Avtor/Urednik		Marčec, Mateja
Naslov		Zasevanje raka endometrija v področne bezgavke
Tip		monografija
Kraj izdaje		Ljubljana
Založnik		Medicinska fakulteta
Leto izdaje		2007
Obseg		str. 74
Jezik		slo
Abstrakt		Background. The aim of this study was to assess the routes of lymphatic spread of endometrial cancer in regional lymph nodes depending on the histological type and other predicting factors for metastasis in regional lymph nodes. We wished to find the group of sentinel nodes in a defined histological type of cancer, upon which we could make conclusions on the entire status of the lymph nodes. If such a group of lymph nodes exists, we can decide on systematic lymphadenectomy and adjuvant treatment. Methods. Our retrospective analysis included data of 174 patients with endometrial carcinoma who underwent surgical treatment with hysterectomy, bilateral salpingooophorectomy and pelvic and/or paraaortic lymphadenctomy between January 1995 and December 2004. Patients with simultaneous oilier primary gynecological cancer were excluded. The removed specimens were examined histopathologically. Lymph nodes were isolated form 21 anatomical regions, which were joined for statistical analysis into eight pelvic and six paraaortic node groups. Results. Statistically more frequently metastases were found in the lymph nodes in papillary serous adenocarcinoma. Lymph node metastases were also found in clear cell adenocarcinoma, mixed carcinoma and endometrioid adenocarcinoma of endometrii, but there was no statistical significance. Metastases in the regional lymph nodes were found statistically significantly more often in poorly differentiated cancers, invasion of more than one half of the myometrium, lymphovascular invasion, cervical invasion and extrauterine metastases. For positive peritoneal cytology we could not find that correlation. Most commonly, metastases were identified in the superficial obturator lymph nodes. However, no lymph node group was significantly more often affected with metastases with regard to the histological type of carcinoma. (Abstract truncated at 2000 characters)
Izvleček		Izhodišča. Namen naloge je bil ugotoviti načine zasevanja raka endometrija v področne bezgavke v odvisnosti od histološkega tipa raka in ostalih napovednih dejavnikov za zasevke v bezgavkah. Želeli smo prepoznati skupino varovalnih bezgavk pri določenem histološkem tipu raka, glede katere bi lahko sklepali na stanje bezgavk v celoti. Če takšna skupina obstaja, se lahko glede na prisotnost oziroma odsotnost zasevkov odločamo o potrebi sistematske limfadenektomije ter nadaljnjem zdravljenju. Metode dela. Retrospektivno smo analizirali podatke 174 bolnic z rakom endometrija, ki so bile kirurško zdravljene z odstranitvijo maternice z adneksi ter medenično in/ali obaortno limfadenektomijo v obdobju od januarja 1995 do decembra 2004. Bolnice s sočasnim drugim primarnim ginekološkim malignim tumorjem so bile izključene. Odstranjeno tkivo je bilo histopatološko pregledano. Bezgavke smo zbirali ločeno iz 21 anatomskih področij, ki smo jih za statistično analizo združili v osem medeničnih in šest obaortnih skupin. Rezultati. Ugotovili smo značilno več zasevkov v bezgavkah pri papilarnem seroznem adenokarcinomu. Zasevki v bezgavkah so bili prisotni še pri svetloceličnem adenokarcinomu, mešanem karcinomu in endometrioidnem adenokarcinomu endometrija, vendar pogostost ni bila statistično značilna. Značilno pogostejši so bili zasevki v bezgavkah tudi pri slabši diferenciaciji raka, invaziji čez polovico miometrija, invaziji v limfno-žilne prostore, invaziji v maternični vrat in prisotnosti zasevkov izven maternice. Pri malignih celicah v ascitesu ali izpirku trebušne votline te povezave nismo ugotovili. Najpogosteje so bili zasevki prisotni v povrhnjih obturatornih bezgavkah, nobena skupina bezgavk pa ni bila značilno pogosteje prizadeta pri določenem histološkem tipu raka. Sklepi. (Izvl. skrajšan na 2000 zn.)
Deskriptorji		ENDOMETRIAL NEOPLASMS ENDOMETRIAL NEOPLASMS ENDOMETRIAL NEOPLASMS ENDOMETRIAL NEOPLASMS ENDOMETRIAL NEOPLASMS LYMPHATIC METASTASIS LYMPHATIC METASTASIS NEOPLASM STAGING RETROSPECTIVE STUDIES