Usporedba patohistološkog nalaza kiretaže i patohistološkog nalaza poslije operacije karcinoma endometrija

master's thesis

• Title (english): The comparison of pathohistological diagnosis of curettage and pathohistological diagnosis after operation of endometrial cancer
• Author: Iva Mlinarević
• Mentor: Pavao Planinić (mentor)
• Committee member: Goran Vujić (predsjednik povjerenstva)
• Committee member: Lovorka Batelja-Vuletić (član povjerenstva)
• Committee member: Pavao Planinić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Oncology

Abstract

CILJ ISTRAŽIVANJA: Ispitati podudarnost histoloških tipova i gradusa karcinoma endometrija određenih iz uzoraka dobivenih frakcioniranom kiretažom i onih dobivenih nakon histerektomije u svrhu evaluacije frakcionirane kiretaže kao dijagnostičke metode karcinoma endometrija i njene preciznosti u određivanju histološkog tipa i gradusa karcinoma. ----- MATERIJALI I METODE: U ovom presječnom istraživanju analizirani su podatci 225 pacijentica operiranih zbog raka endometrija u Klinici za ženske bolesti i porode KBC Zagreb u 2014. i 2015. godini. Prikupljeni podatci su dob, broj poroda, histološki tip, a za endometrioidni tip uključen je i gradus. Uspoređivani su histološki tipovi i gradusi određeni iz uzoraka dobivenih kiretažom te oni određeni nakon histerektomije. ----- REZULTATI: Bahpkar testom nađena je statistički značajna razlika između histoloških tipova određenih uzorcima dobivenih kiretažom u odnosu na one određene nakon histerektomije (P=0,0275). Ukupni postotak podudarnosti konačnih histoloških tipova s kiretmanom iznosi 77,33%, a endometrioidni karcinom endometrija podudara se s patohistološkim nalazom kiretmana u 86,23%. Bhapkar testom je nađena statistički značajna razlika između gradusa određenih iz uzorka kiretaže i histerektomije (P vrijednost = 0,015). Post hoc McNemar testom uočena je statistički značajna promjena proporcije u gradusu 1 (P vrijednost = 0,042) i u slučaju kada na konačnom nalazu nije pronađen tumor (P vrijednost = 0,042). Ukupni postotak podudarnosti konačnih gradusa s kiretmanom iznosi 65,22%. Za 127 endometrioidnih karcinoma endometrija gradusa 1 postotak podudarnosti s nalazom kiretaže iznosi 71,15%, za 28 karcinoma gradusa 2 podudarnost iznosi 43,47%, a 12 gradusa 3 54,54%, a ukupna podudarnost gradusa iznosi 65,22%. ----- ZAKLJUČAK: Ovim istraživanjem je uočena statistički značajna razlika između histoloških tipova i gradusa određenih na uzorcima dobivenih frakcioniranom kiretažom u odnosu na one dobivene histerektomijom. Zaključujemo kako je kiretaža pouzdana dijagnostička metoda karcinoma endometrija, ali pri određivanju proširenosti bolesti, opsežnosti operacije i potrebe za daljnjom terapijom, nužno je kirurško određivanje stadija karcinoma.

Abstract (english)

OBJECTIVE: This study aims to define concordance between histologic types and tumor grade in endometrial cancer defined from samples got from fractional dilatation and curettage (D&C) and postoperative hysterectomy specimens. The main goal is to evaluate fractional curettage as a method to diagnose endometrial cancer and the accuracy of defining histologic types and grades of endometrial cancer. ----- METHODS: In this cross-sectional study, we have analyzed information of 255 patients who, during years 2014. and 2015. underwent a hysterectomy in the Clinical hospital center Zagreb because of doubtful endometrial cancer. We collected the data of the age, the number of childbirth, histologic type, and for the endometrioid type, tumor grade. A comparison of histological types and tumor grades on D&C and hysterectomy specimens was performed. ----- RESULTS: Using the Bahpkar test, we notice the statistically significant difference between histological types on D&C and hysterectomy specimens (P-value = 0,0275). The average accuracy of the histological type defined by the curettage is 77,33%, and for endometrioid endometrial cancer is 86,23%. By using the Bhapkar test was found a statistically significant difference between grades on D&C and hysterectomy specimen (P-value = 0,015327). With the post hoc McNemar test was noticed that the significant difference in proportion was in grade 1 (P value= 0,042116) and in the cases when there was not found malignancy after the hysterectomy (P-value = 0,042157). The average accuracy of tumor grade defined on the curettage is 65,22%. There were 127 endometrioid types grade 1 in the sample, and the concordance rate is 71,15%, for 28 grade 2, the concordance rate is 43,47%, and for 12 grade 3, it is 65,22%. ----- CONCLUSION: We concluded a statistically significant difference between histological types and grades between curettage and postoperative hysterectomy specimen. The D&C is a reliable method in diagnosing endometrial cancer, but to define the extension of the disease and the need for further treatment, surgical staging is necessary.

• Keywords: karcinom endometrija; frakcionirana kiretaža; histološki tip; gradus
• Keywords (english): endometrial cancer; fractional curettage; histologic type; grade
• Language: croatian
• URN:NBN: urn:nbn:hr:105:068393
• 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: 2022-03-17 10:52:16