Abstract | Karcinom pluća obuhvaća skupinu različitih tumora koji potječu iz raznovrsnih tkiva
koja se nalaze u plućima. Najčešće nastaje iz epitelnih stanica glavnih i segmentalnih bronha,
a rjeđe iz malih, perifernih bronha.To je zloćudni epitelni tumor koji raste polagano i podmuklo,
često bez simptoma, brzo se širi u druge organe, a rezultati liječenja su skromni.
Pušenje cigareta navodi se kao glavni rizični čimbenik u nastanku karcinoma pluća, ali i aeropolucija
u urbanim sredinama, izlaganje azbestu, ionizacijskom zračenju, niklu, kromu i arsenu,
te pasivno pušenje pridonose razvoju te bolesti.
SZO (Svjetska zdravstvena organizacija) klasificirala je karcinom pluća prema histološkoj
slici u četiri skupine: karcinom pločastih stanica, karcinom malih stanica, adenokarcinom i
karcinom velikih stanica. Kliničke manifestacije karcinoma pluća ovise o lokalizaciji i veličini
primarnog tumora, njegovoj propagaciji na okolne strukture u toraksu, pojavi regionalnih i
udaljenih metastaza, vrsti tumora, imunitetu organizma, dosadašnjim i sadašnjim bolestima,
profesionalnoj izloženosti etiološkim čimbenicima, životnim navikama (pušenju), spolu, dobi
i komplikacijama samog tumora. U liječenju karcinoma pluća najvažnija je pravovremena
dijagnoza, a koriste se brojne invazivne i neinvazivne metode. Te metode uključuju uzimanje
anamneze, fizikalni pregled, laboratorijsku obradu, određivanje tumorskih markera, citološku
analizu sputuma, bronhoskopiju i analizu citopatoloških uzoraka. Za procjenu proširenosti
bolesti koristi se RTG srca i pluća, CT toraksa, abdomena i mozga, UZV abdomena, scintigrafija
kosti, RTG snimka skeleta kod prisutnih simptoma, citološka punkcija pleuralnog izljeva,
biopsija povećanih limfnih čvorova, MR, PET-CT, medijastinoskopija i punkcija koštane srži.
Temelji zdravstvene skrbi bolesnika s karcinomom pluća su rano otkrivanje, postavljanje pravovremene
dijagnoze, liječenje i adekvatna zdravstvena njega, psihološka potpora i rehabilitacija. |
Abstract (english) | Lung cancer comprises a group of different tumors that come from a variety of tissues
that are found in the lungs. Most often arises from epithelial cells of primary and segmental
bronchs, less frequently from small, peripheral bronchs. It is a malignant epithelial tumor that
grows slowly and insidiously, often without symptoms, spreads rapidly to other organs, and
the results of treatment are modest. Cigarette smoking is stated as a major risk factor in causing
lung cancer, but aeropolucion in urban environments, exposure to asbestos, ionizing radiation,
nickel, chromium and arsenic, as well as passive smoking contributes to the development
of these diseases. WHO (World Health Organization) has classified the lung cancer
according to histological into four groups: squamous cell carcinoma, small cell carcinoma,
adenocarcinoma and large cell carcinoma. Clinical manifestations of lung cancer depend on
the location and size of the primary tumor, its propagation to neighboring structures in the
thorax, emergence of regional and distant metastases, tumor type, the immunity of the organism,
prior and current diseases, occupational exposure to etiologic factors, life habits (smoking),
gender, age and complications of the tumor.
In the treatment of lung cancer the most important is the timely diagnosis and use of many
invasive and non-invasive methods. These methods include history taking, physical
examination, laboratory processing, determination of tumor markers, sputum citology,
bronchoscopy and analysis cytopathic samples. To estimate the prevalence of disease is used
X-ray of the heart and lung, CT of the thorax, abdomen and brain, ultrasound of the abdomen,
bone scintigraphy, X-ray skeleton at present symptoms, pleural effusion FNA biopsy increased
lymph nodes, MR, PET-CT, mediastinoscopy and puncture bone marrow.
Based health care of patients with lung cancer is early detection, posting timely diagnosis,
treatment and adequate medical care, psychological support and rehabilitation. |