Odnos tumorskoga pupanja i tumorskih depozita te njihova povezanost s kliničko-patološkim značajkama u bolesnika oboljelih od kolorektalnoga karcinoma

doctoral thesis

• Title (english): The relationship between tumor budding and tumor deposits and their relation to clinical-pathological parameters in patients with colorectal carcinoma
• Author: Zdenko Bilić
• Mentor: Mario Zovak (mentor)
• Mentor: Alma Demirović (komentor)
• Committee member: Božo Krušlin (predsjednik povjerenstva)
• Committee member: Žarko Rašić (član povjerenstva)
• Committee member: Jasmina Marić Brozić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Surgery); Zagreb
• Defense date and country: 2024-10-25, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

U posljednje vrijeme otkrivene su nove morfološke osobine kolorektalnoga karcinoma kao važni prognostički čimbenici od kojih smo u našem istraživanju proučavali odnos tumorskoga pupanja i tumorskih depozita.
Provedeno je retrospektivno kohortno istraživanje u kojem je bilo uključeno 90 bolesnika koji su bili liječeni radikalnom kirurškom resekcijom na Klinici za kirurgiju Kliničkog bolničkog centra Sestre milosrdnice, u razdoblju između 1. siječnja 2009. i 31. prosinca 2013. godine, s patohistološki potvrđenom dijagnozom kolorektalnoga karcinoma III. stadija. Za svakog bolesnika uključenog u istraživanje analizirani su svi arhivski patohistološki preparati bojeni hemalaun-eozinom kako bi se učinio ponovni uvid u patohistološke osobitosti tumora. Ovisno o prisutnosti tumorskih depozita, patohistološki uzorci su bili podijeljeni u dvije približno jednako velike skupine i to u skupinu s prisutnim tumorskim depozitima (N=39) i u kontrolnu skupinu bez prisutnih tumorskih depozita (N=51). Prisutnost i stupanj tumorskoga pupanja dodatno su analizirani u ovim skupinama i uspoređeni s drugim kliničkim i patohistološkim značajkama.
Izmjerena prevalencija tumorskoga pupanja u kolorektalnom karcinomu III. stadija je bila neočekivano visoka i iznosila je 94.4%. Tumorski depoziti se češće pojavljuju u bolesnika s višim stupnjem tumorskoga pupanja (p=0.004). Prisutnost tumorskih depozita (p=0.01) kao i prisutnost visokog stupnja tumorskoga pupanja (p=0.001) su statistički značajno povezani s kraćim ukupnim preživljenjem bolesnika oboljelih od kolorektalnoga karcinoma III. stadija.
Rezultati istraživanja ukazuju na to da se u ranoj fazi tumorske progresije vjerojatnije radi o direktnom širenju dediferenciranih pupajućih stanica tumora u okolnu stromu, sugerirajući da bi razvoj tumorskoga pupanja i tumorskih depozita mogao biti dio istog kontinuiranog procesa. Također, rezultati dodatno naglašavaju važnost tumorskoga pupanja kao nepovoljnog prognostičkog čimbenika.

Abstract (english)

Recently, some new morphological features of colorectal cancer have been discovered as significant prognostic factors. In our work, we have studied the relationship between tumor budding and tumor deposits.
The retrospective cohort study included 90 patients with pathohistologically confirmed stage III colorectal cancer who were treated with radical surgical resection at the Department of Surgery, Sestre milosrdnice University Hospital Center, in the period between January 1, 2009, and December 31, 2013. All hematoxylin and eosin (H and E)-stained slides from each patient were reviewed, and histological parameters were recorded. The samples were divided into two groups with similar sizes: a group with tumor deposits (N=39), and a control group without tumor deposits (N=51). The presence and tumor budding grade were further analyzed in these groups and compared with other clinical and histological features.
The prevalence of tumor budding in stage III CRC was unexpectedly high (94.4%). The presence of tumor deposits was significantly associated with a higher tumor budding grade (p=0.004). The presence of tumor deposits (p = 0.01) and the higher tumor budding grade (p=0.001) were statistically significantly associated with shorter survival in stage III colorectal cancer.
The results indicate that in the early stage of tumor progression, it is more likely due to the direct spread of tumor bud cells into the surrounding stroma, suggesting that the development of tumor budding and tumor deposits could be part of the same continuous process. Also, the results further emphasize the importance of tumor budding as an unfavorable prognostic factor.

• Keywords: kolorektalni karcinom; tumorsko pupanje; tumorski depoziti
• Keywords (english): colorectal carcinoma; tumor budding; tumor deposits
• Language: croatian
• URN:NBN: urn:nbn:hr:105:555693
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 117 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-11-27 12:19:48