Ispitivanje fakora rizika prisustva maligniteta i pojave recidiva nakon endoskopske resekcije velikih kolorektalnih polipa
Examination of risk factors for malignancy and polyp recurrence after endoscopic resection of large colorectal polyps Factors predicting malignant occurrence and polyp recurrence after endoscopic resection of large colorectal polyps
Докторанд
Mandić, OlgaМентор
Maksimović, NatašaЧланови комисије
Tošković, BorislavSvorcan, Petar
Zdravković, Darko
Milić, Nataša
Метаподаци
Приказ свих података о дисертацијиСажетак
olorektalni karcinom predstavlja treći najučestaliji karcinom u razvijenim regionima
sveta, i drugi vodeći uzrok smrti od karcinoma. Kolorektalni polipi, najčešće adenomatozni,
predstavljaju prekursorsku leziju za pojavu karcinoma. Razvoj polipa do stadijuma karcinoma
obuhvata niz promena u kojima normalni epitel debelog creva prolazi kroz više genetskih mutacija,
dovodeći do citološke displazije i nastanka karcinoma. Ova transformacija adenoma u stadijum
karcinoma može se prekinuti postupkom endoskopske resekcije, za koju je utvrđeno da smanjuje
incidenciju i mortalitet od nastanka kolorektalnog karcinoma. Iako svaka kolorektalna neoplazija
ima maligni potencijal, polipi klasifikovani kao veliki kolorektalni polipi (≥ 20 mm u dijametru)
nose još veći rizik za razvoj karcinoma.
CILJ: Ciljevi studije bili su: ispitati demografske i kliničke karakteristike osoba sa dijagnozom
velikog kolorektalnog polipa; utvrditi prediktore prisustva maligniteta u velikim kolorektalnim
polipima i predik...tore pojave recidiva nakon endoskopske resekcije velikih kolorektalnih polipa
tokom 2 godine praćenja.
METODE: Istraživanje je sprovedeno kao kohortna studija, koja je uključila ispitanike kojima je
rađena endoskopska mukozna resekcija velikih kolorektalnih polipa u Kliničko bolničkom centru
„Bežanijska kosa”, u periodu od 2014. do 2020. godine, a koji su zatim praćeni u dvogodišnjem
vremenskom intervalu. Na osnovu endoskopske evaluacije i klasifikacije polipa, demografskih i
kliničkih karakteristika ispitanika, izvedena je jedna od sledećih procedura: endoskopska mukozna
resekcija u bloku, endoskopska mukozna resekcija „parče po parče” ili operativno lečenje nakon
prve kolonoskopije ili nakon nekompletne endoskopske mukozne resekcije. Tokom 2 godine
nakon urađene endoskopske mukozne resekcije polipa ispitanici su bili pozivani na kontrolnu
kolonoskopiju.
REZULTATI: U istraživanje je uključeno ukupno 472 pacijenta sa velikim kolorektalnim
polipima, predominantno muškog pola (62,9%), i prosečne starosti od 65,7±10,8 godina...
Colorectal cancer is the third most common cancer in developed regions of the
world, after breast and lung cancer, and the second leading cause of cancer realted death.
Colorectal polyps, usually adenomatous, represent precursor lesions of carcinoma development.
The development of adenoma to the stage of carcinoma includes a series of changes in which the
normal epithelium of the large intestine undergoes multiple genetic mutations, leading to
cytological dysplasia and the formation of carcinoma. This transformation of the adenoma to the
carcinoma can be interrupted by endoscopic resection, which has been found to reduce the
incidence and mortality of colorectal cancer. Although every colorectal neoplasia has malignant
potential, polyps classified as large colorectal polyps (≥ 20 mm in diameter) carry an even greater
risk of developing cancer.
OBJECTIVE: The objectives of the study were: to examine the demographic and clinical
characteristics of persons diagnosed with a large colorecta...l polyp; to determine predictors of the
presence of malignancy in large colorectal polyps and predictors of recurrence after endoscopic
resection of large colorectal polyps during 2 years of follow-up.
METHODS: The research was conducted as a cohort study, which included patients who
underwent endoscopic mucosal resection of large colorectal polyps at the Clinical Hospital Center
"Bežanijska kosa", from 2014 to 2020, and who were then followed up for 2 years. Based on the
endoscopic evaluation and classification of polyps, demographic and clinical characteristics of the
patients, one of the following procedures was performed: en bloc endoscopic mucosal resection,
piece-by-piece endoscopic mucosal resection, or operative treatment after the first colonoscopy or
after incomplete endoscopic mucosal resection. During 2 years after the endoscopic mucosal polyp
resection, the subjects were invited to a control colonoscopy.
RESULTS: A total of 472 patients with large colorectal polyps, predominantly male (62.9%), and
with an average age of 65.7±10.8 years, were included in the study...