Is BECLIN-1 Immunoreactivity More Effective than HBME-1 in Diagnosis of Papillary Thyroid Cancer?

BACKGROUND: Even though morphologic findings are generally important in the diagnosis of thyroid tumors, in some cases, morphologic similarities between benign and malignant lesions lead to noticeable differences in evaluation and different diagnoses in the same cases. In our study, we researched whether the autophagy-related protein Beclin-1 (BECN1) is a diagnostic marker in thyroid tumors, as well as its correlation with HBME-1, which has high sensitivity and specificity in distinguishing malignant thyroid lesions. METHODS: Samples from 136 patients that received a thyroidectomy were fixed in 10% formalin. All cases had hematoxylin & eosin (H&E) stains available for review and paraffin blocks for immunohistochemical staining. In immunochemistry tests, BECN1, HBME-1, and Ki-67 were studied. RESULTS: BECN1 immunoreactivity rates were found to be 98.9% in papillary thyroid carcinoma (PTC), 57.1% in follicular carcinoma (FC), and 21.4% in follicular adenoma (FA). HBME-1 immunoreactivity was 100% in PTC, 85.7% in FC, and 64% in FA. In thyroid carcinomas, BECN1 was as effective as HBME-1 as a marker for the diagnosis of malignancy. CONCLUSIONS: We revealed an important role of autophagy in thyroid carcinogenesis, as evidenced by the high rate of BECN1 immunoreactivity in PTC and FC. Moreover, we found that autophagy plays a more important role in PTC, as evidenced by the high immunoreactivity rates. According to our results, BECN1 is a more specific marker than HBME-1 in PTC and has a higher correlation with Ki-67. In routine studies, BECN1 will be more helpful than HBME-1 in the diagnosis of PTC.

Screening of persistent trophoblastic disease with various serum markers.

Eighty percent of the patients with molar pregnancy go into spontaneous remission and do not require any therapy. Serial hCG determinations can identify the 20% who will develop malignant sequelae. It does not seem appropriate to treat all patients. This study was designed to assess several serum markers, including free beta-hCG, total beta-hCG, and CA-125 in order to identify persistent trophoblastic disease. The study was performed at Doctor Zekai Tahir Burak Women's Hospital, Department of Oncology. Forty-seven patients with complete hydatidiform mole were included in the study. In the spontaneous remission group (Group I), total betahCG, CA-125 and free betahCG values were 27988.7+/-18491.6 mlU/ml, 51.7+/-74.7 U/ml and 42.35+/-28.4 mlU/ml, respectively. Patients in whom persistent trophoblastic disease had developed (Group II) the mean serum CA-125 and mean total betahCG values were lower than in group I, whereas the mean free betahCG value was higher but not significant. The mean value of free betahCG per total betahCG was found to be significantly higher in group 2. The free betahCG per total betahCG ratio seems to be a sensitive predictor of persistency of trophoblastic disease. Further prospective studies with a larger series of patients may warrant the exact predictive value of free betahCG per total hCG ratios.

Hydatidiform mole: clinical analysis of 310 patients.

OBJECTIVES: The aim of the study was to analyze the clinical characteristics, treatment and outcome of 310 patients with hydatidiform mole. METHODS: Three hundred ten patients with hydatidiform mole admitted to Dr Zekai Tahir Burak Women's Hospital between 1989 and 1994, were evaluated retrospectively according to their clinical characteristics, treatment modalities and follow-up. RESULTS: The incidence of molar pregnancy was 2.48 per 1000 deliveries and 1.84 per 1000 pregnancies. The age of the patients ranged from 14 to 45 years with a mean age of 25.29 +/- 7.40 years. In 60% of the patients, the molar pregnancy was their first pregnancy. A history of previous hydatidiform mole was found in 5.5% of the patients and eight of them had at least two previous molar pregnancies. The most common presenting symptom was vaginal bleeding (71%). Although theca-lutein cysts were found in 17.1% of the patients, only one patient underwent emergency surgery because of torsion. Dilatation and suction curettage was the first-line treatment; uterine perforation developed in two patients (0.6%). During follow-up 14.5% of patients were diagnosed as persistent cases according to serum beta-human chorionic gonadotropin (beta-hCG) levels. Complete remission was achieved with the administration of 2-8 courses of single-agent chemotherapy in 43 cases; combined chemotherapy (3-7 courses) was given to two patients who were resistant to single-agent therapy. CONCLUSION: Comparison of patients with spontaneous remission and patients with persistent trophoblastic disease with respect to age, histologic type, previous history, initial uterine size, gravidity, presence of theca-lutein cysts and initial beta-hCG levels did not reveal any of the above criteria to be prognostic for the occurrence of persistent disease.

Vulvar syringoma exacerbated during pregnancy.

Although syringoma of the eyelids and the cheeks are well known and defined, vulvar syringoma is a rare clinical variant of this benign eccrine tumor. A case of syringoma of the vulva exacerbated during pregnancies with regression in the periods in between is presented. Histopathological examination showed typical features of syringomas. Only 20 patients with vulvar syringoma have been previously reported in the literature.

Demographic and epidemiologic features of female adolescents in Turkey.

OBJECTIVES: To determine the average menarcheal age and menstrual cycle pattern, prevalence of dysmenorrhea, frequency of smoking, alcohol and drug use, sexual education level, and the gynecologic problems in female adolescents in Turkey. METHODS: A questionnaire consisting of 43 questions were given to 13,665 high school girls between the ages 13-18 years. RESULTS: The results showed that average menarcheal age was 13.28 +/- 1.09 years and 77.8% of the girls had menstrual cycles between 20-35 days; 10,688 (78.1%) of the girls complained about pain during their menstruation and 25.6% frequently missed school for this reason. That notwithstanding, only 0.4% of the adolescents with dysmenorrhea had sought medical consultation. Out of 13,665 girls, 19.7% smoked cigarettes, 14.9% used alcohol, and 0.63% used other drugs. Although 50.8% of the students believed that their knowledge about sexuality was adequate, on evaluating the results, this was not confirmed. Girlfriends were found to be the most important source of sexual knowledge. The study indicated that 88.8% of the girls wanted to have sexual education at schools and 60.5% of those preferred to take such a lecture together with boys. The study also revealed that 10.5% of the girls previously consulted a gynecologist and menstrual disorders (26.1%) and dysmenorrhea (23.4%) were the most common complaints. The results showed that 68.7% of the girls preferred a woman gynecologist and 66.3% wanted to be alone with the doctor during examination. CONCLUSION: We provided data about demographic and epidemiologic features of Turkish female adolescents.