Browsing by Author "Calapkulu, Murat"

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Clinicopathological Predictors of Central Lymph Node Metastasis in Clinically Node-Negative Papillary Thyroid Carcinoma: A Retrospective Cohort Analysis
(Springer, 2025) Sakiz, Davut; Calapkulu, Murat; Sencar, Muhammed Erkam; Unsal, Ilknur Ozturk; Kartal, Mehmet Zabit; Ucan, Bekir; Cakal, Erman
PurposeThis retrospective cohort study aimed to identify clinicopathological predictors of central lymph node metastasis (CLNM) in patients with papillary thyroid carcinoma (PTC).MethodsA total of 503 patients with PTC who underwent thyroidectomy with central lymph node dissection were included. Preoperative clinical data, ultrasonographic features, and postoperative histopathological characteristics were analyzed.ResultsCLNM was detected in 209 (41.55%) patients. Male sex (odds ratio [OR] = 3.12, 95% CI: 1.82-5.35), irregular nodule borders (OR = 2.02, 95% CI: 1.25-3.26) and higher risk categories in the American Thyroid Association (ATA) ultrasonographic pattern stratification system (OR = 13.312, 95% CI: 8.623-20.551) were identified as independent preoperative predictors of CLNM. A simplified model incorporating only the ATA ultrasonographic pattern stratification system and male sex achieved 83.5% accuracy in predicting CLNM. Histopathological evaluation revealed lymphovascular invasion (OR = 4.61, 95% CI: 2.81-7.55), extrathyroidal extension (OR = 2.41, 95% CI: 1.52-3.83), and multifocality (OR = 1.58, 95% CI: 1.04-2.40) as independent predictors of CLNM, while lymphocytic thyroiditis (OR = 0.59, 95% CI: 0.39-0.89) was a protective factor.ConclusionThis study establishes that ATA ultrasonographic suspicion patterns combined with the male sex provide an accurate and simplified model for preoperative CLNM prediction in PTC, outperforming complex nomograms. Key independent predictors included male sex, irregular nodule margins, ATA high-risk patterns, lymphovascular invasion, extrathyroidal extension, and multifocality, while lymphocytic thyroiditis was protective. According to the current study, risk assessment and personalized management should favor a holistic approach, rather than focusing solely on individual risk factors.
Serum Selenium Levels and Subacute Thyroiditis: Associations With Disease Course and Long-Term Outcomes in a Case-Control Study
(BMC, 2025) Cakal, Erman; Sakiz, Davut; Calapkulu, Murat; Sencar, Muhammed Erkam; Unsal, Ilknur Ozturk; Hepsen, Sema; Bostan, Hayri
BackgroundSubacute thyroiditis (SAT) is an inflammatory disease that induces thyrotoxicosis. Selenium is an essential trace element in thyroid physiology, which has anti-inflammatory and antioxidant properties. However, the relationship between serum selenium levels and SAT has not been well studied. The objective of this study was to evaluate serum selenium levels in patients with SAT compared to healthy controls and to investigate potential correlations between selenium status and clinical outcomes, including disease severity, delayed remission, recurrence, and the development of permanent hypothyroidism.MethodsThis case-control study included 59 patients with SAT and 50 healthy control subjects. Serum selenium levels were analysed using inductively coupled plasma mass spectrometry.ResultsThe serum selenium levels of patients with SAT were 69.10 (24.60-130.20) mu g/L, while those of the control group were 64.20 (39.21-106.80) mu g/L (p = 0.121). A negative correlation was detected between serum selenium levels and erythrocyte sedimentation rate, C-reactive protein, neutrophil-to-lymphocyte ratio, free thyroxine, and pain severity. Serum selenium levels did not significantly differ in terms of the response to initial treatment, recurrence, and permanent hypothyroidism.ConclusionThe study results showed no significant difference in serum selenium levels between patients with SAT and the control group. These results suggest that although lower serum selenium levels may be associated with a more severe and painful SAT course, there is no impact on the long-term prognosis.