Repozitorij Medicinskog fakulteta Sveučilišta u Zagrebu

Prognostička vrijednost angiogeneze i sadržaja DNA tumorskih stanica u bolesnica sa seroznim rakom jajnika

Vujić, Goran (2007) Prognostička vrijednost angiogeneze i sadržaja DNA tumorskih stanica u bolesnica sa seroznim rakom jajnika. PhD thesis, Sveučilište u Zagrebu.

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    Croatian abstract

    Karcinom jajnika čini 5% svih karcinoma u žena. Iako na karcinom jajnika otpada 23% ginekoloških karcinoma, skoro 50% svih smrti od genitalnog karcinoma uzrokovano je karcinomom jajnika. Životni rizik za nastanak karcinoma jajnika iznosi 1,44% svih novorođenih (1/69). Petogodišnje preživljenje žena oboljelih od karcinoma jajnika danas se kreće do 45%. Nema značajnih razlika u učestalosti i preživljenju oboljelih od karcinoma jajnika unatrag 10-ak godina. Materijali i metode. U studiju je uključeno 116 bolesnica koje su liječene u Zavodu za ginekološku onkologiju Klinike za ženske bolesti i porode, KBC-a Zagreb u razdoblju od 1993-1998. zbog seroznog karcinoma jajnika. U svih ispitanica prikazani su kliničko-patološki prognostički čimbenici i kirurški uspjeh liječenja. Cilj. Odrediti stupanj neoangiogeneze za svaki pojedini serozni karcinom jajnika uz pomoć monoklonskog protutijela CD-105. Usporediti gustoću krvnih žila po jedinici površine s ostalim kliničkim i patohistološkim prognostičkim čimbenicima. Odrediti sadržaj DNA tumorskih stanica metodom protočne citometrije. Usporediti povezanost sadržaja DNA tumorskih stanica s ostalim kliničkim i patohistološkim prognostičkim čimbenicima. Rezultati. Univarijatnom analizom statistički značajnima u odnosu na preživljenje pokazali su se klinički stadiji bolesti (p<0,001), rani karcinom jajnika u odnosu na uznapredovali karcinom jajnika (p<0,001), stupanj zrelosti tumora ili gradus (p<0,001), veličina ostatnog tumora > 2 cm (p<0,001), vrijednosti MVD-a > 30 (p<0,001), te ploidnost tumora (p<0,001). Coxovom regresijom analizirani su čimbenici koji su se univarijatnom analizom pokazali statistički značajnima, te je na temelju toga formiran model za preživljenje bolesnica sa seroznim karcinomom jajnika visoke predikcije (X2 = 91,902, dF=6, p< 0,001). Pokazano je kako je statistički nezavisan faktor MVD > 30 (p=0,001), klinički stadij bolesti (p=0,002), ostatni tumor veći od 2 cm (p=0,02) i optimalan operacijski zahvat (p=0,001). Zaključak. Klinički stadij bolesti kao i ostatni tumor > 2 cm pokazali su se kao značajni prognostički čimbenici za preživljenje od seroznog karcinoma jajnika. MVD > 30 je izrazito važan statistički čimbenik za lošiji ishod u bolesnica sa seroznim karcinomom jajnika. Uvođenje mjerenja MVD-a u bolesnica sa seroznim karcinomom jajnika dalo bi smjernice u predmnijevanju agresivnog ponašanja tumora.

    English abstract

    Ovarian cancer amounts to 5% of all types of cancer in women. Although ovarian cancer accounts for 23% of all female reproductive types of cancer. Almost 50% of all fatalities caused by genital carcinoma are due to ovarian cancer. The lifetime risk for developing ovarian carcinoma is 1.44% of all newborns, or (1/69). Today, the survival rate for women who have developed ovarian cancer is up to 45%. There have been no significant differences in the frequency of development and the survival rate for the ovarian cancer in the past 10 years. Materials and methods. The study included 116 patients treated for serous ovarian cancer between 1993 and 1998 at the Institute for female reproductive oncology, Hospital for female reproductive medicine, the Zagreb Clinical Medical Center. Clinical and pathological prognostic factors and treatment methods for all 116 patients are presented. Aims. To determine the degree of neo-angiogenesis for each individual case of serous ovarian cancer using monoclonal antibody CD-105; to compare the density of blood vessels per area unit to other clinical and pathohistological prognostic factors; to determine the content of DNA (DNA ploidy) using flow cytometry; to compare the link of tumor cells DNA ploidy to other clinical and pathohistological prognostic factors. Results. Using the univariate analysis method, the following was found statistically relevant to the survival ratio: clinical stage (p<0.001), early ovarian cancer compared to the advanced ovarian cancer (p<0.001), tumor maturity degree or gradient (p<0.001), size of the residual tumor >2 cm (p<0.001), MVD value >30 (p<0.001) and DNA ploidy (p<0,001). Using the Cox regression method, factors proved statistically relevant through the univariant anaysis were analysed to create a survival rate model for serous ovarian cancer patients with high predisposition (x2=91.902, dF=6, p<0.001). The study shows that the statistically independent factor MVD > 30 (P<0.001), clinical stage (p=0.002), residual tumor > 2 cm (p=0.02) and optimized surgery (p=0.001). Conclusion. Clinical stage, as well as the residual tumor > 2 cm have proved significant prognostic factors for surviving serous ovarian cancer. MVD > 30 is an extremely important statistical factor in determining adverse outcome for the patients with serous ovarian cancer. Introducing MVD screening for the patients with serous ovarian cancer would provide guidance in anticipating tumor's aggressive progress.

    Item Type: Thesis (PhD)
    Mentor: Čorušić , Ante
    Divisions: Izvan medicinskog fakulteta
    Depositing User: dr.med. Helena Markulin
    University: Sveučilište u Zagrebu
    Institution: Medicinski fakultet
    Number of Pages: 119
    Status: Unpublished
    Creators:
    CreatorsEmail
    Vujić, Goran
    Date: 13 December 2007
    Date Deposited: 09 Apr 2008
    Last Modified: 23 Sep 2011 18:10
    Subjects: /
    Related URLs:
      URI: http://medlib.mef.hr/id/eprint/361

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