Volume 47, Issue 6

Mortality can be significantly reduced if noninvasive molecular markers that are effective in the diagnosis of both early colorectal cancers and precancerous lesions are used in screening tests.In this study, our aim is to review the studies conducted with molecular markers obtained noninvasively for diagnosis in early-stage colorectal cancer and precancerous lesions and to reveal the most efficient and cost-effective ones.In our study, it has been shown by analyzing noninvasive molecular markers used in the diagnosis of early-stage colorectal cancers and precancerous lesions, that high rates of effective diagnosis can be obtained after given screening processes, even if these are relatively less effective. In particular, miR-21 in faeces and plasma has been found to be the most efficient and cost-effective biomarker.In order to reduce mortality in colorectal cancers, screening tests should be performed with molecular markers that are effective in early-stage colorectal cancers. However, novel biomarkers are also needed to detect both early colorectal cancers and precancerous lesions. When miR-21 analysis in stool and plasma is widely used as a screening test for early-stage colorectal cancer and precancerous lesions, early diagnosis rates can be significantly increased and mortality rates reduced.

Objectives This study aimed to evaluate the effect size of each parameter used in the first trimester Down syndrome (DS) risk analyses by using multiple regression analysis techniques. Methods This data mining study included data of 44,260 pregnant women screened at the Acibadem Labmed laboratories from 2010 to 2019. In this study, risk was calculated using the PRISCA software on the basis of nuchal translucency (NT), crown-rump length measurement, in vitro fertilization application, diabetes mellitus, Down syndrome story, smoking, maternal age, and the level of maternal serum biochemistry markers including pregnancy-associated plasma protein-A (PAPP-A) and free beta-human chorionic gonadotropin (hCGβ). Results Forty-four thousand two hundred sixty risk analysis patients result data were re-investigate, and 851 (1.93%) risk analysis results were found as positive. PAPP-A 747 (CI%, 476–1,170) times, NT value 512 (CI%, 343–764) times, DS story 21 times (CI%, 6.7–63.2) and hCGβ value 7.01 (CI%, 6.31–7.79) times affect the combined first-trimester risk analysis results. Conclusions We have suggested that those accurate PAPP-A levels and NT levels evaluation are the most critical point of combined risk analysis and that the risk of free hCGβ levels after PAPP-A is essential as a biochemical test.

Objectives Vitamin D is one of the major hormones involved in the metabolism of calcium (Ca) and phosphorus (P). In the present study, we aimed to determine the analytical performance of the immunoassay method used for determining plasma 25-hydroxyvitamin D [25(OH)D] levels in routine clinical practice in laboratories. Methods Venous blood samples were collected from 156 patients for the comparisons and were analyzed with Siemens ADVIA Centaur XPT, the Roche Cobas 6,000’s module e601, Abbott Architect i2000, and the liquid chromatography with tandem mass spectrometry (LC-MS/MS). Results The four methods were analyzed and compared through the Passing-Bablok regression for 25(OH)D, and the highest correlation was found at LC-MS/MS and Cobas 6,000’s module e601 (r=0.799), LC-MS/MS/Abbott Architect i2000, and LC-MS/MS/Siemens ADVIA Centaur XPT as r=0.736, 0.721, respectively. The correlation coefficient was found between Abbott Architect i2000 with Roche Cobas e601 and Siemens ADVIA Centaur XPT as r=0.934 and r=0.907, respectively. Also, the correlation coefficient was found between Roche Cobas e601 and Siemens ADVIA Centaur XPT as r=0.906. Conclusions The Roche Cobas assay showed better performance, compared with the other assays. Based on our findings, the chemiluminescence methods in automated systems seem to be expedient.

Objectives In clinical laboratories, it is common to obtain serum and plasma by using a barrier tube due to its various advantages. In this study, we aimed to compare 18 biochemistry analytes in outpatient clinic and outpatient oncology patients by measuring in a Barricor tube and a serum separator tube (SST). Methods Venous blood was drawn into the Barricor tube and SST from volunteers consisting of outpatients and outpatient oncology patients. The biochemical parameters were measured using the AU2700 autoanalyser (Beckman Coulter Inc., CA, USA) and Beckman Coulter Access immunoanalyser (Beckman Coulter Inc., CA, USA). The biochemical analytes evaluated in the two participant groups were compared between the Barricor tube and SST. Results In the study, when the results in both the outpatient group and the outpatient oncology patient group, bias (%), allowable bias (%), CV (%), allowable CV (%), total error (%), total allowable error (TEa) (%) were evaluated; potassium (K) total error (%) between Barricor tube and SST exceeded TEa, however, all other parameters were within TEa. Conclusions Considering its various advantages and compared biochemical analytes, we think that can be switched to the Barricor tube in clinical laboratories and the reference range change can be made for K.

Objectives The variability between methods is seen in the existence of hemoglobin (Hb), triglyceride (TG), blood urea nitrogen (BUN) and glucose in the specimens, which can affect the measurement. Therefore, this study aimed to compare boronate affinity chromatography and turbidimetric inhibition immunoassay methods for glycosylated hemoglobin (HbA 1c ) levels in samples containing different levels of Hb, TG, BUN and glucose. Methods In this study, a total of 412 consecutive samples were used for method comparison. The samples were divided into groups according to HbA 1c , TG, BUN, Hb, and glucose levels. Clinically significant changes for HbA 1c are defined as ≥0.5%. Results The mean relative difference as % was determined as 1.4% by the Bland–Altman plot of Trinity against Roche. The Passing–Bablok analysis indicated good agreement (r=0.985) between two methods. When compared the group with and without a clinically significant difference, we found differences only between glucose levels (p=0.003). Conclusions High glucose levels may cause a difference between the methods. Therefore, we suggest that a method’s performance and properties should be considered prior to clinical usage.

Objectives This study aims to demonstrate that proteolytic enzymes released as a result of hemolysis decrease the small peptide hormones, whereas N-phenyl maleimide (NPM) can be used to prevent hemolysis interference. Methods The serum/plasma pools were prepared at two different concentrations and divided into two equal volumes. NPM solution was added to one sample. The erythrocyte package was washed five times and then centrifuged after each wash. Hemolysis was induced by the osmotic shock method upon adding distilled water. 100 µL of hemolysate stock solutions were added over 400 µL of serum/plasma pool. Repeated five times. Results Negative interference was demonstrated on ACTH at 200 hemolysis index (HI) for low concentration, at 100 HI and 200 HI for high concentration, and insulin at 100 HI and 200 HI for high concentration. Addition of NPM which inactivates protease enzymes prevented the reduction of ACTH and insulin. No interference was observed at C-peptide and IGF-1 concentration until 200 HI. Conclusions Hemolysis was detected to degrade ACTH and insulin, which demonstrated how important the effect of hemolysis can be utilized in deciding whether to accept or reject samples. The addition of NPM can increase accuracy in clinical decisions as well as treatment.

Objectives We aimed to evaluate the effects of acute and chronic aerobic exercise on cognitive function and depression levels in patients with Type 2 Diabetes Mellitus (T2DM) and the changes in related neurotrophic and metabotropic factors. Methods Sixteen female patients (age=57.5 ± 7.3) diagnosed with T2DM were included. A and B sections of the Trail Making Test (TMT) and Beck Depression Inventory (BDI) were used to assess executive function and depression states. Brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), irisin, total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), fasting plasma glucose, hemoglobin A1c, and high-density lipoprotein (HDL) cholesterol were analyzed in blood. Aerobic exercise intensity was applied at 50–70% of the maximal heart rate for 40 min/day, three days weekly on the treadmill. All evaluations were repeated after one exercise session, a 12-week exercise program, and after one year for follow-up. Results TMT-A (p=0.001) and TMT-B (p=0.002) values were increased following both acute and chronic exercise. BDI scores were decreased after long-term exercise (p=0.031). Measurement of metabolic parameters revealed positive changes in HDL cholesterol (p=0.044), TAS (p=0.005), and OSI (p=0.009) values ​​after chronic period exercise. No significant difference was found in BDNF (p=0.271), NGF (p=0.230), and irisin (p=0.101) values ​​after acute or chronic exercise, on the other hand. Conclusions Although aerobic exercise training had a positive effect on metabolic and cognitive outcomes, this effect was independent of neurotrophic and metabotropic factors. Regular and long-term aerobic exercise training has protective and regulatory functions in T2DM.

Objectives This study was aimed to investigate the diagnostic values of serum levels of asprosin and neutrophil gelatinase-associated lipocalin (NGAL) in Retinopathy of prematurity (ROP) and to assess the role of these biomarkers on the development and progression of the condition. Methods This study was carried out from April 2020 to February 2021 in the department of ophthalmology of a tertiary hospital in Turkey. Thirty patients diagnosed with ROP and 30 healthy newborns were included the study. Serum NGAL and asprosin levels were determined via ELISA. Results The median serum NGAL levels were found to be similar between the ROP group and the control group (p=0.595). Median asprosin levels were significantly higher in patients diagnosed with ROP [46.58 (12.70–142.28) ng/mL] compared to healthy subjects [13.05 (10.92–17.73) ng/mL] (p=0.001). The optimal cut-off value of asprosin by ROC analysis was 30 ng/mL (AUC: 0.754, p=0.001) for diagnosing ROP. Serum asprosin levels were positively correlated with serum ALP levels and inversely correlated with gestational week, uric acid and AST values (all, p<0.005). Conclusions Our results demonstrated that asprosin, but not NGAL, could be a biomarker for the diagnosis of ROP.

Objectives We aimed to investigate retrospectively the association between the development of surgical wound infection after orthopedic surgery, and neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) obtained from complete blood count results. Methods A total of 120 patients who underwent orthopedic surgery between 2018 and 2020 were evaluated retrospectively in our study. Wound culture results, complete blood counts, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) values, orthopedic surgery, and wound types were obtained from the laboratory data administration system. The data were statistically analyzed using SPSS 22.0 software. Results A total of 70 patients who experienced surgical wound infection (66% males and 34% females) and 50 patients without wound infection (64% males and 36% females) were included in this study. The mean age was 46.8 ± 11.4 years for the patients with infection after surgery and 50.1 ± 11.7 years for the patients without infection. Preoperative CRP, NLR, and PLR, and post-operative white blood cell (WBC), neutrophils, ESR, CRP, NLR, and PLR values were significantly higher, and lymphocyte concentrations were significantly lower in the group with infection, in comparison with those without infection. In the postoperative period, CRP and ESR were high in patients with and without infection, while NLR was increased in only those with infection. A medium-level correlation was found between NLR and PLR, and CRP and ESR. Sensitivity was 66%, and specificity was 68% with a cut-off of >3.5 for NLR, while sensitivity was 42% and specificity was 71% with a cut-off of >135 for PLR. Conclusions We believe that the estimation of NLR and PLR values before the intervention in patients undergoing orthopedic surgery may be advantageous for identifying infection.

Objectives Dental caries is a multifactorial infectious disease caused by the colonization and proliferation of bacteria in the mouth. Recently, it has been reported that local antioxidant and oxidant status may play an important role in the pathogenesis of dental caries. Visfatin is an adipocytokine that enhances leukocyte activation and release of proinflammatory cytokines. In this study, our aim was to investigate the salivary visfatin levels, total antioxidant capacity (TAC), and total oxidant status (TOS) in patients with and without dental caries. Methods Saliva samples were collected from 50 caries-free individuals and 115 patients with dental caries who were admitted to Selcuk University Restorative Dentistry Clinics. Saliva samples were collected based on the stimulated saliva collection procedure. Visfatin levels were measured using enzyme-linked immunosorbent assay. Spectrophotometric methods were used to determine salivary TAC and TOS. Results Salivary TAC, TOS, and visfatin levels were statistically higher in patients with dental caries compared to caries-free group (p=0.035; p=0.003; p<0.001 respectively). There was a positive correlation between caries number and salivary TOS and visfatin levels. Conclusions Findings of this prospective study demonstrated that oxidative stress may be involved in the pathogenesis of dental caries. Salivary visfatin, TAC, and TOS may be novel markers to evaluate dental caries.

Objectives We measured the serum periostin levels in patients with DLBCL and determined whether the levels reflected the clinical findings. Methods This was a case-control study. DLBCL patients diagnosed between March 2021 and October 2021 (n=36) and healthy volunteers (n=36) (Control group) were included. The serum periostin levels of the two groups were compared. Moreover, subgroup analyses were conducted in the patient group. Results The serum periostin level was significantly higher in the patient than the control group (28.8 ± 3.2 vs. 15.1 ± 7.5 ng/mL, p=0.017). On subgroup analyses, the median serum periostin level of nine (25%) patients with bone marrow involvement was higher than that of the 27 (75%) lacking bone marrow involvement (12.7 vs. 21.7 ng/mL, p=0.018). On ROC analysis, the optimal periostin cutoff for bone marrow involvement was 17.3 ng/mL (sensitivity 77%, specificity 67%, AUC 0.765; 95% CI; 0.606–0.924, p=0.018). By the disease stage, the periostin level was higher in stage 4 patients than in those of other stages (21.3 vs. 12.0 ng/mL, p=0.029). Conclusions The periostin level correlated with such involvement; periostin may serve as a novel prognostic marker of DLBCL.

Objectives Metformin is the first choice for type 2 diabetes mellitus (T2DM) treatment in the guidelines and is used in combination with many drugs. Growth arrest-specific protein 6 (Gas6)/Axl signaling plays a role in many metabolic disorders. This study aims to investigate the effects of metformin and metformin-insulin combination used in patients with T2DM on Gas6, Axl, and soluble Axl (sAxl) levels. Methods A total of 71 patients diagnosed with T2DM and 21 healthy subjects were divided into 4 groups control, diet and exercises recommended (DER), metformin, and metformin + insulin. Diabetic patients were treated with metformin only or with a metformin-insulin combination and monitored for six months. Gas6, Axl, and sAxl levels of subjects’ sera obtained from their baseline and post-therapeutic sixth month blood samples were measured by ELISA methods. Results Compared to baseline, the sixth month Gas6 and Axl levels of metformin and metformin + insulin groups significantly decreased (p<0.05). However, there was no statistically significant difference in sAxl values for these two groups of patients. Conclusions The use of metformin in diabetic patients may be beneficial for inhibiting the Gas6/Axl pathway. This study presents a new aspect of the pleiotropic effects of metformin. This study will be clinically useful for designing therapeutic approaches targeting Gas6/Axl.

Objectives The serum Insulin-like growth factor-binding protein 7 (IGFBP7) levels were tested to predict acute renal damage that may develop in patients with stage III–IV heart failure who were treated with intravenous diuretics in the emergency department. Method Patients with stage III–IV heart failure (n=84) were included in this prospective observational study. All patients were treated with IV diuretic therapy in accordance with a predetermined protocol. The serum IGFBP7 and creatinine levels were analyzed at the beginning of the treatment (0 h), 6th, and 12th hours. The creatinine level and glomerular filtration rate (GFR) at baseline were compared with the 12th hour values. The results were classified according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease) criteria for each patient. The patients were divided into two groups as those in any RIFLE group (RIFLE (+)) and those without (RIFLE (−)). The groups were compared in terms of IGFBP7 levels. Results and Discussion 0, 6th, and 12th hour levels of IGFBP7 were significantly different between the RIFLE + and RIFLE – groups. (p=0.036, 0.042, and 0.006, respectively). The IGFBP7 levels were higher in RIFLE (+) group. However, the IGFBP7 values did not increase with time. In the ROC curve analyze for IGFBP7 levels, the cutoff with the highest sum of sensitivity (0.80) and specificity (0.69) was 118.71. Conclusions The serum IGFBP7 levels can predict the risk of developing AKI before the diuretic treatment in the patients with stage III–IV heart failure.

Objectives The role of vitamin D in primary osteoarthritis (OA) has not been clarified yet. vitamin D receptor (VDR) and fibroblast growth factor-23 (FGF-23) are proteins that play an important role in the metabolism of vitamin D. In this preliminary study, we aimed to examine serum 25-(OH) vitamin D 3 , VDR, and FGF-23 levels in primary knee OA patients. Methods This study includes 60 post-menopausal women who were enrolled into two groups with primary knee OA (n=30, age range between 59.6 ± 5.7 years) and control (n=30, age range between 61.7 ± 6.3 years). Serum levels of 25-(OH) vitamin D 3 were measured by chemiluminescence and serum VDR, and FGF-23 were measured by enzyme-linked immunosorbent assay methods. Results In knee OA group, serum levels of 25-(OH) vitamin D 3 were significantly lower (p=0.033), and serum VDR and FGF-23 levels were significantly higher than those of the control group respectively (p=0.000 and p=0.006). Also, FGF-23 levels showed correlations with 25-(OH) vitamin D 3 , VDR, and calcium levels (p<0.05). Conclusions This is the first study showing a relationship between serum VDR and FGF-23 in knee OA patients. Extensive clinical studies are required to assess the applicability of these parameters in clinical practice.

Objectives Bioactive compounds of Piper crocatum Ruiz & Pav, which have acted as antioxidants can be used to prevent and treat degenerative diseases such as hyperglycemia, cancer, gout and hypertension. This research aimed to determine the highest antioxidant activity from extract and fractions of P. crocatum leaves and to identify the active compounds such as antioxidants. Methods The extraction was performed by maceration with 70% ethanol and then the crude extract was fractionated with three solvents, namely n-hexane, ethyl acetate and water. The identification of antioxidant activity was carried out using Rancimat and CUPRAC. The active compounds was identified using LC-MS (liquid chromatography-mass spectrometry). Results The highest of the Rancimat method was obtained from the ethyl acetate fraction with a protective factor value of 1.38. Ten compounds were identified in the ethyl acetate fraction of P. crocatum leaves. An antioxidant activity according to the CUPRAC method showed the highest antioxidant activity in the sample of the n-hexane fraction with a value of 31.9 µmol Trolox/g extract. Thirteen compounds were identified in the n-hexane fraction of P. crocatum leaves. Conclusions The highest antioxidant activity was obtained from ethyl acetate and n-hexane fraction. Various active compounds was identified in the highest value sample.

Objectives Oncogenic signaling pathways that are activated abnormally play a key activity in tumor initiation and development. This research aimed to examine the preventive efficiency of lycorine in the buccal pouch hamster tumor model based on its capacity to target phosphoinositide 3-kinase (PI3K)/Akt and nuclear factor-kappa B (NF-κB) signaling cascades. Methods The induction of oral tumor in male golden Syrian hamsters was done by 7,12-dimethylbenz [a] anthracene (DMBA) painting on the left buccal pouch thrice a week for 10 weeks. The chemopreventive effect of lycorine (20 mg/kg b.w.) was assessed by treating orally for 14 weeks of the experimental period. The biochemical endpoints such as lipid peroxidation (LPO), antioxidants, and phase I and II detoxification agents were analyzed. Results The treatment of lycorine to DMBA-induced hamsters drastically suppressed tumor incidence and tumor size and reverted the levels of the biochemical indicator. Moreover, lycorine significantly downregulated the p53, Cyclooxygenase 2 (cox-2), and P13K/Akt signaling and inhibited the phosphorylation of NF-κB and nuclear factor-kappa-B-inhibitor alpha (Iκ-Bα) in DMBA-induced hamsters. Conclusions The oral administration of lycorine effectively inhibited tumor cell proliferation, restored the antioxidant, LPO, and detoxification enzymes, and inhibited NF-κB signaling in oral tumorigenesis. Thus, the use of lycorine after a proper clinical trial could be effective for oral tumorigenesis treatment.

Objectives Acrylamide, a widely used chemical in industry, clinical laboratory and waste treatment plants, is considered a carcinogen in humans. The present study examined the hormonal, hematologic, and genotoxic responses in the invertebrate model common carp Cyprinus carpio after exposure to sublethal acrylamide. Methods Fish were exposed to acrylamide at 10 and 50 mg/L for 96 h, along with the respective control group. Serum levels of cortisol and thyroid hormones were measured using diagnostic ELISA direct immunoenzymatic kits. For micronucleus (MN) frequency assay, thin smears of the peripheral blood of fish were prepared. Results Serum levels of cortisol in both treatment groups considerably increased, which proposed that acrylamide caused a stress reaction of acrylamide exposed fish (p<0.05). Fish demonstrated significant decreases in triiodothyronine (T 3 ), free thyroxine (FT 4 ), and free triiodothyronine (FT 3 ) concentrations in a dose-dependent manner after acrylamide exposure (p<0.05). However, serum thyroxine (T 4 ) concentrations did not alter significantly in the treatment groups. Mean MN frequencies of fish erythrocytes increased significantly in acrylamide exposed groups suggesting that acrylamide is genotoxic in common carp (p<0.05). The hematocrit, hemoglobin, and erythrocyte numbers of carp increased significantly in exposure groups (p<0.05). Conclusions These results suggested that acrylamide can significantly affect the hemopoietic system. Furthermore, this study confirmed that the widespread use of acrylamide, even in sublethal concentrations, could affect the survival of non-target organisms, especially fish, in aquatic environments.