https://hdl.handle.net/11436/935 2026-07-31T05:42:52Z https://hdl.handle.net/11436/10982 Enhancing hepatocellular carcinoma surveillance: comparative evaluation of AFP, AFP-L3, DCP and composite models in a biobank-based case-control study Demirtaş, Coşkun O.; Akın, Şehnaz; Karadağ, Demet Yılmaz; Yılmaz, Tuba; Çiftçi, Uğur; Huseynov, Javid; Bulte, Tuğba Tolu; Kaldırım, Yasemin Armutcuoğlu; Dilber, Feyza; Özdoğan, Osman Cavit; Eren, Fatih Background/Objectives: Biomarkers such as lens agglutinin-reactive alpha-fetoprotein and des-gamma-carboxy prothrombin, as well as biomarker- and/or clinical-parameter-derived composite models (GALAD, GAAP, ASAP, aMAP, Doylestown), may improve detection in addition to alpha-fetoprotein, yet comparative data across diverse populations remain limited. Methods: In this biobank-based case-control study, we evaluated 562 adults (120 healthy controls, 277 chronic liver disease, 165 hepatocellular carcinoma) from January 2019 to 2024. Diagnostic performance for any-stage and early-stage hepatocellular carcinoma was assessed across three thresholds: Youden-index-derived optimal cut-offs, research-established cut-offs, and cut-offs ensuring 90% specificity. Receiver operating characteristic analysis was performed. Subgroup analyses were stratified by etiology and alpha-fetoprotein status. Results: At optimal cut-offs, GALAD showed the highest sensitivity for any-stage (90.3%) and early-stage (89.1%) hepatocellular carcinoma, with 70-80% specificity. Using established cut-offs, GALAD retained the highest sensitivity for any-stage (75.8%) and early-stage (57.8%) hepatocellular carcinoma, with 93.5% specificity. GALAD demonstrated the best performance in non-viral hepatocellular carcinomas (area under the curve 0.872), whereas GAAP and ASAP showed similarly high area under the curve values in viral etiology (area under the curve 0.955-0.960). Conclusions: Our results demonstrate the consistent performance of the GALAD score across diverse populations and underscore its superiority over individual biomarkers and other composite models. Notably, the GAAP and ASAP scores-which use one less biomarker (AFP-L3)-exhibited comparable performance, particularly in viral etiology. These findings support the integration of the composite biomarker models into tailored hepatocellular carcinoma surveillance strategies. 2025-01-01T00:00:00Z https://hdl.handle.net/11436/10978 GDF-15 levels in gouty arthritis and correlations with decreasing renal function: a clinical study Cüre, Osman; Yiğit, Ertuğrul; Yiğit, Merve Hüner; Uzun, Hakkı Background/Objectives: Gouty arthritis (GA) is a chronic inflammatory disorder frequently linked to systemic inflammation and impaired kidney function. Growth differentiation factor-15 (GDF-15) has been suggested as a potential biomarker involved in both inflammatory responses and renal dysfunction. Studies on GDF-15 serum levels and renal function decline in GA patients are limited. This study aimed to investigate serum GDF-15 levels in patients with GA and to evaluate the relationship between GDF-15 and renal function parameters. Methods: This prospective case-control study included 60 (intercritical group: 30; acute attack group: 30) patients with gout arthritis and 60 healthy controls, matched for body mass index and sex. The enzyme-linked immunosorbent assay measured serum GDF-15, and renal function and inflammatory markers were also assessed. Group comparisons used non-parametric tests, Spearman's analysis evaluated correlations, and receiver operating characteristic (ROC) analysis assessed diagnostic performance. Results: Serum GDF-15 levels were significantly higher in GA patients than controls (p < 0.001), especially during acute attacks. GDF-15 correlated moderately with renal function markers. ROC analysis showed high diagnostic accuracy for both acute (area under the curve (AUC) = 0.98) and intercritical gout phases (AUC = 0.96). Conclusions: Serum GDF-15 levels are increased in patients with gouty arthritis and are associated with impaired renal function. GDF-15 may serve as a helpful biomarker for disease activity and renal involvement in GA, but its interpretation should be considered in conjunction with other clinical and laboratory parameters. 2025-01-01T00:00:00Z https://hdl.handle.net/11436/10976 Immature platelet fraction as a sensitive biomarker in neonatal sepsis: diagnostic performance preceding thrombocytopenia Er, İlkay; Arpa, Medeni Background: Early and accurate diagnosis of neonatal sepsis remains a clinical challenge due to nonspecific signs and limitations of conventional biomarkers. The immature platelet fraction (IPF), a novel hematologic parameter reflecting thrombopoietic activity, has emerged as a potential early sepsis indicator. This study aimed to evaluate the diagnostic value of IPF in neonatal sepsis prior to the onset of thrombocytopenia. Methods: This prospective study enrolled neonates with early-onset sepsis (EOS), late-onset sepsis (LOS), and healthy controls. IPF, C-reactive protein (CRP), procalcitonin (PCT), and hematologic indices were measured at diagnosis and 48-72 h post-treatment. Diagnostic performance was evaluated via ROC curve analysis, and correlations between IPF and inflammatory/hematologic markers were examined. IPF levels were also compared based on blood culture results. Results: IPF levels were significantly higher in both EOS (n: 56) and LOS (n: 50) groups compared to controls (n: 44) (p < 0.001). ROC analysis showed excellent diagnostic performance, with AUCs of 0.98 (EOS) and 0.99 (LOS). Following antibiotic treatment, IPF levels declined significantly (p < 0.001), supporting its dynamic value. Strong and moderate correlations were found with MPV and CRP, respectively, and an inverse association with platelet count, but not with PCT. Moreover, IPF levels were higher in culture-positive cases compared to culture-negative ones (13.1% vs. 9.8%; p = 0.017) and exhibited diagnostic performance comparable to CRP in predicting blood culture positivity. Conclusions: This study presents original and clinically relevant data supporting IPF as a promising and practical hematologic biomarker for early detection and treatment monitoring of neonatal sepsis. Its integration into standard sepsis evaluation protocols may improve early risk stratification and clinical decision-making in neonatal intensive care settings. 2025-01-01T00:00:00Z https://hdl.handle.net/11436/10934 A case-control study on the role of carbonic anhydrase autoantibodies in the pathogenesis and diagnosis of fibromyalgia Kılıç, Hülya; Hasanova, Narmin; Topaloğlu, Mehmet Serhat; Şahin, Elif; Sağlam, Neslihan; Alemdar, Nihal Türkmen; Menteşe, Ahmet To investigate the levels and diagnostic significance of carbonic anhydrase I (CAI) and II (CAII) autoantibodies and oxidative stress status in fibromyalgia syndrome (FMS) patients. A total of 59 FMS patients and 53 healthy controls were included. CAI and CAII autoantibody levels were measured using a manual ELISA protocol. Serum malondialdehyde (MDA), serum total oxidant status (TOS), serum total antioxidant status (TAS), and oxidative stress index (OSI) were also analyzed. The mean CAI and CAII autoantibody levels were significantly higher in the FMS group compared to the control group (p < 0.000 and p < 0.003, respectively). FMS patients had significantly higher MDA, TOS and OSI levels(p < 0.000 for all comparisons), and lower TAS levels compared to controls but no significant differences (p > 0,705). Elevated CAI and CAII autoantibodies and altered oxidative stress markers in FMS patients suggest autoimmune processes and oxidative stress involvement in the pathogenesis of FMS, providing new insights into potential diagnostic and therapeutic approaches. 2025-01-01T00:00:00Z