Title Mikroinvazivni rak vrata maternice
Title (english) Microinvasive cervical cancer
Author Anja Ovčariček
Mentor Alemka Brnčić-Fischer (mentor)
Committee member Marko Klarić (predsjednik povjerenstva)
Committee member Aleks Finderle (član povjerenstva)
Committee member Danijela Vrdoljak-Mozetič (član povjerenstva)
Granter University of Rijeka Faculty of Medicine Rijeka
Defense date and country 2024-06-27, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Gynecology and Obstetrics
Abstract Mikroinvazivni rak vrata maternice klasificira se kao mikroskopska lezija čija dubina u stromu od baze epitela ne prelazi 5 mm. Stadij IA dijeli se još na stadij IA1 i na stadij IA2. Žene s mikroinvazivnim rakom vrata maternice obično su asimptomatske, bez subjektivnih tegoba. Simptomi, kada su prisutni, obično su ograničeni na međumenstrualno ili postkoitalno krvarenje. Dijagnoza mikroinvazivnog raka vrta maternice postavlja se isključivo patohistološkom analizom suspektne lezije. Uzorak tkiva potreban za patohistološku analizu dobiva se ekscizijskom biopsiom. Ekscizijske biopsije jesu postupci kod kojih dobiveni uzorci tkiva predstavljaju dijelove tkiva cerviksa konusnog oblika, a uključuju donji dio endocervikalnog kanala te dio egzocerviksa. Nakon određivanja kliničkog stadija mikroinvazivnog raka vrata maternice odlučuje se i izabire što je moguće poštedniji oblik liječenja. Zbog niskog rizika širenja bolesti u parametrijalne i uterosakralne limfne čvorove, lezije stadija IA1 liječe se konizacijom. Konizacija je ujedno i tretman izbora za mlade pacijentice koje žele očuvati svoju reproduktivnu sposobnost. Međutim, ukoliko je žena završila s reprodukcijom tada prednost ima histerektomija tipa A. Ako u stadiju IA1 mikroinvazivnog raka vrata maternice postoji invazija limfovaskularnog prostora, time se značajno povećava i rizik od metastaza u limfnim čvorovima te se iz tog razloga uz konizaciju učini i zdjelična limfadenektomija. U liječenju stadija IA2 najprihvatljivije je učiniti histerektomiju sa zdjeličnom limfadenektomijom. U bolesnica mlađih od 35 godina, da bi sačuvale plodnost, izvodi se trahelektomija sa zdjeličnom limfadenektomijom. Općenito, kada se radi o mikroinvazivnom raku vrata maternice, riječ je o malim lezijama koje u pravilu imaju dobru prognozu s visokom stopom petogodišnjeg preživljenja i malim rizikom od pojave recidiva.
Abstract (english) Microinvasive cervical cancer is classified as a microscopic lesion in which the depth of invasion should not be greater than 5 mm from the base of the epithelium. Stage IA is further subdivided into two stages, stage IA1 and stage IA2. Women with microinvasive cervical cancer are usually asymptomatic, without subjective complaints. Symptoms, when they are present, are usually limited to intermenstrual or postcoital bleeding. The diagnosis of microinvasion can only be made by pathohistological analysis of the suspected lesion. The specimen required for pathohistological analysis is obtained by excisional biopsy. Excisional biopsies are procedures in which the obtained tissue samples represent parts of the cervical tissue in a conical shape, and include the lower part of the endocervical canal and part of the exocervix. Once the clinical stage of microinvasive cervical cancer is confirmed, the method of treatment may be decided, which should always be done as sparingly as possible. Since there is a small risk of lymph node metastases to the parametrial and uterosacral lymph nodes, stage IA1 lesions are treated with conization. Conization is the treatment of choice for young patients wishing to preserve their fertility. However, in women who have completed childbearing or in elderly women a hysterectomy type A is preferred. If there is invasion of the lymphovascular space in stage IA1 microinvasive cervical cancer, there is a significant risk of metastases in the lymph nodes and for this reason hysterectomy and pelvic lymphadenectomy are used as the first choice of treatment. In the treatment of stage IA2, it is most acceptable to perform a radical hysterectomy with pelvic lymphadenectomy. The most acceptable treatment of stage IA2 is to perform a radical hysterectomy with pelvic lymphadenectomy In patients under the 35 years old, in order to preserve fertility, trachelectomy with pelvic lymphadenectomy is performed. In general, microinvasive cervical cancer represents small lesions that usually have a good prognosis with a high five-year survival rate and a low risk of recurrence.
Keywords
mikroinvazivni rak vrata maternice
liječenje
konizacija
histerektomija
Keywords (english)
microinvasive cervical cancer
treatment
conization
hysterectomy
Language croatian
URN:NBN urn:nbn:hr:184:484562
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
Terms of use
Created on 2024-07-01 12:03:16