Značaj biopsije limfnog čvora "stražara" u ranim stadijima malignog melanoma kože glave i vrata

master's thesis

• Title (english): Significance of sentinel - node biopsy in early - stage malignant melanoma of the head and neck
• Author: Anamarija Leventić
• Mentor: Mirko Ivkić (mentor)
• Committee member: Livije Kalogjera (predsjednik povjerenstva)
• Committee member: Vladimir Bedeković (član povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2017-07-14, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Maligni melanom je zloćudni tumor pigmentnih stanica kože i sluznica. Jedan je od najagresivnijih tumora u čovjeka. Iako melanom čini tek 4 % svih zloćudnih bolesti kože na njega otpada gotovo 80 % umrlih od kožnih tumora. Incidencija melanoma je u stalnom porastu posljednjih desetljeća stoga je melanom postao bolest javnozdravstvenog značaja. Zahvaljujući dobro razvijenoj limfnoj mreži, posebice u području glave i vrata, melanom može lako i brzo limfogeno i hematogeno metastazirati. U bolesnika u kojih su regionalni limfni čvorovi pozitivni preživljenje je 40 % do 50 % lošije nego u onih koji ih nemaju. Donald Morton je u ranim 90-im popularizirao biopsiju limfnog čvora stražara (SLNB) koja je danas zlatni standard u prognozi i daljnjem planiranju liječenja bolesnika s melanomom. Limfni čvor stražar (sentinel) je prvi limfni čvor u koji se drenira područje tumora. SLNB je indicirana u ranim stadijima melanoma kod kojih nema klinički, radiološki ili patohistološki dokazanih metastaza. Standardne tehnike koje se primjenjuju za SLNB su: preoperativna limfoscintigrafija, primjena limfotropne boje 'blue dye', te detekcija sentinela primjenom ručne gama kamere. U području glave i vrata SLNB se izvodi u općoj endotrahealnoj anesteziji. Kod pacijenata s pozitivnim sentinelom potrebno je napraviti disekciju vrata kako bi se spriječio daljnji rasap bolesti. Pacijente s negativnim sentinelom treba klinički pratiti.

Abstract (english)

Malignant melanoma is a malignant tumor of pigment cells of the skin and mucosa. It is one of the most aggressive tumors in humans. Although melanoma makes up to 4 % of all malignant skin diseases, almost 80 % of the deaths of skin tumors are caused by it. Melanoma incidence has been steadily increasing over the last decades, so melanoma has become a public health issue. Thanks to a well developed lymphatic network, especially in the area of the head and neck, melanoma can easily and quickly limphogenously and hematogenically metastasize. In patients with positive regional lymph nodes survival is 40 % to 50 % worse than in those without them. In the early 1990s, Donald Morton popularized the sentinel lymph node biopsy (SLNB), which is today the gold standard for prognosis and further planning of treating patients with melanoma. The lymph node guard (sentinel) is the first lymph node to drain the tumor area. SLNB is indicated in early stages of melanoma with no clinical, radiological or pathohistologically proven metastases. The standard techniques used for SLNB include: preoperative lymphoscintigraphy, lymphotropic blue dye application, and sentinel detection by hand gamma camera. In the area of the head and neck, SLNB is performed in endotracheal anesthesia. In patients with a positive sentinel, neck dissection is required to prevent further disease spread. Patients with a negative sentinel should be monitored clinically.

• Keywords: melanom; SLNB; limfni čvor stražar
• Keywords (english): melanoma; SLNB; sentinel lymph node
• Language: croatian
• URN:NBN: urn:nbn:hr:105:786796
• 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: 2017-11-28 12:53:59