Koriokarcinom

master's thesis

• Title (english): Choriocarcinoma
• Author: Ivan Ljoka
• Mentor: Joško Lešin (mentor)
• Committee member: Goran Vujić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Joško Lešin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2019-07-12, 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

Koriokarcinom je jedan od histoloških tipova entiteta zvanog gestacijske trofoblastične neoplazije (GTN) koji nastaju abnormalnom proliferacijom tkiva trofoblasta, kojima može prethoditi bilo hidatiformna mola ili nemolarna trudnoća. GTN osim koriokarcinoma ukjučuje još i: invazivnu molu, tumor ležišta posteljice (TLP) te epiteloidni trofoblastični tumor (ETT). Invazivna mola i koriokarcinom odlikuju se visokim vrijednostima beta hCG-a, dok TLP i ETT karakteriziraju niske vrijednosti beta hCG-a.
U Europi i Sjevernoj Americi, incidencija koriokarcinoma je otprilike 1 na 40 000 trudnoća. Prije razvoja učinkovite kemoterapije za GTN, većina bolesnica s bolešću ograničenom na maternicu je bila izliječena histerektomijom dok je proširena bolest uglavnom bila fatalna. U današnje vrijeme gestacijski koriokarcinom s niskim rizikom ima gotovo 100 % preživljavanje u žena liječenih kemoterapijom, a visokorizični bolesnici s koriokarcinomom imaju 91 % do 93 % preživljavanja primjenjujući polikemoterapiju. U terapiji se koriste još zračenje i kirurško liječenje. Gotovo 50 % GTN potječe iz molarne trudnoće, 25 % iz spontanog pobačaja ili ektopične (tubarne) trudnoće, a 25 % iz terminske ili prijevremene trudnoće. Koriokarcinom predstavlja najagresivniji histološki tip GTN i odlikuje se ranom vaskularnom invazijom te udaljenim presadnicama. Klinička slika ovisi o proširenosti bolesti i lokalizaciji metastaza.

Abstract (english)

Choriochacinoma is one of the histological types of entities called gestational trophoblastic neoplasia (GTN) that is formed by abnormal proliferation of trophoblastic tissue, which may be preceded by either a hydatidiform mole or nonmolar pregnancy. GTN, apart from choriocarcinoma, also includes: invasive mole, placenta tumor (TLP) and epithelioid trophoblastic tumor (ETT). Invasive moles and choriocarcinoma are characterized by high beta hCG values while TLP and ETT are characterized by low beta hCG values. In Europe and North America, choriocarcinoma affects about one in 40 000 pregnancies. Prior to the development of effective chemotherapy for GTN, most patients with limited disease were cured by hysterectomy while the spread of the disease was mostly fatal. At present, low-risk gestational choriocarcinoma has nearly 100 % survival in women treated with chemotherapy, and high-risk patients with choriocarcinoma have 91 % to 93 % survival using multiple agent chemotherapy with or without radiation and surgery. Radiation and surgical procedures are used in therapy. Almost 50 % of GTN is derived from molar pregnancy, 25 % from spontaneous abortion or ectopic (tubular) pregnancy and 25 % from terminal or premature pregnancy. Choriocarcinoma is the most aggressive GTN histological type and is characterized by early vascular invasion and remote transplantation. The clinical picture depends on the spread of the disease and the location of the metastases.

• Keywords: koriokarcinom; incidencija; terapija; beta hCG; etiologija; klinička slika
• Keywords (english): choriocarcinoma; incidence; therapy; beta hCG; etiology; clinical picture
• Language: croatian
• URN:NBN: urn:nbn:hr:105:494137
• 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: 2019-12-19 10:18:02