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master's thesis
Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća
Zagreb: University of Zagreb, School of Medicine, 2022. urn:nbn:hr:105:505956
Matijašević, Leo
University of Zagreb
School of Medicine
Department of Pathology

Institutional repository: Dr Med - University of Zagreb School of Medicine Digital Repository

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Matijašević, L. (2022). Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća (Master's thesis). Zagreb: University of Zagreb, School of Medicine. Retrieved from https://urn.nsk.hr/urn:nbn:hr:105:505956

Matijašević, Leo. "Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:505956

Matijašević, Leo. "Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća." Master's thesis, University of Zagreb, School of Medicine, 2022. https://urn.nsk.hr/urn:nbn:hr:105:505956

Matijašević, L. (2022). 'Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća', Master's thesis, University of Zagreb, School of Medicine, accessed 19 April 2024, https://urn.nsk.hr/urn:nbn:hr:105:505956

Matijašević L. Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća [Master's thesis]. Zagreb: University of Zagreb, School of Medicine; 2022 [cited 2024 April 19] Available at: https://urn.nsk.hr/urn:nbn:hr:105:505956

L. Matijašević, "Važnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća", Master's thesis, University of Zagreb, School of Medicine, Zagreb, 2022. Available at: https://urn.nsk.hr/urn:nbn:hr:105:505956

Metadata
TitleVažnost patološke analize u odabiru ciljane terapije bolesnika s karcinomom pluća
Title (english)The importance of pathological analysis in the treatment options of targeted therapy in patients with diagnosis of lung cancer
AuthorLeo Matijašević
MentorLovorka Batelja-Vuletić (mentor)
Committee memberSven Seiwerth (predsjednik povjerenstva)
Committee memberMarko Jakopović (član povjerenstva)
Committee memberLovorka Batelja-Vuletić (član povjerenstva)
GranterUniversity of Zagreb
School of Medicine
(Department of Pathology)
Zagreb
Defense date and country2022-07-15, Croatia
Scientific / art field,
discipline and subdiscipline		BIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Pathology
Abstract
Cilj Cilj ovog diplomskog rada je prikazati aktualni i nadolazeći patološko-dijagnostički algoritam karcinoma pluća u Republici Hrvatskoj, uključujući različite metode uzimanja tkivnih uzoraka, tj. invazivne dijagnostike. Dat će se pregled definiranih predanalitičkih, analitičkih i postanalitičkih parametra, prikaz aktualnih ESMO i NCCN smjernica za karcinome pluća te dijagnostički pristup vezan uz postojeće ciljane terapije te imunoterapiju. ----- Metode Pretraživanjem aktualne dostupne literature iz baze podataka Medline putem mrežne stranice PubMed naveden je kratki prikaz patološke analize koja se koristi u odabiru ciljane terapije kod karcinoma pluća. ----- Zaključak Uzorci koji se analiziraju u patologiji su mali uzorci tkiva te veliki resekcijski, operativni materijal. Alternativne uzorke čine citološki blokovi i citološki razmazi, za koje ne postoje preporuke u aktualnim smjernicama. Morfologija tumora se analizira na hemalaun-eozinskim preparatima. U slučaju nedostatnosti se za patološki dijagnozu koriste imunohistokemijski markeri. Preporučeni panel je TTF1 i p40, te CD56 za potvrdu neuroendokrine diferencijacije. Patološka dijagnoza određuje se sukladno aktualnoj WHO klasifikaciji tumora pluća. Patološka analiza obuhvaća i analizu prediktivnih biomarkera za ciljane terapije. Posljednje ESMO smjernice i nove NCCN smjernice preporučuju analizu PD-L1 statusa kako bi se, potencijalno, i imunoterapija uvrstila u terapiju pacijenta s nesitnostaničnim karcinomom pluća. Prediktivni biomarkeri mogu se, ovisno o biomarkeru, analizirati na razini mRNA, jednom od sljedećih metoda - RT-PCR, NGS ili na razini proteinskog produkta metodom imunohistokemije. Donesene su i smjernice za patološku analizu neoadjuvantno tretiranog tumorskog tkiva koje sadrže 11 preporuka s ciljem procjene prethodne terapije i odabira sljedećeg terapijskog pristupa.
Abstract (english)
Objective The aim of this review is to present, current and future, pathological diagnostic algorithms for lung cancer in Croatia. Different invasive tissue-samling methods, pre-analytical, analytical and post-analytical parameters will be described. Also, the current ESMO and NCCN guidelines for lung cancer, as well as diagnostics-related response to the existing targeted and immunotherapies will be reviewed. ----- Methods A brief overview of the pathological analysis used in the selection of targeted therapies for lung cancer will be presented by the research of currently available literature from the Medline database via the PubMed website. ----- Conclusion The specimens analyzed in pathology are small tissue samples and operative material. Alternative samples are cytological blocks and cytological smears. However, the current guidelines do not provide any recommendations for these type of samples. Tumor morphology is analyzed on hemalaun-eosin preparations which are not sufficient for the pathological diagnosis. The recommended immunohistochemical markers panel is TTF, p40, and CD56. The latter confirms the neuroendocrine differentiation. Pathological diagnosis is given in accordance with the current WHO classification of lung tumors. Pathological analysis also includes the analysis of predictive biomarkers for targeted therapies Recent ESMO guidelines and NCCN guidelines recommend PD-L1 status analysis with the aim of including immunotherapy in the treatment of non-small cell lung cancer. Predictive biomarkers can be analyzed at DNA or mRNA level using RT-PCR or NGS. Also, the protein product can be analyzed immunohistochemically. Guidelines for the pathological analysis of neoadjuvant-treated tumor tissue have been adopted, containing 11 recommendations.
Keywords
Keywords (english)
Languagecroatian
URN:NBNurn:nbn:hr:105:505956
Study programmeTitle: Medicine
Study programme type: university
Study level: integrated undergraduate and graduate
Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
Type of resourceText
File originBorn digital
Access conditionsOpen access
Terms of useLicence In copyright icon
Created on2023-01-19 09:05:53