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    Characteristics of Hepatocellular Carcinoma Aggressiveness Factors in Turkish Patients
    (Karger, 2018) Akkiz, Hikmet; Carr, Brian I.; Yalcin, Kendal K.; Guerra, Vito; Kuran, Sedef; Altintas, Engin; Uskudar, Oguz
    A large cohort of hepatocellular carcinoma (HCC) patients from several collaborating Turkish institutions were examined for the tumor parameters of maximum diameter (MTD), portal vein thrombosis (PVT), and alpha-fetoprotein (AFP) levels. A relationship was found between MTD and blood platelet levels. Patients with large >= 5 cm tumors who had normal platelet levels had significantly larger tumors, higher percent of PVT, and significantly lower blood total bilirubin and liver cirrhosis than similar >= 5 cm tumor patients having thrombocytopenia. A comparison of patients with and without PVT showed significantly larger tumors, greater multifocality, blood AFP, and C-reactive protein levels, and, interestingly, lower HDL levels in the patients with PVT. Fifty-eight percent of the total cohort had AFP levels <= 100 IU/mL ( and 42.1% had values <= 20 IU/mL). These patients had significantly smaller tumors, less tumor multifocality and percent PVT, lower total bilirubin, and less cirrhosis. There was considerable geographic heterogeneity within Turkey in the patterns of HCC presentation, with areas of higher and lower hepatitis B virus, hepatitis D virus, cirrhosis, and tumor aggressiveness parameters. Turkish patients thus have distinct patterns of presentation, but the biological relationships between MTD and both platelets and bilirubin levels are similar to the relationships that have been reported in other ethnic patient groups. (C) 2017 S. Karger AG, Basel
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    Characteristics of patients with hepatocellular carcinoma: A multicenter study
    (Kare Publ, 2022) Guzelbulut, Fatih; Karaogullarindan, Umit; Akkiz, Hikmet; Altintas, Engin; Demirtas, Coskun Ozer; Bahadir, Ozgur; Keklikkiran, Caglayan
    Background and Aim: The aim of the present study was to examine the etiology of hepatocellular carcinoma (HCC) by underlying cause and determine the characteristics and clinical features of patients with HCC. Materials and Methods: The study comprised 1802 HCC patients diagnosed and followed up by Liver Diseases Outpatient Clinics in 14 tertiary centers in Turkey between 2001 and 2020. Results: The mean age was 62.3 +/- 10.7 years, and 78% of them were males. Of the patients, 82% had cirrhosis. Hepatitis B virus (HBV) infection was the most common etiology (54%), followed by hepatitis C virus (HCV) infection (19%) and nonalcoholic fatty liver disease (NAFLD) (10%). Of the patients, 56% had a single lesion. Macrovascular invasion and extrahepatic spread were present in 15% and 12% of the patients, respectively. The median serum alpha-fetoprotein level was 25.4 ng/mL. In total, 39% of the patients fulfilled the Milan Criteria. When we compared the characteristics of patients diagnosed before and after January 2016, the proportion of NAFLD-related HCC cases increased after 2016, from 6.6% to 13.4%. Conclusion: Chronic HBV and HCV infections remain the main causes of HCC in Turkey. The importance of NAFLD as a cause of HCC is increasing.
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    Hepatitis C virus infection is probably associated with autoimmune disorders and malignancies but not with autoimmune thyroiditis
    (Asian Network for Scientific Information, 2007) Kuvandik, Guven; Helvaci, Mehmet Rami; Ozer, Cahit; Altintas, Engin; Kaya, Hasan; Duru, Mehmet
    In this study initially consecutive patients with Autoimmune Thyroiditis (AT) were taken in the Endocrinology Polyclinics. Beside that age and sex-matched patients with HCV infection and control cases were randomly studied in the Gastroenterology and Internal Medicine Polyclinics, respectively. One hundred and seventy-two patients with AT, 62 with HCV infection and 110 control cases were studied. AT was diagnosed in eight (12.9%) cases of the HCV infecteds' group and this ratio was 11.8% (13 cases) in the control group (p>0.05). Similarly, HCV infection was detected in one (0.5%) case of AT group and this ratio was 0.9% (one case) in the control group (p>0.05). Parallel to these results, prevalences of antithyroid peroxidase and/or antithyroglobulin antibodies were detected as 29.0% (18 cases) and 32.7% (36 cases) in the HCV infecteds' and control groups, respectively (p>0.05). As another face of the results, it was detected one case of monoclonal gammopathy of undetermined significance and one case of lichen planus in the HCV infecteds' group. As a conclusion, HCV infection may be associated with autoimmune disorders and malignancies but not with AT.