Morfološka analiza u dijagnostičkom postupniku idiopatskih upalnih bolesti crijeva

master's thesis

• Title (english): Morphological analysis in diagnostic algorithm of chronic inflammatory bowel disease
• Author: Marija Njirić
• Mentor: Anita Škrtić (mentor)
• Committee member: Monika Ulamec (predsjednik povjerenstva)
• Committee member: Slavko Gašparov (član povjerenstva)
• Committee member: Anita Škrtić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pathology); Zagreb
• Defense date and country: 2018-07-13, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Basic Medical Sciences; Cytology, Histology and Embryology

Abstract

Idiopatske upalne bolesti crijeva su kronični upalni poremećaj crijeva s dva zasebna entiteta, Crohnovom bolesti i ulceroznim kolitisom. Etiologija bolesti je multifaktorijalna, ulogu imaju genetsko naslijeđe, poremećaj regulacije imunološkog sustava u sluznice crijeva i okolišni čimbenici. Ne postoji zlatni standard za postavljanje dijagnoze, već se ona donosi na temelju korelacije između kliničke slike, endoskopskih i histoloških nalaza. Kao cilj današnje terapije je postavljeno cijeljenje sluznice crijeva, a anti-TNF monoklonalna antitijela su novi lijekovi s uspjehom u postizanju navedenog cilja. Opći cilj ovoga rada je bilo utvrđivanje prisutnosti općih morfoloških obilježja upalnih bolesti crijeva u endoskopskim biopsijama debelog crijeva. Specifični ciljevi su bili utvrđivanje prisutnosti sigurnih morfoloških obilježja koji mogu pomoći u diferenciranju između dviju bolesti i utvrđivanje međuovisnosti endoskopske i histološke aktivnosti bolesti. Uzorak ovog retrospektivnog istraživanja su bila 32 pacijenta, 21 s Crohnovom bolesti i 11 s ulceroznim kolitisom. Najuočeniji morfološki parametri upalnih bolesti crijeva su bili bazalna plazmacitoza i promjene oblika i arhitekture kripti sluznice. Za usporedbu aktivnosti Crohnove bolesti su se koristile CDEIS endoskopska klasifikacija i AHS histološka klasifikacija aktivnosti bolesti. Za usporedbu aktivnosti ulceroznog kolitisa su se
koristile Mayo endoskopska klasifikacija i Nancy histološka klasifikacija aktivnosti bolesti. Statističkim testovima se u Crohnovoj bolesti našla pozitivna korelacija r = 0,122 između dvije klasifikacije, uz p = 0,966, a u ulceroznom kolitisu korelacija je iznosila r = 0,574, a p = 0,288. Rezultati nisu statistički značajni, ali iz njih je vidljiva složenost bolesti i potreba za daljnjim istraživanjem jer tema ima perspektivu i zahtijeva daljnju obradu.

Abstract (english)

Inflammatory bowel disease is a chronic inflammatory disorder with two seperate entities, Crohn's disease and ulcerative colitis. The etiology of disease is multifactorial, it consists of genetic predisposition, abnormalities in immune regulation and the effect of enviromental factors. The diagnosis of IBD is based on the correlation between medical history, endoscopic parameters and histopathology. The goal of today's therapy is mucosal healing, and anti-TNF monoclonal antibodies are new drugs with success in achieving this goal. The primary goal of this paper was to determine the presence of general morphological features of IBD in endoscopic colon biopsies. The specific objectives were to determine the presence of reliable morphological features that can help differentiate between two entities of IBD and to determine the interdependance of endoscopic and histological activity of the disease. For the purpose of producing this study a retrospective research of 32 patients, 21 with Crohn's disease and 11 with ulcerative colitis, was done. The most commonly found morphological parameters of IBD were basal plasmacytosis and changes in the shape and architecture of the crypts. To evaluate and compare Crohn's disease activity, CDEIS endoscopic classification and AHS histological classification of
disease were used. To evaluate and compare the activity of ulcerative colitis, Mayo endoscopic classification and Nancy histological classification of disease activity were used. Regarding Crohn's disease, statistical tests found a positive correlation (r = 0,122) between two classifications and calculated p value was 0,966. A positive correlation (r = 0,574) was found in ulcerative colitis, with a p value of 0,288. The calculated results are not statistically significant but they represent the complexity of IBD and the need for further research.

• Keywords: endoskopska biopsija debelog crijeva
• Keywords (english): endoscopic biopsy of the colon
• Language: croatian
• URN:NBN: urn:nbn:hr:105:048659
• 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: 2019-03-14 07:48:40