Karcinom želuca

master's thesis

• Title (english): Gastric cancer
• Author: Saša Kolar
• Mentor: Branko Troskot (mentor)
• Committee member: Neven Ljubičić (predsjednik povjerenstva)
• Committee member: Marko Jakopović (član povjerenstva)
• Committee member: Branko Troskot (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Želučani karcinom zauzima drugo mjesto na svjetskoj ljestvici uzroka smrti od
malignih bolesti i ubraja se u teško izlječive maligne bolesti, ponajprije jer se u većini slučajeva dijagnosticira u poodmaklom stadiju. Želučani karcinom je jedna od nekoliko malignih bolesti za koju se dokazalo da infektivni agensi imaju bitnu etiološku ulogu.
Infekcija s H. pylori uzrokuje kronični aktivni gastritis, koji može predstavljati rizičnu stepenicu u kaskadi razvoja želučanog karcinoma. Epstein-Barr virus (EBV) je detektiran u 2-16 % želučanih karcinoma u svijetu, no unatoč tome, njegova uloga u karcinogenezi nije jasno utvrđena. U okolišne, neinfektivne etiološke čimbenike ubrajaju se i dijeta bogata solju, nitratima, a siromašna antioksidansima. Identificirana su 3 onkogena puta koja su deregulirana u većini slučajeva (>70%) želučanih karcinoma: proliferaciju/matične stanice, NF-kappaβ i Wnt/beta-katenin puteve.
Njihovo istraživanje sugerira da interakcija ovih procesa može imati važnu ulogu u usmjeravanju progresije bolesti i određivanju stope preživljenja. Izbor terapije zahtijeva prethodno određivanje stadija maligne bolesti, a najčešće se koristi TNM-klasifikacija, o kojoj ovisi i prognoza bolesti. Na raspolaganju je više terapijskih modaliteta: kirurški (kurabilne i nekurabilne resekcije, palijativni op. zahvati),
adjuvantna i neoadjuvantna kemo i radio terapija, simptomatsko liječenje.

Abstract (english)

Gastric cancer is the second leading couse of death from malignant disease in the
world and is one of the most difficult malignancies concerning the treatment, primarily
because in most cases it is diagnosed in late stages. Gastric cancer is one of the few
malignancies for whom has been proven that the infectious agent plays an important
etiologic role.
Infection with H. Pylori causes chronic active gastritis, which may represent a risky step in the cascade of the development of gastric cancer. Epstein-Barr virus (EBV)
has been detected in 2-16 % of gastric cancer in the world, but its role in
carcinogenesis is not clearly established. The environmental, non-infectious etiological factors include the diet rich in salt, nitrates and low in antioxidants.
Ooi et al. identified 3 oncogene patways that are deregulated in the majority of cases
(>70 %) of gastric cancer: proliferation/stem cells, NF-kappaβ and Wnt/beta-catenin
pathways. Their research suggests that the interaction of these processes may play
an important role in guiding the progression of the disease and determining the
survival rates. The choice of therapy requires pre-staging of malignant disease, most
commonly using TNM-classification which plays an important role in the prognosis of
the disease, too. There are more than few therapeutic modalities: surgery (curable
and incurable resection, palliative surgery), adjuvant and neoadjuvant chemotherapy
and radiotherapy and symptomatic treatment.

• Keywords: želučani karcinom; infektivni agensi; H. pylori; etiološki čimbenici; TNM-klasifikacija
• Keywords (english): gastric cancer; infectious agents; H. Pylori; etiological factors; TNM-classification
• Language: croatian
• URN:NBN: urn:nbn:hr:105:275893
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-12 14:33:56