Čvor u štitnjači kao prognostički čimbenik u papilarnom karcinomu štitnjače

master's thesis

• Title (english): Thyroid nodules as prognostic factors in papillary thyroid carcinoma
• Author: Anamarija Zrilić
• Mentor: Milan Vrkljan (mentor)
• Committee member: Neven Ljubičić (predsjednik povjerenstva)
• Committee member: Nikola Đaković (član povjerenstva)
• Committee member: Milan Vrkljan (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

Papilarni karcinom štitnjače predstavlja najčešću zloćudnu novotvorinu endokrinološkog sustava. Može se pojaviti u bilo kojoj životnoj dobi, najčešće između 20. i 50. godine života, tri do četiri puta češće u žena. Klinički se očituje kao bezbolni palpabilni čvor u štitnjači, a sklon je širenju na susjedne strukture i metastaziranju u regionalne limfne čvorove. Unatoč tomu, njegova prognoza je vrlo dobra. Najčešće se radi o dobro diferenciranim karcinomima sa sporim rastom i povoljnim tijekom bolesti kod kojih je izlječenje moguće postići u čak 90% bolesnika. Prognoza u pojedinačnim slučajevima ovisi o dobi, spolu, veličini i diferenciranosti tumora, invaziji u okolne strukture, prisustvu metastaza u regionalnim limfnim čvorovima i udaljenim metastazama. Različite kombinacije ovih prognostičkih čimbenika korištene su u nekoliko klasifikacijskih sustava kojima se određuje stadij i prognoza papilarnih karcinoma. U svakome od njih uzeta je obzir veličina tumora. Ona se pokazala značajnim prognostičkim pokazateljem proširenosti i ishoda bolesti; kod tumora većih od 2 cm u velikom postotku slučajeva mogu se očekivati metastaze u vratnim limfnim čvorovima, a kod onih većih od 4 cm često već postoji lokalna invazija tumora i udaljene metastaze. Veći tumori imaju lošiju prognozu, povezani su s većom proširenošću bolesti zbog čega je i vjerojatnost povrata bolesti i smrtnost veća.

Abstract (english)

Papillary thyroid carcinoma is the most common endocrine malignant tumor. It occurs 3- 4 times more frequently in females than in males and usually presents in the 20–50 year age group as an asymptomatic thyroid nodule. Although it often invades extrathyroid tissue and causes cervical lymph node metastasis, the prognosis is good. In most cases papillary thyroid carcinoma is a well-differentiated and slow-growing tumor with a favorable course and almost 90% of the patients can be cured. For a more specific prognosis in individual cases there are several prognostic factors: age, gender, tumor size, tumor grade, extrathyroid invasion, lymph node metastasis, and distant metastasis. Different combinations of these prognostic factors are used in several scoring systems which determine tumor stage and predict the clinical outcome. Tumor size is used in all of these scoring systems. It is considered to be a significant prognostic factor, since in tumors measuring 2 cm or more microscopic lymph node metastasis can be expected, and in those larger than 4 cm extrathyroid invasion and distant metastasis are more commonly present. Larger tumors have a worse prognosis, as they are associated with wider spread of the disease, lower disease-free survival, and higher mortality.

• Keywords: štitnjača; čvor u štitnjači; papilarni karcinom štitnjače; prognostički čimbenici; veličina tumora
• Keywords (english): thyroid; thyroid nodule; papillary thyroid carcinoma; prognostic factors; tumor size
• Language: croatian
• URN:NBN: urn:nbn:hr:105:592321
• 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: 2018-12-19 11:40:34