Although the sensitivity of reverse transcriptase-polymerase chain reaction (RT-PCR) is low in the diagnosis of coronavirus disease 2019 (COVID-19), it is the gold standard. Clinical improvement is prioritized in the follow-up of patients with COVID-19 who are followed as possible or definitive cases. Although the priority in the discharge decision is the resolution of complaints, it is also important to see radiological improvement and RT-PCR negativity. A total of 2 of our patients who were hospitalized and treated in our clinic with a diagnosis of COVID-19 were discharged after their complaints were resolved and their treatment was completed. The patients had 2 negative RT-PCR results at discharge. Both of them presented to the hospital with symptoms such as fever, cough, and shortness of breath after the discharge, and both showed positive RT-PCR results. Considering recurrent COVID-19 infection, we aimed to present treatment and the 2 cases we followed.
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Aim: The excision repair cross-complementation group 1 (ERCC-1) protein is a potential prognostic biomarker of the efficacy of
platinum-based chemotherapy in non–small-cell lung cancer (NSCLC). The purpose of this study was to evaluate the clinicopathology
and prognostic significance of ERCC-1 expression, ERCC-1 (19q13) amplification in NSCLC patients; and the relationship between
platinum-based chemotherapy.
Materials and Methods: We used the ERCC-1 antibody to measure the level of expression of ERCC-1 protein by immunohistochemical
analysis from 351 patients and ERCC-1 gene copy number was evaluated by fluorescence in situ hybridization (FISH) in tumors
from 81 patients.
Results: ERCC-1 expression in tumor cells was positive in 312 patients (88.9%). The ERCC-1 amplification in tumor cells was positive
in 58 patients (71.6%) out of 81. The ERCC-1 amplification was also more frequent in early-stage tumors than late-stage tumors
(p = 0.025). In the patients with positive ERCC-1 expression, longer overall survival was associated with early stage NSCLC (p =
0.001). Patients having adenocarcinoma with negative ERCC-1 expression demonstrated longer overall survival than patients with
squamous cell carcinoma (p = 0.037).
Conclusion: Our study demonstrated that increased ERCC-1 amplification is not associated with ERCC-1 protein expression. High
ERCC-1 expression in patients with early-stage NSCLC is a good prognostic factor, although it is a negative predictor, indicating
treatment resistance, in patients with advanced-stage NSCLC receiving platinum-based chemotherapy. We suggest that patients
having adenocarcinoma with negative ERCC-1 expression benefit more with platinum-based chemotherapies.
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Erhan UĞURLU ,
Nazlı ÇETİN ,
Furkan UFUK ,
Nilüfer YİĞİT ,
Hüseyin Gökhan YAVAŞ ,
Seçim KOLAK ,
Neşe DURSUNOĞLU ,
Sevin BAŞER ,
Göksel ALTINIŞIK ,
Sibel PEKCAN ,
Ahmet ÇALIŞKAN
Purpose: We aimed to determine the number of possible and precise cases among the patients hospitalized
in our clinic and to examine the differences between the sociodemographic, clinical, chest CT and laboratory
findings of these two groups.
Materials and methods: The data of all patients hospitalized at the department of pulmonology service
between March 13 as the date of the first case and May 5 with probable and definitive COVID-19 were evaluated
retrospectively. Patient ward files and hospital data management system were examined. Chest CT findings of
the patients were interpreted by two radiologists separately according to the CO-RADS classification blinded to
clinical and PCR test results of the patients and then consensus was achieved with joint evaluation.
Results: A total of 99 patients, 38 RT-PCR positive, 61 RT-PCR negative, were included in the study. Neutrophilto-
lymphocyte ratio (NLR) values and lymphocyte count were lower at a statistically significant level in positive
patients (respectively p=0.038, p=0.041). Similarly, CRP values were observed to be lower at a statistically
significant level in positive patients (p=0.029). When the patients with RT-PCR (+) and RT-PCR (-) but with
positive chest CT findings according to CO-RADS staging were compared, the values of WBC, LDH and CRP
level was observed to be high were statistically significant in the group with RT-PCR (-) but positive chest CT
findings (respectively p=0,001, p=0,033, p=0,004). The highest AUC value was obtained in the model developed
using cough, WBC, LDH, CRP values and thorax CT score, and it was seen that this model could be successful
in distinguishing RT-PCR positivity (AUC=0.725, 95% CI:0.619-0.830).
Conclusion: In the presence of clinical findings, without waiting for RT-PCR positivity, the probability of
COVID-19 disease will increase if there are elevated WBC, CRP and LDH findings with CT findings (stage 4-5
according to CO-RADS).
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