| Abstract | Cilj rada je ispitati jesu li mitoze vjerodostojan pokazatelj metastaza u sentinel limfnom čvoru. U istraživanje je uključeno 120 bolesnika s melanomom. Nakon rutinske predoperacijske obrade bolesnika (kompletna krvna slika, koagulogram, biokemijski nalazi, elektrokardiogram, telerendgenogram srca i pluća), limfoscintigrafski se određuje lokalizacija sentinel limfnog čvora. Za svakog bolesnika obrađeni su sljedeći podaci: prisutnost ulceracije, debljina melanoma po Breslowu, tip rasta, vaskularna invazija, patohistološki nalaz jednog ili više sentinel limfnih čvorova (prisutnost metastaza). Od ukupno 120 bolesnika, 59 je muškaraca i 61 žena. Nije bilo statistički značajne razlike između dobi bolesnica i bolesnika (t-test p=0,53). Lokalizacija melanoma u 120 bolesnika uključenih u istraživanje najčešće je uključivala trup i to u 61 bolesnika (50,8%).Najčešće zastupljen melanom je površinsko šireći melanom (SSM) u 95 bolesnika (79,2%). Ulceracija je prisutna u 40 bolesnika (33,3%), regresija melanoma je zamijećena u 2 bolesnika (1,7%), vaskularna invazija u 7 bolesnika (5,8%), limfocitna infiltracija tumora u 14 bolesnika (11,7%), a više od jedne mitoze po kvadratnom milimetru u 3 bolesnika (2,5%). U 27 bolesnika (22,5%) u sentinel limfnom čvoru nalazila se metastaza. U 11 bolesnica i 16 bolesnika sentinel limfni čvor bio je metastatski promijenjen. Lokalizacija melanoma između spolova statistički se značajno razlikuje (p=0,014), te je u žena češća na udovima (28/61, 45,9%), a u muškaraca na trupu (36/59, 60,3%). Dob, spol, lokalizacija melanoma nemaju prognostičku vrijednost prisutnosti metastaze u sentinel limfnome čvoru. Mitoze nisu statistički značajan prognostički čimbenik. Debljina melanoma (p=0,00001) i ulceracija (p=0,007) statistički su značajni prognostički pokazatelji metastaza u sentinel limfnome čvoru što je analizirano univarijatnom logističkom regresijom. |
| Abstract (english) | The aim of the study was to examine if mitosis was a significant prognostic factor of positive sentinel lymph node. This study included 120 patients with melanoma. After a routine pre-surgery treatment of the patients (complete blood count, coagulogram, biochemical findings, electrocardiogram, x-ray of the heart and lungs), lympho-scintigraphy determines localization of sentinel lymph node. For each patient the following data were analyzed: the presence of ulceration, Breslow thickness melanoma, a type of growth, vascular invasion, histopathological finding of one or more sentinel lymph nodes (presence of metastases). There were 59 men and 61 women out of the 120 patients. No statistically significant differences between patients' age and patients were determined (t-test, p = 0.53). The most common localization of melanoma of the 120 patients was on the body of 61 patients (50.8%). Most frequent melanoma is superficial spreading melanoma (SSM) in 95 patients (79.2%). Ulceration was present in 40 patients (33.3%), regression of melanoma was observed in 2 patients (1.7%), vascular invasion in 7 patients (5.8%), lymphocytic infiltration of the tumor in 14 patients (11.7%), and more than one mitosis per square millimeter in 3 patients (2.5%). In 27 patients (22.5%) of sentinel lymph node metastasis was located. In 11 out of 16 patients with sentinel lymph node metastasis was changed. Localization of melanoma between the sexes was statistically significant (p = 0.014), and is more common in women on the limbs (28/61, 45.9%), and in men on the body (36/59, 60.3%). Age, gender, localization of melanoma have prognostic value of the presence of metastases in the sentinel lymph node. Mitosis was not statistically significant prognostic factor. The thickness of the melanomas (p = 0.00001) and ulceration (p = 0.007) were statistically significant prognostic indicators of metastasis in sentinel lymph node as analyzed univariate logistic regression. |
