Özlem Erdem

Diagnostic and prognostic potential of microRNA profiles in endometrioid endometrial cancer

Gene regulation is influenced by microRNAs (miRNAs), a class of non-coding RNAs currently being studied as biomarkers for various diseases. miRNAs, which act as regulators of gene expression and potential biomarkers, were profiled in endometrioid type endometrial cancer (EEC). 28 miRNAs were selected based on their role in regulating EEC-related oncogenes and tumor suppressors (e.g., PTEN, KRAS, β-CATENIN), maintaining tissue stability, and their previous associations with endometrial cancer. This study investigated the expression of miRNAs and their association with key signalling pathways (PI3K/AKT, RAS/MAPK, Wnt/β-Catenin) and their potential as diagnostic biomarkers for EEC. The study also investigated the relationship between miRNA regulation, endometrial pathology, and PTEN, KRAS, and β-CATENIN mRNA expression levels. Women who had received an EEC diagnosis participated in a 14-month prospective cohort study at Gazi University Hospital. Samples were obtained from patients with EEC during frozen sections and healthy women who underwent hysterectomy for benign disease. qPCR examined the miRNA and mRNA levels. 97 women participated, comprising 47 EEC patients and 50 healthy controls. The association was identified between miRNA expression levels and cancer grade. As the tumor grade increases, the expression of miRNAs (miR-let-7c, miR-18a-3p, miR-21, miR-30b, miR-96, miR-130a, miR-141, miR-181b, miR-182, miR-183, miR-2001, miR-200b, miR-200c, miR-203, miR-205, and miR-429) gradually increases. Conversely, twelve miRNAs demonstrated relative expression during the transition from normal endometrium (NE) to EEC (miR-let-7c, miR-let-7e, miR-30c, miR-101, miR-125b, miR-126, miR-129-2, miR-217, miR-324-3p, miR-518b, miR-543, and miR-596). miRNAs could serve as valuable biomarkers for both early detection of EEC and for distinguishing between different tumor grades. We showed that miRNAs have good diagnostic sensitivity for identifying EEC and EC grading. In addition, miRNA improved the ability to discriminate between ECs of different grades.

Homologous recombination deficiency gene panel analysis results in synchronous endometrial and ovarian cancers

The objective of this study was to analyze the genetic alterations of tumors within the scope of the homologous recombination deficiency gene panel in patients diagnosed with synchronous endometrial ovarian cancer who have been followed for over 5 years using next-generation sequencing. DNA was isolated from the patient's formalin-fixed, paraffin-embedded tissue blocks. Next-generation sequencing was performed using the Illumina capture-based sequencing method. Samples were sequenced using the Sophia HR Solution DNA Kit. Seven patients were included in this study. The ratios of likely pathogenic (LP)/pathogenic (P) somatic mutations in ATM (serine/threonine kinase or Ataxia-telangiectasia mutated gene), BRCA2 (breast cancer type 2 susceptibility gene), BARD1 (BRCA1 associated RING domain 1), TP53 (tumor protein p53), BIRP1 (BRCA1-interacting helicase 1 gene), PALB2 (partner and localizer of BRCA2), and CHECK2 were 21 (48.8%), 8 (18.6%), 5 (11.6%), 3 (6.9%), 2 (4.6%), 2 (4.6%), and 2 (4.6%), respectively, in endometrium, and the ratios of somatic mutations in ATM, BRCA2, TP53, BARD1, RAD54L (DNA repair/recombination protein like), BIRP1, and RAD51D (RAD51 recombinase paralog D) were 24 (60%), 6 (15%), 5 (12.5%), 2 (5%), 2 (5%), 1 (2.5%), and 1 (2.5%), respectively, in ovary. In endometrioid-synchronous endometrial ovarian cancer cases, P/LP mutations were observed in ATM and CHECK2 genes in endometrium and ATM, BRCA2, and TP53 genes in ovary. In two non-endometrioid-synchronous endometrial ovarian cancer cases, CHEK2 (checkpoint kinase 2) mutations were observed in endometrium and ATM and TP53 mutations in ovary, whereas in one case, P/LP mutations in ATM and TP53 genes were common in both tissues. Pathogenic variations confirming the diagnosis of synchronous endometrial ovarian cancer with genetic alterations were identified in all but one case. ATM gene mutation emerged as the most common alteration and has a potential association with a favorable prognosis.

Krukenberg Tumor Presentation of Recurrent Gallbladder Cancer After a Decade

Krukenberg tumors are among rare cases of metastatic ovary cancers. They are presented as a solid mass which generally has bilateral and sometimes cystic components and is also known through symptoms related to the mass effect and/or hormonal imbalance. However, they may present findings before the primary tumor or remain asymptomatic for a long time. We presented a patient, who was diagnosed with gallbladder cancer nine years ago and whose adjuvant treatment was completed, applied to the outpatient clinic with the complaint of vaginal bleeding. Surgery was recommended to the patient and the patient was diagnosed with metastatic signet ring cell gallbladder cancer. The patient was started on gemcitabine-capecitabine treatment after surgery. The case is important both due to the rareness of metastasis of gall bladder cancer on the ovaries and also the detection of metastasis following the nine-year recurrence-free period. This case shows that routine controls including a careful gynecological examination in a patient primarily detected to have gastrointestinal malignity are important for recognizing late metastases.

Is there still a necessity for awareness and information about HPV infection and vaccine for adolescent in developing countries?

Increasing awareness of human papilloma virus (HPV) and vaccines among the target population is an important factor for decreasing the rate of malignancies related to HPV. The aim of this cross-sectional study was to determine Turkish high school and college students' knowledge level of HPV and vaccines via a survey. The HPV knowledge scale (HPV-KS) has been developed to measure the level of knowledge about HPV and vaccination. The response rate of 'Yes' to the question of whether the participants have heard of HPV and the vaccine was 60.8% and 58.8%, respectively. The lack of information was the commonest reason for not being vaccinated in 54% of the participants. According to the HPV-KS, the median value of the knowledge level of the participants was 35.7 (IQR; 14.3-57.1). The HPV-KS scores were significantly higher among those with parents who had graduated from university and had an income above the minimum wage than those who did not (