Uloga kolposkopije kod preinvazivnih lezija vrata maternice

master's thesis

• Title (english): The role of colposcopy in pre-invasive cervical lesions
• Author: Fabijan Feratović
• Mentor: Tomislav Župić (mentor)
• Committee member: Držislav Kalafatić (predsjednik povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Committee member: Tomislav Župić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Vrat maternice (lat. cervix) donji je dio maternice koji spaja tijelo maternice s rodnicom. Nastaje tijekom šestog tjedna embriogeneze iz paramezonefričkih cijevi ili Mullerovih cijevi. Vrat maternice je prekriven višeslojnim pločastim epitelom, a prema cervikalnom kanalu jednoslojnim cilindričnim epitelom i granica između ova dva epitela naziva se skvamokolumnarna granica (SKG). Preinvazivne lezije vrata maternice označavaju atipične stanice vrata maternice uzrokovane humanim papiloma virusom (HPV) koje imaju mogućnost prijelaza u rak vrata maternice. Humani papiloma virusi se dijele u nisko rizične i visoko rizične tipove koji uzrokuju nastanak cervikalne intraepitelne neoplazije (CIN) najčešće u području transformacijske zone. Cervikalne intraepitelne neoplazije se dijele u tri stupnja ovisno o debljini zahvaćenosti sluznice od bazalnog sloja prema površini na CIN 1, 2 i 3. Viši stupanj ima veću mogućnost prijelaza u invazivni rak. Kolposkopija je medicinski postupak kojim se pod uvećanjem i osvjetljenjem pregledava vrat maternice, rodnica i stidnica. Ta metoda je prvi puta opisana 1924. od strane Hansa Hinselmanna, njemačkog liječnika rođenog u Neumuensteru 1884.godine. Obavlja se pomoću kolposkopa koji pruža uvećani pogled te omogućuje kvalificiranom liječniku razlikovati normalan od abnormalnog nalaza. Kolposkopija ima najveću preciznost u dijagnostici preinvazivnih lezija visokih gradusa, a manju u otkrivanju lezija nižih gradusa. Zato se, uz uzimanje kolposkopijom vođene biopsije, smatra zlatnim standardom u dijagnosticiranju prekanceroznih stanja. Prilikom kolposkopskog pregleda može se, pod lokalnom anestezijom, izvesti i terapijski postupak LLETZ (engl. Large Loop Excision of the Transformation Zone) kojim se električnom petljom uklanja displastično tkivo na vratu maternice. Kolposkopija ima veliku vrijednost zbog svoje visoke osjetljivosti i mogućnosti prepoznavanja preinvazivnih lezija i time omogućava pravodobno liječenje, čime se sprječava nepotrebna uporaba invazivnih metoda liječenja.

Abstract (english)

Neck of the uterus (lat.cervix) is the lower part of the uterus which connects the body of the uterus with the vagina. Cervix is formed during the 6th week of embryogenesis from the paramesonephritic or Muller tubes. Part of the cervix is covered with columnar and squamous epithelium. The border between these two types of cells is called the sqamocolumnar junction. Preinvasive lesions of the cervix atypical cells within the cervix caused by human papilloma virus(HPV) which have the ability to become cancer. HPVs are divided into low risk and high risk types. HPV causes cervical intraepithelial neoplasia (CIN) most often in the area of transformation zone. Cervical intraepithelial neoplasia is divided into three grades depending
on the thickness of the mucosa involved from the basal layer towards the surface into CIN 1, 2 and 3. Colposcopy is a medical procedure in which cervix, vagina and vulva are observed under light and magnification. Colposcopy if first described 1924 by Hans Hinselmann, a german doctor born in Neumuenster in 1884. It is done using a colposcope which provides a magnified view of these areas allowing a qualified doctor to differentiate between normal and abnormal tissue. Colposcopy has the highest diagnostic accuracy for high grade lesions compared to low grade lesions. That is why, when combined with colposcopy guided biopsy, it is considered a golden standard in diagnosing precancerous lessions. During colposcopy exam, it is possible, under local anesthesia, to perform a therapeutic procedure LLETZ that uses an electrical loop to remove dysplastic tissue of the cervix. Colposcopy has great value because of its high sensitivity and ability to precisely recognize preinvasive lesions and therefore avoid missing potentially malignant states and lack of right treatment. On the other hand, it has the ability to prevent overtreatment when it is not necessary.

• Keywords: kolposkopija; vrat maternice; preinvazivne lezije; cervikalna intraepitelna neoplazija; CIN; LLETZ; humani papiloma virus; HPV; rak vrata maternice
• Keywords (english): colposcopy; cervix; preinvasive lesions; cervical intraepithelial neoplasia; CIN; LLEZZ; human papilloma virus; HPV; cervical cancer
• Language: croatian
• URN:NBN: urn:nbn:hr:105:672820
• 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
• Public note: Pohranitelj objekta unio ključne riječi.
• Created on: 2021-05-04 07:02:55