Title Usporedba lakunarnosti i tumorskoga pupanja u kolorektalnom karcinomu Title (english) The comparison of lacunarity and tumor budding in colorectal carcinoma Author Martina Šarec Ivelj Mentor Gorana Aralica (mentor)Mentor Paško Konjevoda (komentor)Committee member Slavko Gašparov (predsjednik povjerenstva)Committee member Leonardo Patrlj (član povjerenstva)Committee member Mirjana Kujundžić Tiljak (član povjerenstva)Granter University of Zagreb Defense date and country 2021-02-17, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Universal decimal classificationUDC ) 616 - Pathology. Clinical medicine Abstract Kolorektalni karcinom je treća maligna neoplazma u muškaraca i druga kod žena. „Zlatni standard“ je patohistološka dijagnoza iz endoskopske biopsije. Nakon resekcije, određuje se klinički stadij bolesti. Peritumorsko pupanje je povezano s kraćim preživljenjem i višim TNM stadijem. To je morfološki odraz epitelno-mezenhimne tranzicije, a posljedica je genetskih promjena tumorskih stanica koje postaju agresivnije i sklonije metastaziranju. Iako je standardizirani postupak određivanja pupanja predložen, teži se objektivizaciji. Pupanje se u endoskopskoj biopsiji naziva intratumorsko pupanje. U ovom doktoratu pupanje je određeno metodama po Nakamuri i Lugliju, na preparatima bojenim CK AE1/AE3. Kao objektivna metoda mjerena je lakunarnost.
Iz podataka endoskopske biopsije, algoritmi rpart i mvpart smatraju kako najveći informacijski sadržaj imaju: lakunarnost na ×4, lakunarnost na ×10 te broj pupova. Stablo odluke kaže da bolesnici, kojima je lakunarnost na ×4 < 0,20 i lakunarnost na ×10 < 0,22, imaju HR 3,16 (značajno povećan rizik umiranja).
Iz podataka resektata, rpart algoritam smatra kako najveći informacijski sadržaj imaju: N stadij, broj pozitivnih limfnih čvorova te lakunarnost ×10. Stablo odluke kaže da bolesnici N stadija 1b, 2a i 2b, s lakunarnošću ×10 <0,22 te 16 i više pupova, imaju HR 2,57 (znatno povišen rizik umiranja). Party algoritam ima 1 čvor – bolesnici s perineuralnom invazijom imaju znatno kraće preživljenje.
Lakunarnost u kolorektalnom karcinomu je važan prognostički čimbenik i u endoskopskoj biopsiji i u resektatu. Osim toga, perineuralna invazija u resektatu je glavni prognostički čimbenik.
Abstract (english) Colorectal carcinoma is a global public health problem, with its incidence being the third malign neoplasm among the men and the second among the women. The gold standard for the diagnosis of colorectal carcinoma is pathohistologic analysis taken during colonoscopy. After tumor resection, pathohystologic sample holds many parameters which altogether make clinical stage of disease. Peritumoral budding is morphlogical expression of epithelial-mesenchimial transition which is consequence of additional genetic changes of tumor cells which become more agressive and more prone to metastasize. The standardised procedure of peritumoral budding determination is recommended, but the goal is to be more objective. Tumor budding during endoscopic biopsy is called intratumoral budding. In this study tumoral budding has been determined according to Nakamura and Lugli, on histology sections CK AE1/AE3 stained. Lacunarity has been measured as the objective method. According to the results of endoscopic biopsy rpart and mvpart algorithms made a tree decision using three variables with the highest information content: amount of lacunarity under 4× magnification, amount of lacunarity under 10x magnification, and the number of the budds. The decision tree has shown that the patients wo have the amount of lacunarity under the 4× magnification less than 0,20 and then the amount of lacunarity under the 10× magnification less then 0,22 have HR 3,16 which is highly incresed risk of dying compared to the population under examination as the whole. Out of the results of resected specimen analyses, rpart algorithm has shown that the highest information content has N stage, the number lymph nodes with metastases and the amount of lacunarity under the 10× magnification. Out of these parameters the decision tree has been made in which the patients with N stage of disease 1b, 2a, 2b have the amount of lacunarity under 10× magnification less then 0,22 and the number of budds 16 or more. They have HR 2,57 which means highly increased risk of dying. Party algorithm for specimen variables has only one node – perineural invasion, where those with perineural invasion have significantly less survival time. The lacunarity in colorectal carcinoma is important prognostic factor as much in endoscopic biopsy as in specimen. Besides, party algorithm sets apart perineural invasion as the main prognostic factor.
Keywords
Javno zdravstvo
Motivacija
Kolorektalne novotvorine
Kolonoskopija
Biopsija
Limfni čvorovi
Referentni standardi
Keywords (english)
Public Health
Motivation
Colorectal Neoplasms
Colonoscopy
Biopsy
Lymph Nodes
Reference Standards
Language croatian URN:NBN urn:nbn:hr:105:137849 Promotion 2021 Study programme Title: Biomedicine and Health Sciences Type of resource Text Extent 98 str. File origin Born digital Access conditions Open access Terms of use Created on 2021-05-13 07:43:32
