Yazar "Ersev, Ayşe Alp" seçeneğine göre listele

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    Feasibility of imprint cytology for evaluation of mediastinal lymph nodes in lung cancer
    (National Center for Biotechnology Information, 2006) Orki, Alpay; Tezel, Çağatay; Koşar, Altuğ; Ersev, Ayşe Alp; Dudu, Canan; Arman, Bülent
    Background: Intraoperative evaluation of mediastinal lymph nodes is a necessary step which helps us to decide whether or not to continue the operation of lung cancer. Imprint cytology (IC) can be used as an alternative method in staging. It is a more rapid and simpler procedure than frozen section (FS) analysis. Therefore, we compared the diagnostic accuracy of IC with permanent section on 1050 mediastinal lymph nodes. Methods: A total of 255 non-small cell lung cancer patients who underwent surgical procedure between January 1995 and April 2004 were included. There were 236 males and 19 females with a mean age of 54.2 years (range 26-79 years). In order to obtain lymph node samples mediastinoscopy was performed in 232 (91%), anterior mediastinotomy in 50 (20%) and video-assisted thoracoscopic surgery in 16 (6.3%) patients. During final pathological diagnosis, both imprint and permanent section slides were compared. Results: There were five false-positive and eight false-negative results. The sensitivity, specificity and the predictive values for positive and negative results were 93.1, 99.5, 95.6 and 99.1%, respectively. The overall efficiency was 98.8%. Conclusions: The diagnostic IC is an accurate, reliable, simple and less time-consuming method for evaluation of mediastinal lymph nodes in lung cancer, compared with FS method.
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    The impact of immunohistochemical detection of positive lymph nodes in early stage lung cancer
    (National Center for Biotechnology Information, 2006) Tezel, Çağatay; Ersev, Ayşe Alp; Kiral, Hakan; Koşar, Altuğ; Keleş, Murat; Dudu, Canan; Arman, Bülent
    Background: Detection of micrometastatic disease is an interesting area in non-small cell lung cancer (NSCLC). We conducted a study to determine whether the detection of mediastinal lymph node spread by immunohistochemical (IHC) analysis offers some prognosis with respect to patients' disease-free survival or not. Methods: Between 1997 and 2003, twenty-one early stage lung cancer patients underwent complete resection with mediastinoscopy and systemic nodal dissection. Four hundred and twenty-six paraffin-embedded lymph node sections from 21 patients were analyzed. Epithelial specific-antigen Ab-9 and Keratin-Pan Ab-1 were used as IHC marker. Results: Based on nodal spread four of the 21 patients (19.04%) were up-staged after IHC analysis. Two patients with stage IB (T2N0) up-staged to stage IIIA (T2N2); two patients staged as IIB (T2N1) up-staged to IIIA (T2N2). Statistical analysis showed that the lymphatic dissemination detected with IHC analysis was associated with reduced disease-free survival (DFS) (p = 0.002). Conclusions: Our study provides some indication that patients with lymphatic micrometastasis have a reduced DFS. Before creating a new TNM staging system, more information is needed to understand the prognostic impact of micrometastatic dissemination.
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    The prognostic significance of histopathologic angioinvasion in stage I non-small cell lung cancer
    (Turkish Society of Cardiovascular Surgery and Turkish Society of Thoracic Surgery, 2009) Tezel, Çağatay; Koşar, Altuğ; Ersev, Ayşe Alp; Tezel, Yelda; Arman, Bülent
    Amaç: Çalışmamızda akciğer kanserinde prognozu etkileyen histopatolojik bulgulardan vasküler invazyonun, lenfatik yayılım yapmamış erken evre akciğer kanserindeki prognostik önemi araştırıldı. Ça­lış­ma pla­nı: Aralık 1997-Ocak 2004 yılları arasında küratif mediastinal lenf nodu rezeksiyonu uygulanmış erken evre (T1-2N0M0) küçük hücreli dışı akciğer kanserli 40 hasta (32 erkek, 8 kadın; ort. yaş 53.8±8.7 yıl; dağılım 35-69 yıl) geriye yönelik olarak değerlendirildi. Tümör histolojisi, grade, vasküler invazyon ve rezeksiyon büyüklüğü çalışılan kriterlerdendi. Patoloji kesitleri yeniden incelendi ve en az iki vasküler yapının invazyonu ve/veya damar lümeninde tumoral tromboz bulunması vasküler invazyon olarak tanımlandı. Bulgular: Üç yıllık hastalıksız sağkalım %67.2±7.5, beş yıllık sağkalım ise %64.5±7.6 olarak hesaplandı. Vasküler invazyonun olup olmamasına göre değerlendirme yapıldığında genel sağkalım süreleri arasında anlamlı farklılık saptanmadı (Log rank: 0.85; p:0.357; p>0.05). Bununla birlikte, adenokarsinomlu olguların lokal nüks veya uzak metastaz nedeni ile kötü prognoz gösterdiği tespit edildi (p<0.01). So­nuç: Olgu sayımız sınırlı olsa da, geriye yönelik çalışmamızda, erken evre akciğer kanserinde histolojik tipin, sağkalım açısından histolojik vasküler invazyondan daha etkin olduğu görüldü.