Dijagnostika i liječenje nemelanomskih zloćudnih tumora kože

professional thesis

• Title (english): Diagnosis and treatment of nonmelanoma skin cancer
• Author: Mirela Krišto
• Mentor: Romana Čeović (mentor)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2020-12-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Dermatovenerology

Abstract

Bazocelularni karcinomi (BCC) i planocelularni karcinomi kože (SCC), zajedničkog naziva nemelanomski zloćudni tumori kože (NMSC), danas su najčešći zloćudni tumori u bijeloj populaciji u većine zemalja svijeta. Uzroke povećane incidencije nalazimo u djelovanju nekoliko čimbenika rizika od kojih su najvažniji povećana izloženost suncu, duže trajanje života i genetska predispozicija.
Obrada bolesnika s tumorskim tvorbama suspektnim na NMSC započinje uzimanjem anamneze i fizikalnim pregledom kože. Jedna od najčešće korištenih neinvazivnih dijagnostičkih tehnika je dermatoskopija. Pregled uzorka kože dobivenog biopsijom smatra se zlatnim standardom u dijagnostici NMSC-a. Među novim dijagnostičkim tehnikama vrlo uspješnom se pokazala refleksijska konfokalna mikroskopija (RCM).
Terapija NMSC-a je kirurška i nekirurška. Za veliku većinu NMSC-a, kirurške metode predstavljaju kurativni tretman jer su najbolji način odstranjenja tumora u cijelosti. Pri tom se uz standardnu eksciziju kao zlatni standard, koriste Mohsova mikrografska kirurgija (MMS) i ablativne metode.
Nekirurške metode liječenja terapija su izbora za određene bolesnike te se u mnogim slučajevima stope izlječenja približavaju onima postignutima kirurgijom, a prednosti su niži troškovi liječenja te kozmetički prihvatljiviji ishod.
U ove oblike liječenja ubrajamo fotodinamičku terapiju (PDT), topički 5-fluorouracil (5-FU), topičku terapiju imikvimodom, intralezijski interferon alfa-2b (IFN-α2b), radijacijsku terapiju i kemoterapiju.
Nove molekularne terapije usmjerene protiv Hedgehog (Hh) signalnog puta, kao što su vismodegib i sonidegib, predstavljaju učinkovit terapijski tretman za lokalno uznapredovale/ neoperabilne BCC (laBCC) i metastaske BCC (mBCC).

Abstract (english)

Basal cell carcinomas (BCC) and squamous cell carcinomas (SCC), together referred to as nonmelanoma skin cancer (NMSC), are the most commonly diagnosed malignant neoplasms in the Caucasians in most countries around the world. Causes of this condition may be found in few risk factors such as increased exposure to sunlight, longer life expectancy and genetic predisposition.
Workup of patients with lesions suspicious of NMSC should begin with a history and physical examination of the skin. Dermoscopy is one of the most commonly used noninvasive diagnostic techniques. The evaluation of a sample obtained by skin biopsy is considered as the gold standard in the diagnosis of NMSC. Among novel diagnostic techniques, reflectance confocal microscopy (RCM) showed great success.
Therapy of NMSCs includes surgical and nonsurgical techniques. For the vast majority of NMSCs, surgery is the curative treatment of choice as it provides the best means of controlling that the entire tumor is removed. Besides excisional surgery as gold standard, Mohs' micrographic surgery (MMS) and ablative methods can also be used.
Nonsurgical methods represent a therapy option for certain patients as in many cases cure rates approach those provided by surgery, and other advantages are lower overall costs and more cosmetically acceptable outcomes.
These methods include photodynamic therapy (PDT), topical 5-fluorouracil (5-FU), imiquimod therapy, intralesional interferon alfa-2b (IFN-α2b), radiotherapy and chemotherapy. Novel molecular therapies targeted against Hedgehog (Hh) signaling pathway, such as vismodegib and sonidegib, represent powerful treatment options for locally advanced/ inoperable BCCs (laBCCs) and metastatic BCCs (mBCCs).

• Keywords: nemelanomski zloćudni tumori kože; bazocelularni karcinom; planocelularni karcinom; dijagnostika; kirurško liječenje; nekirurško liječenje; inhibitori Hedgehog puta
• Keywords (english): nonmelanoma skin cancer; basal cell carcinoma; squamous cell carcinoma; diagnosis; surgical treatments; nonsurgical treatments; Hedgehog pathway inhibitors
• Language: croatian
• URN:NBN: urn:nbn:hr:105:916905
• Study programme: Title: Dermatology and venereology; Study programme type: university; Study level: postgraduate specialist; Academic / professional title: sveučilišni/a magistar/magistra dermatologije i venerologije (sveučilišni/a magistar/magistra dermatologije i venerologije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-02-14 10:31:01