Premaligne promjene i rak prostate

master's thesis

• Title (english): Premalignant lesions and prostate cancer
• Author: Ramona Relković
• Mentor: Borislav Spajić (mentor)
• Committee member: Božo Krušlin (predsjednik povjerenstva)
• Committee member: Tomislav Meštrović (član povjerenstva)
• Committee member: Borislav Spajić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Urology); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Urology

Abstract

Karcinom prostate je najčešća maligna bolest i drugi uzročnik smrti muške populacije u razvijenim zemljama te predstavlja jedan od vodećih zdravstvenih problema u muškaraca druge i treće životne dobi. U Hrvatskoj, kao i u Europskoj uniji, je karcinom prostate drugi po učestalosti s 15% udjela i drugi uzročnik smrti muške populacije oboljele od malignoma (HZJZ, bilten 2013). Adenokarcinom je patohistološki najčešći karcinom prostate s udjelom višim od 95% među svim karcinomima prostate.
U današnje vrijeme dostupni su brojni dijagnostički postupci kao što su digitorektalni pregled (DRP), serumski prostata specifični antigen (PSA) i transrektalnim ultrazvukom vođena biopsija prostate (TRUZ), koji su povećali broj dijagnosticiranih karcinoma prostate u ranoj lokaliziranoj fazi s boljom mogućnošću izlječenja. Nažalost, u Hrvatskoj je samo 50% tumora lokalizirano u trenutku postavljanja dijagnoze, a polovica nakon operativnog zahvata pokazuje znakove ekstraprostatičnog širenja (HZJZ, bilten 2013). Biopsija prostate pod kontrolom ultrazvuka je danas standardna dijagnostička metoda i jedina pouzdana preoperativna metoda za dokazivanje karcinoma prostate, a njome možemo otkriti i proširenost bolesti. Odluka o biopsiji se donosi na temelju vrijednosti PSA i/ili suspektnog DRP-a.
Osim karcinoma prostate velikom broju muškaraca se biopsijom otkrije benigna hiperplazija prostate ili neka od premalignih promjena prostate. Premaligne promjene prostate su specifični morfološki entiteti koje nalazimo u bioptičkom materijalu prostate, te predstavljaju povišen rizik za kasniju detekciju karcinoma prostate. Nekoliko lezija prostate se smatra potencijalnim prekursorima karcinoma prostate: prostatična intraepitelna neoplazija (PIN), atipična proliferacija malih acinusa (ASAP), proliferacijska inflamatorna atrofija (PIA) i atipična adenomatozna hiperplazija (AAH). Prostatična intraepitelna neoplazija je jedini potencijalni entitet koji zadovoljava uvjete za karcinom in situ. Za ostale premaligne promjene prostate nije dokazana čvrsta veza s karcinomom prostate.

Abstract (english)

Prostate cancer is the most common malignant disease and the second leading cause of death among men in developed countries and therefore is one of the leading health problems in men. In Croatia, as well as in the European Union, it is the second most common cancer with 15% share and the second cause of death among male population suffering from malignancies (HZJZ, bilten 2013). Adenocarcinoma is the most common type of prostate cancer and accounts for more than 95% of all prostate cancers.
Nowadays, access to many diagnostic possibilities such are digit-rectal examination (DRE), serum prostatic specific antigen (PSA) and trans-rectal ultrasound guided prostatic biopsy (TRUS) increases the number of diagnosed prostate cancers at an early, localized stage, that has higher recovery rate. Unfortunately, only 50% of all prostate cancers are diagnosed in localized stage in Croatia, and half of these present with extra-prostatic spreading post-operatively (HZJZ, bilten 2013). The ultrasound guided prostate biopsy is a standardized diagnostic method and the only reliable pre-operative method for prostate cancer staging. The decision whether to perform biopsy is made upon results of PSA test and/or suspicious DRE.
With most patients, other than diagnosing the prostate cancer, biopsy usually detects benign prostate hyperplasia or premalignant prostate lesion. Premalignant prostate lesions are specific morphological entities found in prostate biopsy material and can indicate an increased risk for later detection of prostate cancer. Several lesions are considered to be potential precursors of prostate cancer: prostatic intraepithelial neoplasia (PIN), atypical small acinar proliferation (ASAP), proliferative inflammatory atrophy (PIA) and atypical adenomatous hyperplasia (AAH). Prostatic intraepithelial neoplasia is the only potential entity that satisfies all the requirements for carcinoma in situ. However, other premalignant prostatic lesions have not been linked with prostate cancer so far.

• Keywords: karcinom prostate; biopsija prostate; benigna hiperplazija prostate; PIN. ii
• Keywords (english): prostate cancer; prostatic biopsy; benign prostate hyperplasia; PIN
• Language: croatian
• URN:NBN: urn:nbn:hr:105:755756
• 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: 2015-10-12 10:06:21