specimen when any epithelial abnormality is seen during microscopic examination of the cholecystectomy materials.Öğe Calculation of the Ki67 index in pancreatic neuroendocrine tumors: A comparative analysis of four counting methodologies(Nature Publishing Group, 2015) Reid, Michelle Dian; Bağcı, Pelin; Ohike, Nobuyuki; Saka, Burcu; Erbarut Seven, İpek; Dursun, Nevra; Balcı, Serdar; Gucer, Hasan; Jang, Kee-Taek; Tajiri, Takuma; Baştürk, Olca; Kong, So Yeon; Goodman, Michael; Akkaş, Gizem; Adsay, VolkanKi67 index is now an essential part of classification of pancreatic neuroendocrine tumors. However, its adaptation into daily practice has been fraught with challenges related to counting methodology. In this study, three reviewers used four counting methodologies to calculate Ki67 index in 68 well-differentiated pancreatic neuroendocrine tumors: (1) 'eye-ball' estimation, which has been advocated as reliable and is widely used; (2) automated counting by image analyzer; (3) manual eye-counting (eye under a microscope without a grid); and (4) manual count of camera-captured/printed image. Pearson's correlation (R) was used to measure pair-wise correlation among three reviewers using all four methodologies. Average level of agreement was calculated using mean of R values. The results showed that: (1) 'eye-balling' was least expensive and fastest (average time <1 min) but had poor reliability and reproducibility. (2) Automated count was the most expensive and least practical with major impact on turnaround time (limited by machine and personnel accessibility), and, more importantly, had inaccuracies in overcounting unwanted material. (3) Manual eye count had no additional cost, averaged 6 min, but proved impractical and poorly reproducible. (4) Camera-captured/printed image was most reliable, had highest reproducibility, but took longer than 'eye-balling'. In conclusion, based on its comparatively low cost/benefit ratio and reproducibility, camera-captured/printed image appears to be the most practical for calculating Ki67 index. Although automated counting is generally advertised as the gold standard for index calculation, in this study it was not as accurate or cost-effective as camera-captured/printed image and was highly operator-dependent. 'Eye-balling' produces highly inaccurate and unreliable results, and is not recommended for routine use.Öğe Can the use of reference pictures improve the interobserver variability on assessment of liver steatosis percentage: A digital platform based approach(Springer, 2017) Türkmen Çetinaslan, İlknur; Çakır, Aslı; Çapar, Aslı Gizem; Saka, Burcu; Kahraman, Zuhal; Erkan, Sengiz; Özkan, Yücel; Kepil, Nuray; Keser, Sevinç Hallaç; Güçin, Zuhal; Ceyran, Bahar; Çoban, Ganime; Yılmaz Seğmen, Müberra; Arıcı, Sema; Dursun, Nevra; Doğusoy, Gülen Bülbül; Tuncel, Dilek; Özgüven Yılmaz, Banu; Paşaoğlu, Esra; Kamalı Harman, Gülçin; Kırımlıoğlu, Hale; Erdamar, Sibel; Yıldız, Şemsi; Erdoğan Yıldırım, Nilsen; Armutlu, Ayşe[Abstract Not Available]Öğe Changes in the ER, PgR, Her-2 and Ki-67 biological markers between preoperative core needle biopsy and surgical excision specimen: A comparative study(Springer, 2018) Çalış, Elif; Özöver, İrem; Çakır, Aslı; Saka, Burcu; Basım, Pelin; Türkmen, İlknur[Abstract Not Available]Öğe Clinicopathologic and prognostic significance of immunohistochemical expression of HIF-1 alpha, CXCR4 and CA9 in colorectal carcinoma(Elsevier Gmbh, 2017) Saka, Burcu; Ekinci, Özgür; Dursun, Ayşe; Akyürek, NalanObjective: To investigate the immunohistochemical expressions of HIF-1 alpha, CA9 and CXCR4 in resected human CRC specimens in relation to clinicopathologic and prognostic variables. Methods: A total of 186 patients (mean(SD) age: 56.7(12.6) years, 54.0% were males) with colorectal adenocarcinoma were included in this retrospective study. Resection specimens of the primary tumor were reviewed to confirm the diagnoses and the stage of the disease. Data on age, gender, tumor characteristics (localization, size, macroscopic growth pattern, histologic type, grade, angiolymphatic invasion, TNM stage), applied treatments and clinical outcome (overall survival, local recurrence and distant metastasis) were obtained from the hospital records. Immunohistochemical analysis of tissue specimens was performed to determine HIF-1 alpha, CA9 and CXCR4 expressions. Results: Overall, 94.0% of cases showed HIF-1 alpha immunoreactivity, 89% showed CXCR4 immunoreactivity, and 15.6% showed CA9 immunoreactivity, while weak expression of immunohistochemical markers was noted in 51.1%, 93.0% and 50.5% of cases, respectively. HIF-l alpha expression was higher among males than in females (median (min-max) final score of 6 (0-9) vs. 3 (0-9), p = 0.013). CA9 expressed at higher levels in ulcerovegetative and depressed tumors than in polypoid ones [0(0-9) vs. 0(0-6), p = 0.039]. CXCR4 expression was significantly higher in tumors < 5 cm than >= 5 cm [6(0-9) vs. 3(0-9), p = 0.028] and in grade 1-2 than grade 3 tumors [4(0-9) vs. 3(0-9), p = 0.030]. No significant difference was noted in survival with respect to strength of HIF-1 alpha, CA9 and CXCR4 immunoreactivity. Conclusion: In conclusion, our findings revealed weak-to-moderate HIF-l alpha and CXCR4 immunoreactivity in majority of resection samples, and weak CA9 immunoreactivity in majority of CA9 positive cases. Other than gender (HIF-1 alpha), macroscopic growth pattern (CA9) and tumor size and histologic grade (for CXCR4), none of the clinicopathologic and prognostic factors investigated were associated with expression of immunohistochemical markers and level of immunoreactivity had no impact on survival.Öğe Comparison of CT methods for determining graft steatosis in living donor liver transplantation(Springer, 2019) Şeker, Mehmet; Erol, Cengiz; Sevmiş, Şinasi; Saka, Burcu; Durur-Karakaya, AfakPurpose: To evaluate and compare the diagnostic performance of non-enhanced computed tomography (NECT) and contrast-enhanced CT (CECT) attenuation indices in the assessment of hepatic steatosis by using biopsy as the reference standard. Materials and methods: This retrospective study was approved by our Institutional Review Board. 55 Potential donors who underwent both NECT and triphasic CECT and core liver biopsy, were included the study. Average attenuation measurements that were obtained from multiple regions in liver, spleen, and psoas muscle on both unenhanced and CECT were used for analysis. Hepatic attenuation measurements were analyzed with and without normalization with the spleen and psoas muscle. Linear regression and receiver operating characteristic (ROC) curve analysis were used to evaluate the statistical association between CT indices and steatosis at histology. Results: Linear regression analysis confirmed the strongest correlation between steatosis and normalized measurements of hepatic attenuation with splenic attenuations on hepatic venous phase of CECT scan (R 0.821; R2 0.674 and R 0.816; R2 0.665, respectively). The use of ROC curve analysis also demonstrated that normalized measurements of hepatic attenuation with splenic attenuations on hepatic venous phase of CECT showed high diagnostic performance regarding the qualitative distinction of steatosis (AUC values greater than 0.9). Conclusion: Attenuation measurements of liver normalized with spleen on hepatic venous phase may be useful in evaluating steatosis in donor candidates with moderate to severe steatosis who are unacceptable for liver donation. In this manner unnecessary liver biopsy may be avoided in those donor candidates.Öğe Comparison of intratumoural and peritumoural budding in colorectal carcinoma(Springer, 2016) Ramadan, Saime; Çetinaslan Türkmen, İlknur; Saka, Burcu; Oran, Gülbin; Haksal, Mustafa Celalettin; Öncel, Mehmet[Abstract Not Available]Öğe 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, BurcuPurpose: 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.]Öğe Epithelial inclusions in the gallbladder: cytoisospora belli organisms or degenerative intracytoplasmic pas-positive hyaline globules(Nature Publishing Group, 2020) Pehlivanoğlu, Burçin; Erbarut Seven, İpek; Memiş, Bahar; Saka, Burcu; Bağcı, Pelin; Balcı, Serdar; Cheng, Jeanette; Baştürk, Olca; Reid, Michelle; Adsay, N. VolkanBackground: Lai et al. reported 18 cases of Cystoisospora belli in the gallbladders (GBs), detected incidentally in 0.5% ofimmunocompetent patients (PMID: 27158759). However, a recent molecular study failed to confirm this observation at molecular level(PMID: 30020094). Although Lai et al. indicated that Cystoisospora in the GB is quiescent in immunocompetent patients, this diagnosisnevertheless has major implications, resulting in extensive patient workup for undetected immunosuppression.Öğe Epithelial inclusions in the gallbladder: cytoisospora belli organisms or degenerative intracytoplasmic pas-positive hyaline globules(Nature Publishing Group, 2020) Pehlivanoğlu, Burçin; Erbarut Seven, İpek; Memiş, Bahar; Saka, Burcu; Bağcı, Pelin; Balcı, Serdar; Cheng, Jeanette; Baştürk, Olca; Reid, Michelle; Adsay, N. VolkanBackground: Lai et al. reported 18 cases of Cystoisospora belli in the gallbladders (GBs), detected incidentally in 0.5% ofimmunocompetent patients (PMID: 27158759). However, a recent molecular study failed to confirm this observation at molecular level(PMID: 30020094). Although Lai et al. indicated that Cystoisospora in the GB is quiescent in immunocompetent patients, this diagnosisnevertheless has major implications, resulting in extensive patient workup for undetected immunosuppression.Öğe Field risk ("field-effect"/"field-defect") in the gallbladder and biliary tree: An under-recognized phenomenon with major implications for management and carcinogenesis(Nature Publishing Group, 2019) Reid, Michelle; Losada, Hector; Muraki, Takashi; Pehlivanoğlu, Burçin; Memiş, Bahar; Koshiol, Jill; Bağcı, Pelin; Seven, İpek Erbarut; Balcı, Serdar; Saka, Burcu; Dursun, Nevra; Jang, Keetaek; Ohike, Nobuyuki; Tajiri, Takuma; Goodman, Michael; Carlos Roa, Juan; Araya, Juan; Bellolio, Enrique; Sarmiento, Juan; Xue, Yue; Baştürk, Olca; Adsay, Volkan[Abstract Not Available]Öğe Field risk ("field-effect"/"field-defect") in the gallbladder and biliary tree: An under-recognized phenomenon with major implications for management and carcinogenesis(Nature Publishing Group, 2019) Reid, Michelle; Losada, Hector; Muraki, Takashi; Pehlivanoğlu, Burçin; Memiş, Bahar; Koshiol, Jill; Bağcı, Pelin; Seven, İpek Erbarut; Balcı, Serdar; Saka, Burcu; Dursun, Nevra; Jang, Keetaek; Ohike, Nobuyuki; Tajiri, Takuma; Goodman, Michael; Carlos Roa, Juan; Araya, Juan; Bellolio, Enrique; Sarmiento, Juan; Xue, Yue; Baştürk, Olca; Adsay, Volkan[Abstract Not Available]Öğe Follicular cholecystitis: Reappraisal of incidence, definition, and clinicopathologic associations in an analysis of 2550 cholecystectomies(SAGE Publications Inc, 2020) Saka, Burcu; Memiş, Bahar; Erbarut Seven, İpek; Pehlivanoğlu, Burçin; Balcı, Serdar; Bağcı, Pelin; Reid, Michelle; Dursun, Nevra; Tapia Escalano, Oscar; Carlos Roa, Juan; Carlos Araya, Juan; Kong, So Yeon; Baştürk, Olca; Koshiol, Jill; Adsay, N. VolkanContext.Follicular cholecystitis (FC) is a poorly characterized entity.Objective.To determine its frequency/clinicopathologic associations.Design.A total of 2550 cholecystectomy specimens were examined. Two hundred three of these were consecutive routine cholecystectomies submitted entirely for microscopic examination to determine the relative frequency of incidental pathologies in gallbladders (GBs). The remainder had representative sampling. Underlying conditions were nonobstructive pathologies (1270 nonspecific cholecystitis), obstructive (62 distal biliary tract tumors, 35 primary sclerosing cholangitis, and 31 autoimmune pancreatitis), and neoplastic (n = 949). FC was defined as 3 distinct lymphoid follicles (LFs)/centimeter.Results.In the GBs totally submitted for microscopic examination, the true frequency of FC was found to be 2.5% (5/203), and in the representatively sampled group, it was 1.9%, with similar frequencies in nonobstructive, obstructive, and neoplastic cases (2.3%, 3.1%, and 1.3%, respectively, P = .77). When the 39 FC in nonneoplastic GBs contrasted with ordinary chronic cholecystitis, they were associated with older age (68 vs 49 years, P < .0001), similar gallstone frequency (68 vs 81%), female/male ratio (2.7 vs 2.6), and wall thickness (4 mm for both). None had lymphoma/parasites/Salmonella infection. Of 17 cases who had undergone gastric biopsy, 5 had chronic gastritis (2 with Helicobacter pylori). Microscopically, the LFs were the main inflammatory process often with minimal intervening inflammation. IgG4-positive plasma cell density was low (<10/high-power field) in 21/24(87.5%) cases.Conclusions.Follicular cholecystitis is seen in 2% of cholecystectomies, typically in significantly older patients, suggesting a deranged immune response. A third of the patients reveal biopsy-proven gastritis. FC does not seem to be associated with autoimmunity, lymphoma, or obstructive pathologies.Öğe Gallbladder polyps: Correlation of size and clinicopathologic characteristics based on updated definitions(Public Library of Science, 2020) Taşkın, Orhun C.; Baştürk, Olca; Reid, Michelle D.; Dursun, Nevra; Bağcı, Pelin; Saka, Burcu; Balcı, Serdar; Memiş, Bahar; Bellolio, Enrique; Araya, Juan Carlos; Roa, Juan Carlos; Tapia, Oscar; Losada, Hector; Sarmiento, Juan; Jang, Kee-Taek; Jang, Jin-Young; Pehlivanoğlu, Burçin; Erkan, Mert; Adsay, VolkanBackground Different perspectives exist regarding the clinicopathologic characteristics, biology and management of gallbladder polyps. Size is often used as the surrogate evidence of polyp behavior and size of >= 1cm is widely used as cholecystectomy indication. Most studies on this issue are based on the pathologic correlation of polyps clinically selected for resection, whereas, the data regarding the nature of polypoid lesions from pathology perspective -regardless of the cholecystectomy indication- is highly limited. Methods In this study, 4231 gallbladders -606 of which had gallbladder carcinoma- were reviewed carefully pathologically by the authors for polyps (defined as >= 2 mm). Separately, the cases that were diagnosed as "gallbladder polyps" in the surgical pathology databases were retrieved. Results 643 polyps identified accordingly were re-evaluated histopathologically. Mean age of all patients was 55 years (range: 20-94); mean polyp size was 9 mm. Among these 643 polyps, 223 (34.6%) were neoplastic: I. Non-neoplastic polyps (n = 420; 65.4%) were smaller (mean: 4.1 mm), occurred in younger patients (mean: 52 years). This group consisted of fibromyoglandular polyps (n = 196) per the updated classification, cholesterol polyps (n = 166), polypoid pyloric gland metaplasia (n = 41) and inflammatory polyps (n = 17). II. Neoplastic polyps were larger (mean: 21 mm), detected in older patients (mean: 61 years) and consisted of intra-cholecystic neoplasms (WHO's "adenomas" and "intracholecystic papillary neoplasms", >= 1 cm; n = 120), their "incipient" version (<1 cm) (n = 44), polypoid invasive carcinomas (n = 26) and non-neoplastic polyps with incidental dysplastic changes (n = 33). In terms of size cut-off correlations, overall, only 27% of polyps were >= 1 cm, 90% of which were neoplastic. All (except for one) >= 2 cm were neoplastic. However, 14% of polyps <1 cm were also neoplastic. Positive predictive value of >= 1 cm cut-off -which is widely used for cholecystectomy indication-, was 94.3% and negative predictive value was 85%. Conclusions Approximately a third of polypoid lesions in the cholecystectomies (regardless of the indication) prove to be neoplastic. The vast majority of (90%) of polyps >= 1 cm and virtually all of those >= 2 cm are neoplastic confirming the current impression that polyps >= 1 cm ought to be removed. However, this study also illustrates that 30% of the neoplastic polyps are <1 cm and therefore small polyps should also be closely watched, especially in older patients.Öğe Hepatocellular carcinomas with granulomatous inflammation in tumor stroma: Clinicopathologic characteristics(Federation of Turkish Pathology Societies, 2022) Saka, Burcu; Özden, Ferhat; Armutlu, Ayşe; Ertuğrul, GökhanObjective: To determine the frequency of granulomatous inflammation within hepatocellular carcinoma (HCC) and its clinicopathologic associations. Material and Method: Fifty-eight HCCs (51 explants, 3 lobectomies, and 4 segmentectomies) were reviewed. Results: Five (8.6%) cases (F/M=1/4, mean age: 63.6) were identified with granulomas.1/5 had history of neoadjuvant therapy. 4/5 patients presented with early stage (pT1/2). All were well-differentiated (Grade1-2/4). The mean number of tumor foci was 3.6, with a median size of 2.2 cm. All of them had advanced fibrosis. No difference was identified from cases without granulomas (n=53) in terms of prognosis and aforementioned parameters (p> 0.05). Granulomas were mainly concentrated in peripheral parts of the tumors. One case with nodule-in-nodule formation had granulomas lined along the border of the inner nodule. In 2 cases, granulomas were identified in steatohepatitic areas, while another had clear cell change. Only 1 had necrotizing granulomas, none with acid resistant bacilli. Two cases revealed concomitant granulomas in the adjacent liver parenchyma in addition to the tumor stroma. Except for one with a history of tuberculosis, none of the cases had a granulomatous disease. Conclusion: This is the largest case series of HCCs with granulomas by far. Our data revealed neither clinicopathologic and prognostic difference nor definite etiology related to granulomas. Yet, association with steatotic and clear tumor cells suggests the role of cytoplasmic content, while distribution of granulomas points to host immune response.Öğe Histopathologic infiltration pattern predicts metastasis and progression better than pT-stage and grade in well-differentiated pancreatic neuroendocrine tumors: A proposal for an infiltration-based morphologic grading system(Springer Nature, 2021) Taşkın, Orhun; Reid, Michelle; Bağcı Çulçi, Pelin; Balcı, Serdar; Armutlu, Ayşe; Demirtaş, Deniz; Pehlivanoğlu, Burçin; Saka, Burcu; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Corobea, Adelina Birceanu; Xue, Yue; Erkan, Mert; Kapran, Yersu; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Adsay, Nazmi Volkan[Abstract Not Available]Öğe Histopathologic infiltration pattern predicts metastasis and progression better than pT-stage and grade in well-differentiated pancreatic neuroendocrine tumors: A proposal for an infiltration-based morphologic grading system(Springer Nature, 2021) Taşkın, Orhun; Reid, Michelle; Bağcı Çulçi, Pelin; Balcı, Serdar; Armutlu, Ayşe; Demirtaş, Deniz; Pehlivanoğlu, Burçin; Saka, Burcu; Memiş, Bahar; Bozkurtlar, Emine; Leblebici, Can Berk; Corobea, Adelina Birceanu; Xue, Yue; Erkan, Mert; Kapran, Yersu; Sökmensüer, Cenk; Scarpa, Aldo; Luchini, Claudio; Baştürk, Olca; Adsay, Nazmi Volkan[Abstract Not Available]Öğe Is it justifiable to move the grade-1 ki67 index cut-off from 3% to 5% for pancreatic neuroendocrine tumors as has been proposed? The cases that fall to 3-5% category have clinicopathologic characteristics closer to those > 5%(Nature Publishing Group, 2020) Reid, Michelle; Balcı, Serdar; Bağcı, Pelin; Saka, Burcu; Pehlivanoğlu, Burçin; Erbarut Seven, İpek; Baştürk, Olca; Adsay, N. VolkanBackground: Grading of linear parameters into meaningful (clinically relevant) clusters is a well-known challenge. Recently several groupshave proposed to change the Ki67 index cut-off for grade 1 (G1) category for PanNETs from < 3% to < 5%. This proposal presupposes thatthe cases with Ki67 index of 3-5% are NOT clinically different than the 0-3% group and thus can be lumped together with the current G1 (0-3% cases), instead of their current home in the G2 category (> 3%).
