Title Rani karcinom želuca Title (english) Early gastric cancer Author Lucija Okreša Mentor Nadan Rustemović (mentor)Committee member Rajko Ostojić (predsjednik povjerenstva)Committee member Nadan Rustemović (član povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Granter University of Zagreb Defense date and country 2018-07-13, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract S obzirom na veliku incidenciju karcinoma želuca u svijetu i njegovu veliku smrtnost, bitno ga je pravovremeno dijagnosticirati kako bi liječenje bilo što uspješnije. U zapadnoeuropskim zemljama, u jednoj godini, incidencija je od 10 do 15 novooboljelih na 100 000 stanovnika, dok je u Hrvatskoj taj broj do 35 za muškarce i oko 20 za žene te na taj način čini treći malignom prema učestalosti (nakon karcinoma bronha i pluća te kolorektuma). Najbolju prognozu imaju karcinomi koji su dijagnosticirani još u svom početnom stadiju, odnosno rani karcinomi želuca. Koncept ranog karcinoma želuca potječe iz Japana iz 1962. godine, kada je rani karcinom želuca bio definiran kao neoplazma koja se može uspješno liječiti operacijom, dok je danas taj isti karcinom definiran mnogo specifičnije, kao adenokarcinom koji je ograničen na mukozu ili submukozu, bez obzira na to zahvaća li metastazom i limfne čvorove. Karcinomi tog tipa, u odnosu na kasnije i naprednije stadije želučanih karcinoma, imaju znatno bolju prognozu (petogodišnje preživljenje je oko 90%). Sam karcinom želuca može nastati na dva načina: de novo (iz normalne želučane sluznice) ili iz prekanceroznih lezija kao što su područja intestinalne metaplazije, žljezdane displazije ili adenomatoznih polipa. Uzrok karcinoma želuca nije nam poznat, ali su poznati brojni rizični čimbenici, kao što su infekcija s Helicobater pylori, pušenje, loše prehrambene navike. Simptomi ranog raka želuca nisu specifični, zbog čega se obično karcinomi i otkrivaju u kasnijoj fazi. Pacijenti mogu biti bez simptoma ili se mogu prezentirati s dispepsijom, blagom epigastričnom boli, mučninom ili anoreksijom. Dijagnoza se najčešće postavlja endoskopijom sa sustavnim neciljanim i ciljanim biopsijama sumnjivih lezija. S obzirom da se endoskopska resekcija (En bloc EMR) smatra ujedno i metodom kojom se određuje stadij karcinoma kao i metodom liječenja, ta bi metoda trebala biti metoda prvog izbora kod pacijenata s ranim karcinomom želuca.
Abstract (english) Given the large incidence of stomach cancer in the world and its high mortality, it is essential to diagnose it in a timely manner so that treatment can be most successful. In Western European countries the annual incidence ranges from 10 to 15 new patients per 100,000 population, while in Croatia this number is approx. 35 for men and about 20 for women, and thus makes it the third malignancy in frequency (after bronchial and lung cancer and colorectal cancer). The best prognosis is for cancers that are diagnosed in their initial stages, ie. early stomach cancers. The concept of early stomach cancers originated in Japan in 1962, when early gastric cancer was defined as a neoplasm that can be effectively treated by surgery, whereas the same cancer is now defined much more specifically, as adenocarcinoma limited to the mucosa or submucosa, irrespective of lymph node metastasis. Carcinoma of this type, compared to later and more advanced stages of gastric cancer, have a significantly better prognosis (about 90% of 5-year survival). Stomach cancer can occur in two ways: de novo (from normal gastric mucosa) or from precancerous lesions such as areas of intestinal metaplasia, glandular dysplasia, or adenomatous polyps. The cause of stomach cancer is still not known, but there are many known risk factors, such as infection with Heliobacter pylori, smoking, an unhealthy diet, etc. Symptoms of early gastric cancer are not specific, which is why the cancers are usually detected in their later development stage. Patients may be without symptoms or may be presented with dyspepsia, mild epigastric pain, nausea or anorexia. Diagnosis is most commonly confirmed by endoscopy with systemic un-targeted and targeted biopsies of suspicious lesions. Endoscopy resection is considered both a staging procedure and a treatment method for early gastric cancer, which makes en bloc resection the first choice in the treatment of these patients.
Keywords
karcinom želuca
rani karcinom želuca
endoskopska resekcija
endoskopski ultrazvuk
Keywords (english)
gastric cancer
early gastric cancer
endoscopic mucosal resection
endoscopic ultrasound
Language croatian URN:NBN urn:nbn:hr:105:529813 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2018-12-17 10:31:59
