Procena individualnih prediktivnih faktora za nastanak karcinoma kolona
An analysis of individual predictive factors for the development of colon carcinoma
Author
Tomašević, Ratko S.Mentor
Milosavljević, TomicaCommittee members
Krstić, MiodragPekmezović, Tatjana
Golubović, Gradimir
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Show full item recordAbstract
Uvod: Kolorektalni karcinom (CRC) najčešće nastaje sporadično kao rezultat
akumulacije genetskih promena u sadejstvu sa različitim spoljašnjim uticajima kao
rizičnim faktorima. Jedan je od najčešćih malignih tumora kod oba pola i značajan
zdravstveni problem kako u svetu tako i u Srbiji. Nažalost, polovina bolesnika se
otkriva u uznapredovaloj fazi bolesti. Stoga su prepoznavanje prediktivnih faktora za
nastanak bolesti i prevencija od izuzetnog značaja u borbi protiv ekspanzije CRC-a.
Cilj: Utvrđivanje prediktivnog značaja pojedinih demografskih, naslednih,
socioekonomskih i dijetetskih faktora kao i celokupnog stila života za nastanak
kolorektalnog karcinoma koristeći pojedine statističke pokazatelje i Bayes-ovu analizu u
cilju identifikacije najznačajnijih za nastanak bolesti. Želeli smo da procenimo
prediktivni potencijal biomarkera karcinoembrionskog antigena (CEA) i karbohidratnog
antigena 19-9 (CA 19-9) kod detekcije obolelih u ranim fazama bolesti. Cilj je bio i
dizajniranje no...vog grafičkog okvira koji povezuje pojedine parametre i određuje njihov
značaj u individualnoj proceni rizika.
Metode: Ova prospektivna studija slučajeva i kontrola je sprovedena je u Kliničko
bolničkom centru Zemun u Službama gastroenterologije, opšte hirurgije i traumatologije
tokom 2014. i 2015. godine. U istraživanje je uključeno 372 ispitanika od kojih je 181
bolesnik sa histološki potvrđenom dijagnozom karcinoma kolona i 191 ispitanik u
kontrolnoj grupi koji su primljeni zbog akutnih, neneoplastičnih razloga. Da bi se
prikupile relevantne informacije vezane za faktore rizika dizajniran je specijalni upitnik.
Pitanja su se odnosila na širok spektar potencijalnih uticaja nepromenljivih i
promenljivih rizičnih faktora. Dijagnostika kolorektalnog karcinoma je podrazumevala
kliničke, endoskopske, histopatološke i laboratorijske preglede, ultrazvuk i
kompjuterizovanu tomografiju u skladu sa dobrom kliničkom praksom. U statističkoj
analizi prediktivne sposobnosti pojedinih parametara korišćena je binarna logistička
regresiona analiza. Dijagnostička tačnost tumorskih markera utvrđena je
izračunavanjem senzitivnosti, specifičnosti i primenom Receiver Operating
Characteristics (ROC) krive...
Introduction: Colorectal carcinoma (CRC) usually arises sporadically and results from
interaction of genetic changes accumulation with some different external risk factors. It
is one of the most frequent cancers among both genders and important health problem
worldwide, as well as in Serbia. Unfortunately, the halves of the patients are detected in
advanced disease. Therefore, an identification of CRC development predictive factors is
crucial in the cope with it.
Objective: To identify and assess the predictive significance of certain demographic,
hereditary, socioeconomic, dietary and lifestyle factors as the most important causes of
CRC by using of certain statistical indicators and Bayesian analysis. Additionally,
predictive power of biomarkers (carcinoembryonic antigen - CEA and carbohydrate
antigen 19-9 - CA 19-9) in the patient’s early stages disease detection was evaluated.
Another aim of the study was to design a new graphical framework that linked
individual parameters and det...ermined their importance in individual risk assessment.
Methods: This prospective case control study was conducted at the Departments of
Gastroenterology, General surgery and Traumatology of Clinical Hospital Centre
Zemun during 2014-2015. Out of 372 patients, 181 were with histologically confirmed
CRC and 191 control subjects were hospitalized due to acute non neoplastic reasons. In
order to collect relevant information regarding risk factors, a special questionnaire was
designed. The questions encompassed wide range impacts of determined risk factor.
Diagnostic evaluation of CRC included clinical, endoscopic, histological, and laboratory
examinations. Additionally, imaging procedures for secondaries detection were
performed (abdominal ultrasound and computed tomography), according to good
clinical practice. Binary logistic regression analysis model was used for assessment of
predictive ability of individual parameters. The diagnostic accuracy of tumor markers
was determined by calculating the sensitivity, specificity and application of Receiver
Operating Characteristics (ROC) curve. BayesianLab server version 5.4. was used in the
purpose of Bayesian analysis...