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Öğe Comparison of SUVmax values obtained from F-18 FDG PET/CT and cell-free DNA levels measured from plasma in oncology patients(Galenos, 2019) Çelik, Fatmanur; Tan, Yusuf Ziya; Özdemir, Semra; Sılan, FatmaObjectives: The aim of this study was to compare the quantitative value of standardized uptake value (SUV) SUVmax obtained from F-18 FDG positron emission tomography/computed tomography (PET/CT) imaging of oncology patients with the cell-free DNA (cfDNA) amounts measured in plasma of patients and thus investigate if cfDNA is a significant marker to identify the presence of malignancy in the early period. Methods: A total of 184 patients were included in the study. The clinical, histopathologic, laboratory and treatment parameters were extracted from patient files. SUVmax and cfDNA quantities were assessed. Results: There was no statistically significant difference in plasma cfDNA values between patient and control groups. The comparison of SUVmax and cfDNA values in the study showed that there was a weak correlation between SUVmax and cfDNA. There was a significant difference between tumor size and SUVmax values. However, there was no statistically significant difference between tumor size and cfDNA. Conclusion: cfDNA measurements in the blood as a screening test have provided hope for early diagnosis and monitoring of cancer patients. Comparison of cfDNA levels obtained from plasma and quantitative parameters from PET/CT images of oncology patients in detailed advanced studies with larger patient series are required. © 2019 by Turkish Society of Nuclear Medicine Molecular Imaging and Radionuclide Therapy published by Galenos Yayınevi.Öğe Comparison of two different periods of renal cortical activity ratios in the evaluation of ureteropelvic junction obstruction by dynamic renal scintigraphy(2014) Hasbek, Zekiye; Özdemir, Semra; Turgut, Bülent; Erselcan, Taner; Cankorkmaz, Levent; Alaygut, DemetAmaç. Retrospektif olan bu çalışmada amacımız, üreteropelvik bileşkede darlığı olan çocuk hastagrubunda, renal sintigrafilerde, 1inci ve 20nci dakikalardan elde edilen kortikal aktivite oranının,obstrüksiyonun varlığının belirlenmesinde takip parametresi olarak kullanılabilirliğiniaraştırmaktır. Yöntem. Çalışmaya toplam 322 renogram dahil edildi. Standart renogram eğrileridiüretiğe verdiği cevaba göre vizüel olarak nonobstrüktif, obstrüktif ve şüpheli olaraksınıflandırıldı. Ayrıca her bir böbrek için 1inci ve 20nci dakikalarda kortikal ROIler çizildi vekortikal sayımlar elde edildi. Bunun dışında renogram ile hesaplanan T 1/2 10 dakikanın altındaolan böbrekler normal, 10-20 dakika indetermine, >20 dakika kötü drenaj olarak kabul edildi.Obstrüksiyon paternleri ile 1inci ve 20nci dakikalardaki kortikal aktivite oranları karşılaştırıldı.Bulgular. Kortikal aktivite sayımlarının oranları ile vizüel olarak belirlenen obstrüktif patern(nonobstrüktif, obstrüktif ve şüpheli) karşılaştırıldığında, Tc-99m DTPA renogramında,1inci/20nci dak. kortikal aktivite oranı %82,8in üzerinde olan hastalar obstrüktif, %59,3 ile%82.8 olan hastalar obstrüksiyon açısından şüpheli olarak bulundu. Tc-99 m MAG-3 ile yapılansintigrafilerde ise, 1inci/20nci dak. kortikal aktivite oranı %74,2nin üzerinde olan hastalarobstrüktif, %44,6 ile %74,2 olan hastalar obstrüksiyon açısından şüpheli olarak bulundu. T½parametresinin böbreklerin obstrüksiyon paterni ile karşılaştırılması sonucunda; vizüeldeğerlendirmeye göre non-obstrüktif olan 299 böbreğin 124ünde (41,5%) T½ indetermine grupta,7sinde (2,3%) ise T½ obstrüktif gruptaydı. Vizüel değerlendirmede şüpheli grupta yer alan 17böbreğin 4ünde (23,5%) T½ normal grupta, 5inde (29,4%) T½ indetermine grupta ve 8inde(47,1%) T½ obstrüktif grupta yer almaktaydı. Sonuç. Biz çocuk hasta grubunda 1inci/20ncidakika kortikal aktivite oranlarının kullanılmasının da obstrüksiyon tanısının konulmasındayardımcı olduğunu düşünmekteyiz.Öğe Contradictory Effect of Coronary Collateral Circulation on Regional Myocardial Perfusion That Assessed by Quantitative Myocardial Perfusion Scintigraphy(Elmer Press, 2021) Özdemir, Semra; Barutçu, Ahmet; Akşit, Ercan; Duygu, Ali; Koç Öztürk, FulyaBackground: Previous studies showed conflicting results about the contribution of coronary collateral circulation (CCC) to myocardial perfusion and function. The aim of this study was to investigate these contradictory problems by gated myocardial perfusion scintigraphy (gated MPS) for the first time. Methods: The current cohort was retrospectively selected among patients who underwent gated MPS and coronary angiography within 2 months. Two different groups including 96 patients were assessed by gated MPS to detect the understanding of the miscellaneous effect of CCC on myocardial perfusion. Group 1 consisted of those who had collateral arteries that were not-well-developed (Rentrop grade 0 - 1) (n = 58), while group 2 consisted of those who had collateral arteries that were well-developed (Rentrop grade 2 - 3) (n = 38). Results: There was no statistically significant difference between groups 1 and 2 in terms of perfusion and functional parameters obtained from gated MPS. Furthermore, no statistically significant difference was found in the phase analysis parameters which is a novel technique to evaluate left ventricular synchronization. On the other hand the left ventricular mass index values were high and quite close to the statistically significant value (P = 0.059) in group 2. Conclusions: The current results that obtained by using the gated MPS technique for the first time in the evaluation of CCC showed that the well-developed collateral circulation has a positive effect on myocardial perfusion and function, but this effect was not statistically significant. Results need to be supported by large scale of patients' size.Öğe Epigenetic silencing of the tumor suppressor HIC1 and SFRP2 genes in prostate carcinomas(Springer, 2011) Kilic, Davran; Özdemir, Öztürk; Korgali, Esat; Özdemir, Semra; Koksal, Binnur; Gultekin, Yener[Anstract Not Available]Öğe F-18 FDG Pozitron Emisyon Tomografisi/Bilgisayarlı Tomografi ile Miyokardiyal Canlılık Görüntüleme Kılavuzu: Guidelines for Myocardial Viability Imaging with F-18 FDG(Galenos Publishing House, 2020) Özdemir, Semra; Başoğlu, Tarık; Demir, Hakan; Altun, Gülay Durmuş; Özdemir, Elif; Şen, Feyza; Tosun, Fevziye CanbazMyocardial viability imaging with Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT), in patients who are appropriate for coronary revascularization, in the presence of left ventricular dysfunction and rest myocardial perfusion defect due to coronary artery disease, has become a frequently used method to differentiate viable myocardial (hibernating) and non-viable myocardial tissues (scar). This guideline, has been prepared by Turkey Society of Nuclear Medicine Cardiology Working Group to provide a standart approach to cardiac viability imaging with F-18 FDG PET/CT. For this purpose details on instrumentation and reporting are summarized and all presented suggestions are submitted by evaluating the international guidelines and current literature. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.Öğe Incidentally detected large diaphragmatic hernia in Tl-201 myocardial perfusion scintigraphy; no substantial effect on the study results(2011) Özdemir, Semra; Erselcan, Taner; Hasbek, Zekiye; Tandoğan, İzzet; Gümüş, CesurBu makalede Talyum-201(Tl-201) ile yapılan miyokard perfüzyon sintigrafisi sırasında tesadüfensaptanan bir vaka sunuldu. Stres ve rest SPECT projeksiyonlarının değerlendirilmesi esnasında ilk10 projeksiyon görüntüsünde orta mediastende ve sağ akciğer alanında geniş bir foton defektli alanizlendi. Yapılan tomografide hastanın da haberdar olmadığı Morgagni tipte bir diafragmatik hernisaptandı. Büyük boyutlu bu kitlenin kardiak aktiviteyi engelleyeceği, kardiak kesitlerde önemlidefektler yaratabileceği ve yanlış sonuçlara neden olabileceği düşünüldü. Bundan dolayı kitleninkalp üzerindeki attenüasyon etkisini engelleyebilecek farklı açıda yeni bir rest çekimi yapıldı.Ancak ilginç olarak bu iki farklı rest çalışma sonuçları arasında anlamlı bir fark izlenmedi. Diğertaraftan bu vaka, MPS çalışmasının tüm verilerinin incelenmesinin raslantısal tanıdaki öneminibize hatırlatmaktadır.Öğe Iodine-123 Meta-iodobenzylguanidine Cardiac Innervation Imaging Guideline(Galenos Publishing House, 2020) Altun, Gülay Durmuş; Serim, Burcu Dirlik; Özdemir, Elif; Özdemir, Semra; Şen, Feyza; Demir, Hakan; Tosun, Fevziye CanbazSympathetic innervation of the heart plays an important role in the pathophysiology of diseases, especially congestive heart failure and arrhythmias. Iodine-123 metaiodobenzylguanidine (I-123 MIBG) scintigraphy allows for early detection of problems by imaging at the neurotransmitter level before cardiac structural changes occur. In this way, it is possible to correctly manage the diagnosis and treatment processes of the patients. The main purpose of this guide is to ensure the national standardization of cardiac I-123 MIBG scintigraphy applications. In addition, it is intended to guide nuclear medicine doctors in the proper execution of indications, imaging and clinical processes, evaluation and reporting stages. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.Öğe Myocardial Perfusion PET Procedure Guideline(Galenos Publishing House, 2024) Karaçavuş, Seyhan; Yalçın, Hülya; Özkan, Elgin; Demir, Hakan; Çağlıyan, Feyza; Özdemir, Semra; Tosun, Fevziye CanbazMyocardial perfusion imaging using positron emission tomography (PET) constitutes a non-invasive diagnostic procedure that provides crucial diagnostic and prognostic insights in the context of coronary artery disease. It enables the identification of microvascular circulation disorders in the early phases. The utilization of myocardial PET perfusion studies is on the rise, primarily owing to significant advantages compared to single photon emission tomography. These advantages include superior resolution and sensitivity, robust attenuation correction, reduced radiation exposure, and the capability for absolute quantification of stress and rest myocardial blood flow. This guide endeavors to establish standardized protocols for quantitative myocardial PET perfusion imaging and aims to provide information concerning their clinical applications and interpretation, aligning with international guidelines and relevant literature. © 2024 Galenos Publishing House. All rights reserved.Öğe Myocardial Perfusion SPECT Procedure Guideline(Galenos Publishing House, 2020) Tosun, Fevziye Canbaz; Özdemir, Semra; Şen, Feyza; Demir, Hakan; Özdemir, Elif; Altun, Gülay DurmuşAfter Turkish Society of Nuclear Medicine “Cardiology Group” had first published “Nuclear Cardiology Practice Guidelines” in 2001, in line particular with the technological developments, significant changes both in the hardware, software and also in the protocols have occurred in the era of nuclear cardiology. Besides many new clinical uses in nuclear cardiology and specific developments in both single photon emission computerized tomography and positron emission tomography systems, such as specific cardiac gamma camera systems and blood flow studies, myocardial perfusion scintigraphy (MPS), which is still performed today mostly with conventional gamma camera systems, ranks first among both nuclear cardiology and also general conventional nuclear medicine procedures in almost all nuclear medicine clinics. The aim of this guideline is to assist nuclear medicine physicians in MPS studies, in terms of indications, application, imaging methods, evaluation and reporting stages. The recommendations in this guide has been prepared by “Turkish Society of Nuclear Medicine Cardiology Task Group” to ensure the standardization of the MPS applications in our country in the light of international studies and current guidelines. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.Öğe Nuclear medicine procedures in diagnosis of infective endocarditis(Galenos Publishing House, 2020) Demir, Hakan; Tosun, Fevziye Canbaz; Altun, Gülay Durmuş; Özdemir, Elif; Özdemir, Semra; Şen, FeyzaInfective endocarditis (IE) is described as infection of endocardial surfaces of heart and if available prosthesis materials. Despite all up to date developments in diagnosis and treatment of its, IE is mortal and morbid disease. IE causes numerous non-specific symptoms and findings in patients. Currently, various difficulties are observed in diagnosis and differential diagnosis of IE. Duke criteria is used for supporting of diagnosis. Also, echocardiography, computerized tomography (CT), positron emission tomography (PET)/CT, magnetic resonance, labeled leukocyte scintigraphy, blood culture, polymerase chain reaction investigations are used. Although, histopathological diagnosis is gold standard. In this procedure guideline nuclear medicine methods (PET/CT and labeled leukocyte scintigraphy) will be handled that used more frequently in recent years for diagnosis of IE. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.Öğe PET-BT’de Uterusda Tesadüfi Olarak Saptanan Benign/Fizyolojik 18F-FDG Tutulumları ve Etkileyen Faktörler(2021) Şahin, Hacı Öztürk; Özdemir, SemraAmaç: Flor-18 işaretli florodeoksiglukoz (18F-FDG ) ile pozitron emisyon tomografisi/bilgisayarlı tomografi (PET-BT) tetkiki sırasında fizyolojik ve/veya benign nedenlerle oluşabilecek uterin 18F-FDG tutulumları ve bunu etkileyebilecek faktörleri araştırmaktır. Gereç ve Yöntem: Jinekolojik onkolojik patolojiler dışındaki nedenlerle PET-BT çekilen ve yüksek uterin 18F-FDG tutulumu saptanan, geçirilmiş uterin cerrahisi olmayan 10’u premenopozal toplam 16 hasta çalışmaya dahil edildi. Tüm hastalar pelvik manyetik rezonans (MR) tetkiki ile değer-lendirildi. Bulgular: Yüksek uterin 18F-FDG tutulumu mevcut olan 16 hastamızın 13’ünde uterin leiomyom saptanırken 3’ünde herhangi bir pelvik patoloji saptanmadı. Pelvik patoloji saptanmayan hastaların hepsine menstrüasyon döneminde PET-BT çekildiği saptandı. Leiomyom’lu 13 hastanın ortalama SUVmax değeri 5.41 idi. Yapılan istatistiksel analizde SUVmax değeri ile yaş, menopoz durumu, kan LDH düzeyi, miyom çapı, miyomun tekli/çoklu olması ve tamoksifen kullanımı parametreleri arasında korelasyon olmadığı saptandı. Menstrüasyon‘a bağlı uterin 18F-FDG tutulumu saptadığımız 3 hastanın ortalama SUVmax değeri 7.3’dü. Sonuç: Özellikle premenopozal dönemde PET-BT’de rastlantısal saptanan uterin 18F-FDG tutulumlarının, malign süreçler ekarte edildikten sonra menstrüasyona ya da benign patolojilere bağlı olabileceği akılda tutulmalıdır.Öğe Predictive value of standard serum markers for bone metastases in prostate cancer(SpringerOpen, 2021) Özdemir, Semra; Ersay, Ahmet Reşit; Koç Öztürk, Fulya; Özdemir, Beril SuBackgroundThe early detection of bone metastases is very important in prostate cancer follow-up. This study aimed to compare conventional tumor markers, namely free prostate-specific antigen (free PSA), total prostate-specific antigen (total PSA), free PSA/total PSA ratio, alkaline phosphatase (ALP) values, Gleason scores and (99 m) Tc-MDP bone scintigraphy findings in the prediction of bone metastases in prostate cancer.MethodsIn total, 175 patients with prostate cancer who underwent whole-body bone scintigraphy were included in the study. All selected scintigraphic studies were reprocessed. Free PSA, total PSA, free PSA/total PSA ratio, alkaline phosphatase (ALP) values and Gleason scores of patients were recorded.ResultsThe results of our study show that the presence of bone metastasis correlates very weakly with free PSA/total PSA ratio (rho=0.179), weakly with total PSA (rho=0.318) and Gleason score (rho=0.382), moderately with ALP (rho=0.539), free PSA (0.416). Only ALP variable had a diagnostic value and ALP cutoff value was 76.50 IU/L, with 80% sensitivity and 82.1% specificity.ConclusionAccording to the results of our study; the free PSA, total PSA, free PSA/total PSA ratio and Gleason score values were not considered as a reliable parameter in the prostate cancer cases follow-up for bone metastasis development. Only ALP had a diagnostic value and ALP cutoff value was 76.50 IU / L with 80% sensitivity and 82.1% specificity in predicting bone metastases in prostate cancer.Öğe Procedure guideline for detection of inflammation with F-18 FDG PET/CT in cardiac sarcoidosis(Galenos Publishing House, 2020) Sen, Feyza; Demir, Hakan; Altun, Gülay Durmus; Özdemir, Elif; Özdemir, Semra; Tosun, Fevziye CanbazHistologic confirmation of cardiac sarcoidosis (CS) is challenging. When taken into account of either the invasive nature or potential false negativity of the endomyocardial biopsy, imaging methods represent as a major alternative to establish a clinical diagnosis. Among the imaging methods, the use of fluorine-18-fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) which detects active inflammation in CS is becoming widespread. Recently, F-18 FDG PET has been identified as one of the new diagnostic criteria in CS, by the Heart Rhythm Society. For diagnosis, a combination of both myocardial perfusion and inflammation findings should be interpreted visually and/or semiquantitatively. Yet, the precision of diagnostic accuracy has been limited by lack of an adequate reference standard. This procedure guideline presents current literature defining the role of F-18 FDG PET in the diagnosis and management of CS along with technical details and recommendations about imaging protocol and interpretation. © 2020 Nuclear Medicine Seminars. All Rights Reserved.Öğe Procedure Guideline for Scintigraphic Imaging in Cardiac Transthyretin Amyloidosis(Galenos Publishing House, 2020) Özdemir, Elif; Tosun, Fevziye Canbaz; Altun, Gülay Durmuş; Demir, Hakan; Özdemir, Semra; Şen, FeyzaAmyloidosis is a multisystem disease that results from extracellular deposition of amyloid fibriles in tissue and cardiac involvement may be seen. Cardiac amyloidosis is a rare and mostly underdiagnosed cause of heart failure. Several types of amyloid can infiltrate the myocardium. Diagnosis is usually made with endomyocardial biopsy. Scintigraphic imaging with Technetium (Tc-99m) labelled biphosponates may facilitate early detection of cardiac involvement and distinguish various forms of cardiac amyloidosis. The aim of this guideline is to assist nuclear medicine physicians in recommending, imaging, reporting and interpreting the results of scintigraphy with Tc-99m labelled bone radiopharmaceuticals for the evaluation of transthyretin cardiac amyloidosis. © Telif Hakkı 2020 Türkiye Nükleer Tıp Derneği / Nükleer Tıp Seminerleri, Galenos Yayınevi tarafından yayınlanmıştır.Öğe Procedure Guideline with F-18 FDG PET/CT in Large Vessel Vasculitis(Galenos Publishing House, 2024) Ertürk, Seyit Ahmet; Özkan, Elgin; Demir, Hakan; Çağlıyan, Feyza; Özdemir, Semra; Karaçavuş, Seyhan; Yalçın, HülyaLarge vessel vasculitis is defined as an inflamatuar disease that mainly affects large arteries, with two main variants, Takayasu arteritis and giant cell arteritis (GCA). GCA may be associated with polymyalgia rheumatica (PMR), a rheumatic inflammatory condition characterized by inflammation of periarticular structures. Fluorine-18 (F-18) fluorodeoxyglucose (FDG) positron emisyon tomography (PET)/computed tomography (CT) is a functional imaging technique frequently used in oncology and plays an important role in the field of inflammatory diseases. The aim of this guideline is to assist nuclear medicine physicians in determining indications, patient preparation, imaging methods, evaluation and reporting stages during the evaluation of patients with suspected or diagnosed large vessel vasculitis and/or PMR with F-18 FDG PET/CT. © 2024 Galenos Publishing House. All rights reserved.Öğe Prognostic Prediction of BRCA Mutations by F-18-FDG PET/CT SUVmax in Breast Cancer(Turkish Society of Nuclear Medicine, 2021) Özdemir, Semra; Sılan, Fatma; Akgün, Mehmet Yılmaz; Aracı, Nilgün; Çırpan, İsmail; Öztürk, Fulya Koç; Özdemir, ÖztürkObjectives: This study aimed to investigate the prognostic prediction of germline BRCA1 and BRCA2 mutations by comparing the maximum standardized uptake value (SUVmax) obtained from18fluoride-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), which is considered a prognostic factor in breast cancer (BC). Methods: Retrospective interdisciplinary laboratory results of 92 patients with BC who had germline BRCA1 or BRCA2 mutation profiles and underwent18F-FDG PET/CT were compared. Genotyping was made by next-generation sequencing, and PET/CT scans were re-evaluated. The histopathological data, genetic results, and clinical demographics of all patients were recorded. Patients were divided into two groups in accordance with the presence of germline BRCA1 and/or BRCA2 mutations. Between-group statistical comparison was performed. Results: In PET/CT performed for primary staging, patients with BRCA-positive BC had significantly higher SUVmax (p=0.039), larger tumor size (p=0.025), and presence of axillary nodal metastases (p=0.023) than patients with BRCA-negative BC. Although the Ki-67 index was higher in the BRCA-positive group than BRCA-negative group, this difference was not significant (p=0.157). Moreover, in the BRCA-positive and negative groups, SUVmax, Ki-67 index, and tumor size, grade, and stage were significantly correlated with each other. Conclusion: The results of this study showed a strong association between BRCA mutations and SUVmax, which indicates the poor prognosis of BC.Öğe Standardized Reporting of Myocardial Perfusion SPECT Imaging(Galenos Publishing House, 2020) Tosun, Fevziye Canbaz; Demir, Hakan; Taşçı, Cengiz; Özdemir, Elif; Özdemir, Semra; Şen, Feyza; Altun, Gülay DurmuşMyocardial perfusion single photon emission computerized tomography (MPS) report is the final product of a series of complex procedures, starting with patient preparation and ending with interpretation of the process. The report should summarize the patient’s identity, the purpose(s) of the test, all the procedures, drugs and radiopharmaceuticals performed, and the characteristics of the practicing physician and clinic as much as clearly possible. The aim of this guide is to assist nuclear physicians in MPS studies, especially during the reporting phase.The recommendations in this guide were prepared by “Turkey Society of Nuclear Medicine Cardiology Task Group”, to ensure the standardization of our MPS reporting in our country, considering the developments and contribution of the structured reporting into the clinical practice in the light of international studies and current guidelines. © Telif Hakkı 2020 Türkiye Nükleer Tıp DerneğiÖğe Tc-99m DMSA scintigraphy in the diagnosis of renal anomalies: A Turner syndrome case(2013) Özdemir, Semra; Tan, Yusuf Ziya; Topalo?lu, Naci; Sılan, Fatma; Tekin, MustafaTurner syndrome (45, X0) is a chromosomal abnormality characterized by short stature, ovarian failure, streak gonad, hypertension, autoimmune thyroid disease, heart and renal anomalies. Here we report a case of Turner syndrome associated with crossed renal ectopia with fusion anomaly. A 8 year-old girl who had growth retardation and frequent urinary tract infection was investigated by Tc-99m DMSA scintigraphy. DMSA scan imaging showed crossed renal ectopia with fusion anomaly. The current case showed us once again that static renal Tc-99m DMSA scintigraphy imaging is an important diagnostic tool. It can not only determine renal cortical function but also can determine the congenital anomalies of the kidney including fusion anomalies. Copyright © 2013 by Türkiye Klinikleri.Öğe The molecular etiological parameters in thyroid cancer(Cumhuriyet University, Faculty of Medicine, 2014) Özdemir, Semra; Özdemir, ÖztürkThyroid cancer is a common endocrine malignancy its prevelance is increasing worldwide. Currently, the application of molecular technologies has focused on etiological parameters for the accurate diagnosis and therapy of thyroid cancer. Until now in this issue many molecular and immunohistochemical parameters have been reported. Recent literature show that strong association between genetic parameters and thyroid cancer. Initiation and progression of thyroid cancers arise as the consequence of multiple genetic and epigenetic alterations such as; structural point mutations, chromosomal rearrangements and epigenetic events that activate proto-oncogenes and inactivate tumor suppressor genes. There are lots of various tumor-suppressor genes are epigenetically silenced in thyroid cancers. Gain-of-function for proto-oncogenes and loss-of-function for tumour supressor genes have a crucial role in the initiation and/or progression of the thyroid carcinogenesis. The determining of somatic and/or germline molecular alterations have been recognized as helpful diagnostic and prognostic markers and valuable tools for the management of tumoural/nontumuoral nodules in thyroid cancer patients. Known details about those molecular etiological parameters provide further research and clinical development targets, novel diagnostic and therapeutic strategies for thyroid cancers treatment. Current article reviews the molecular etiological alterations in thyroid cancer that help identify relevant biologic pathways to drive cancer development. Direct and undirect moleculer ethiological parametes and action mechanisims that play crucial role in the thyroid cancers widely reviewed in the currenr report. © 2014, Cumhuriyet University, Faculty of Medicine. All rights reserved.Öğe Tiroid kanserinde moleküler etyolojik faktörler(2014) Özdemir, Semra; Özdemir, ÖztürkTiroid kanseri en sık görülen endokrin kanserdir ve dünya çapında sıklığı giderek artmaktadır. Sonzamanlardaki moleküler teknolojik çalışmalar, tiroid kanser tanı ve tedavisinin doğru yapılabilmesiiçin etyolojik parameterlere yoğunlaşmış durumdadır. Şimdiye kadar bu konuda üzerindeçalışılmış birçok moleküler ve immünohistokimyasal parametre bildirilmiştir. Son literatürbilgileri, tiroid kanseri ile genetik parametreler arasında güçlü bir ilişkinin olduğunu ortayakoymuştur. Normal tiroid dokusunda kanser tetiklenmesi ve ilerlemesi, nokta mutasyonlar,translokasyonlar, kromozomlararası yeniden düzenlemeler (rearrangements), aktif proto-onkogenve inaktif tümör baskılayıcı gen şeklinde meydana gelen epigenetik alterasyonlar gibi çoklugenetik ve epigenetik değişikliklerle gerçekleşmektedir. Yine son rapor edilen literatür bilgileri,proto-onkogenlerin fonksiyon kazanarak ve tümör süpresör genlerin ise fonsiyon kaybederek tiroidkanserlerinin tetiklenmesinde ve/veya ilerlemesinde görev yapmaları bu gen ailelerininkarsinogenezisde antagonistik bir etkiye sahip olduklarını göstermektedir. Tiroid doku tümörlerive nodüllerinin, moleküler genetik belirteçler açısından (somatik, germ-line) kimliklendirilmesininmalign-benign doku ayırt edilmesinde, kesin tanı ve etkin tedaviçin hayati öneme sahiptir. Her birkanser olgusunda özgün moleküler genetik değişikliklerin neler olduğu öncelikle tespit edilmelidir.Ancak bu durumda kanser subtiplemesi doğru yapılabilir ve bu doğrultuda hastanın doğru ve etkintedavi alması sağlanabilir. İlgili nodül ve tümör dokusunun neden kanserleştiğinin ipuçlarını yineiçinde barındırmaktadır, bu moleküler etyolojik sebeplerin doğru tespiti tiroid kanserlerinintedavisi için yeni ve etkin tedavi stratejilerinin geliştirilmesine olanak sağlar. Bu derlememakalesinde son literatür bilgileri ışığında tiroid kanserlerinde doğrudan ve/veya aracılık edenmoleküler genetik paremetreler ve etki mekanizmaları olabildiğince geniş bir spektrumda elealınmıştır.
