Karakteristike hormonske aktivnosti karcinoma nadbubrežne žlijezde

master's thesis

• Title (english): Characteristics of hormonal activity of adrenal carcinoma
• Author: Kristina Vitas
• Mentor: Tina Dušek (mentor)
• Committee member: Darko Kaštelan (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Tina Dušek (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2022-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Karcinomi kore nadbubrežne žlijezde zloćudni su i rijetki tumori, s velikim rizikom od pojave recidiva. Prema kliničkoj slici mogu biti funkcionalni i nefunkcionalni, ovisno o tome izlučuju li hormone i njihove prekursore. Funkcionalni tumori mogu izlučivati kortizol, aldosteron, androgene hormone i estradiol, te ovisno o tome pokazuju znakove Cushingova sindroma, Connova sindroma, virilizacije ili feminizacije. Često su tumori povezani s autonomnim lučenjem kortizola, tzv. subkliničkim Cushingovim sindromom. Dijagnoza se postavlja uzimanjem anamneze, kliničkom slikom, hormonskim testovima i radiološkom obradom (najčešće CT snimkama), te se mogu pronaći i kao slučajan nalaz – incidentalomi. Liječenje najčešće podrazumijeva adrenalektomiju, te adjuvantnu primjenu mitotana kako bi se umanjio rizik od pojave recidiva.
Cilj je ovog rada dokazati odnos funkcionalnosti adrenokortikalnih karcinoma s demografskim obilježjima bolesnika, karakteristikama tumora (veličina tumora, Ki67 indeks i Weissov score), s tijekom bolesti (proširenost bolesti u trenutku dijagnoze i pojava recidiva), te s ishodom bolesti. Uspoređujući skupine ljudi s funkcionalnim i nefunkcionalnim tumorima, dokazane su značajno veće vrijednosti Ki67 indeksa i Weissova scorea u bolesnika s funkcionalnim tumorima, kao i veći broj bolesnika s proširenom bolešću u trenutku dijagnoze. Razlika među skupinama prema pojavi recidiva bolesti i učestalosti smrtnog ishoda nije statistički značajna. U uzorku je najveći broj bolesnika imao tumore koji izlučuju androgene hormone, a jednak je broj bolesnika imao tumore koji luče kortizol i tumore koji izlučuju dvije vrste hormona. Dokazana je i značajno veća učestalost tumora koji luče kortizol i androgene hormone u ženskom spolu, u odnosu na muški.

Abstract (english)

Adrenocortical carcinomas are malignant and rare tumors, with a high risk of recurrence. According to the clinical presentation, they can be functional or non-functional, depending on whether they secrete hormones and their precursors. Functional tumors can secrete cortisol, aldosterone, androgenic hormones or estradiol, and depending on this they show signs of Cushing's syndrome, Conn's syndrome, virilization or feminization. Tumors are often associated with autonomous secretion of cortisol, the so-called subclinical Cushing's syndrome. The diagnosis is established by anamnesis, clinical findings, hormonal tests, radiological processing (mostly CT scans), and they can also be found as a random finding - incidentalomas. Treatment usually involves adrenalectomy and adjuvant mitotane administration to reduce the risk of recurrence.
The aim of this paper is to demonstrate the relationship between the functionality of adrenocortical carcinomas and the patient's demographic characteristics, tumor characteristics (tumor size, Ki67 index and Weiss score), the course of the disease (the expansion of the disease at the time of diagnosis and occurrence of relapse) and the outcome of the disease. Comparing the groups of people with functional and non-functional tumors, significantly higher values of the Ki67 index and Weiss score were demonstrated in patients with functional tumors, as well as a greater number of patients with extended disease at the time of diagnosis. The difference between the groups according to the recurrence of the disease and the frequency of death is not statistically significant. In the sample, the largest number of patients had tumors that secrete androgenic hormones, and an equal number of patients had tumors that secrete cortisol and tumors that secrete two types of hormones. It has been proven that the frequency of tumors secreting cortisol and androgenic hormones is significantly higher in females compared to males.

• Keywords: adrenokortikalni karcinom; kortizol; androgeni hormoni
• Keywords (english): adrenocortical carcinoma; cortisol; androgenic hormones
• Language: croatian
• URN:NBN: urn:nbn:hr:105:306770
• 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: 2023-03-22 12:22:39