Tumorsko pupanje i mikrosatelitna nestabilnost u bolesnika sa sporadičnim karcinomom debelog crijeva i rektuma stadija II

doctoral thesis

• Title (english): Tumor budding and microsatellite instability in patients with sporadic colon and rectal cancer stage II
• Author: Josip Baković
• Mentor: Sven Seiwerth (mentor)
• Mentor: Čedna Tomasović-Lončarić (komentor)
• Committee member: Davor Tomas (predsjednik povjerenstva)
• Committee member: Leonardo Patrlj (član povjerenstva)
• Committee member: Lovorka Batelja Vuletić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-06-10, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Cytology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pathology
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Bolesnici s kolorektalnim karcinomom stadija II predstavljaju skup biološki dosta različitih tumora različitog preživljenja unatoč homogenosti klasifikacije stadija II. Razvojem molekularne biologije i histopatologije javlja se potreba bolje kategorizacije s ciljem prepoznavanja karcinoma s većim rizikom diseminacije.
U provedenoj studiji retrospektivno je analizirano 89 bolesnika s kolorektalnim karcinomom stadija II gdje su uz standardne sastavnice patohistološkog nalaza za kolorektalni karcinom određivani mikrosatelitna nestabilnost i tumorsko pupanje na standardnim hemalaun-eozinskim preparatima. Dobiveni podaci korišteni su za analizu preživljenja, i to odvojeno za endoskopske biopsije i resektate, uporabom algoritma rekurzivnoga particioniranja zvanog rpart.
Iz podataka endoskopske biopsije, rpart algoritam smatra da najveći informacijski značaj imaju tumorsko pupanje, vaskularna invazija te dob bolesnika. Rpart algoritam iz podataka resektata određuje da najveći informacijski značaj imaju broj pregledanih limfnih čvorova, tumorsko pupanje te vaskularna invazija. U ovom radu rpart algoritam nije prepoznao mikrosatelitnu nestabilnost kao prognostički čimbenik na endoskopskoj biopsiji ni resektatu.
Važno je istaći da uz biološke karakteristike tumora osnovnu prognostičku značajku kolorektalnog karcinoma stadija II čini kvaliteta izvedenog kirurškog zahvata te samog patohistološkog nalaza koja se očituje prvenstveno u broju pregledanih limfnih čvorova. Rezultati ovog rada upućuju na to da uz mikrosatelitnu nestabilnost tumorsko pupanje treba postati sastavni dio patohistološkog nalaza kolorektalnog karcinoma.

Abstract (english)

Colorectal cancer stage II represent a set of biologically quite different tumors with different survival despite the homogeneity of the stage II classification.
The study retrospectively analyzed 89 patients with colorectal cancer stage II, where in addition to the standard components of the pathohistological findings for colorectal cancer, MSI and tumor budding were determined. The data obtained were used for survival analysis, for endoscopic biopsies and resects.
From endoscopic biopsy data, the rpart algorithm considers that tumor budding, vascular invasion, and age of patients are of the greatest informational importance. The rpart algorithm from the resect data determines that the number of examined
lymph nodes, tumor budding and vascular invasion are of the greatest informational importance. In this paper, the rpart algorithm did not recognize microsatellite instability as a prognostic factor.
It is important to point out that in addition to the biological characteristics of the tumor, the basic prognostic feature of stage II colorectal cancer is the quality of the performed surgery and the pathohistological findings, manifested primarily in the number of examined lymph nodes. The results suggest that in addition to microsatellite instability, tumor budding should become an integral part of the pathohistological findings of colorectal cancer.

• Keywords: kolorektalni karcinom stadij II; mikrosatelitna stabilnost/nestabilnost; tumorsko pupanje; limfni čvorovi; vaskularna invazija.
• Keywords (english): colorectal cancer stage II; microsatellite stability/instability; tumor budding; lymph nodes; vascular invasion.
• Language: croatian
• URN:NBN: urn:nbn:hr:105:908981
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 72 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-24 09:36:30