master's thesis
DIJAGNOSTIKA DIFUZNOG B-VELIKOSTANIČNOG LIMFOMA

Snježana Miter (2015)
Sveučilište u Rijeci
Medicinski fakultet
Katedra za internu medicinu
Metadata
TitleDIJAGNOSTIKA DIFUZNOG B-VELIKOSTANIČNOG LIMFOMA
AuthorSnježana Miter
Mentor(s)Antica Duletić-Načinović (thesis advisor)
Abstract
Limfom je neoplazma obiljeţena zloćudnim bujanjem razvojnih oblika limfocita. Kod trećine oboljelih od ne-Hodgkinovih limfoma (NHL) dijagnosticira se difuzni B-velikostanični limfom (DLBCL). DLBCL je heterogena skupina neoplazmi porijekla B-stanica i prema klasifikaciji limfoidnih novotvorina SZO iz 2008. godine sadrţi šest nozoloških entiteta: DLBCL nespecificirani, B-LCL bogat T-stanicama ili histiocitima, primarni DLBCL CNS-a, primarni koţni DLBCL noţnog tipa, EBV pozitivni DLBCL starijih, DLBCL povezan s kroničnom upalom. Očituju se brzorastućom tumorskom masom nodalne ili ekstranodalne lokalizacije. Agresivnog su kliničkoga tijeka zahtijevajući brzu dijagnostičku obradu i liječenje. Dijagnoza je temeljena na patohistološkoj analizi bioptata tumorske mase uz imunofenotipizaciju. Morfološkim, imunohistokemijskim, citogenetskim i molekularnim metodama opisuju se maligne stanice i abnormalne strukturne promjene gena zbog kromosomskih aberacija poput translokacija, insercija, delecija, amplifikacija i mutacija tumor-supresorskih gena. Dijagnostika obuhvaća laboratorijske pretrage, nuklearnomedicinske i radiološke metode za odreĎivanje proširenosti bolesti, izraţavanje prognoze pomoću IPI-a i evaluacije tijekom i nakon liječenja. Primjenom suvremenih protokola liječenja rituksimabom i citostaticima postiţe se 60% preţivljenje. Razlog refraktornosti na rituksimab odreĎenog broja bolesnika je u biološkoj raznolikosti DLBCL. Istraţivanja na genomu malignih stanica DLBCL pokušavaju objasniti ponašanje, pronaći dijagnostički i prognostički značajne biomarkere, razviti jednostavne i pouzdane metode njihova dijagnosticiranja za kliničku primjenu i usmjeriti liječenje bolesnika s nepovoljnim odgovorom na terapiju.
Keywordsdiffuse large B-cell lymphoma DLBCL diagnosis prognosis rituximab
GranterSveučilište u Rijeci
Medicinski fakultet
Lower level organizational unitsKatedra za internu medicinu
PlaceRijeka
StateCroatia
Scientific field, discipline, subdisciplineBIOMEDICINE AND HEALTHCARE
Clinical Medical Sciences
Internal Medicine
Study programme typeuniversity
Study levelintegrated undergraduate and graduate
Study programmeMedicine
Academic title abbreviationdr. med.
Genremaster's thesis
Language Croatian
Defense date2015
Parallel abstract (English)
Lymphoma is a malignant neoplasm characterized by proliferation of lymphocytes' life forms. A third of non-Hodgkin's lymphoma (NHL) patients are diagnosed with diffuse large B-cell lymphoma (DLBCL). It is a heterogeneous group of neoplasms of B-cell origin and according to the 2008 WHO classification of lymphoid neoplasms it contains six nosological entities: DLBCL-NOS, THRBCL, primary DLBCL of the CNS, primary cutaneous DLBCL leg type, EBV+ DLBCL of the elderly, DLBCL associated with chronic inflammation. They manifest a fast growing tumor mass of nodal and extranodal sites. Given its aggressive clinical course, a prompt diagnostic evaluation and treatment is required. Diagnosis is based on histological analysis of tumor biopsy with immunophenotyping. Morphological, immunohistochemical, cytogenetic and molecular methods are used to diagnose malignant cells and abnormal structural gene changes caused by chromosomal aberrations like translocations, insertions, deletions, amplifications and mutations of tumor-suppressor genes. Diagnostic evaluation uses laboratory tests, nuclear medicine and radiological methods for determining the staging and forcasting the outcome by IPI and evaluation during and after the treatment. By applying modern treatment protocols with rituximab and cytostatic, 60% survival rate is achieved. The reason for rituximab-refractoriness in a number of patients is DLBCL biological heterogeneity. A research on the malignant cells genome in DLBCL is trying to explain behavior, discover diagnostic and prognostic-significant biomarkers, develop simple methods of detection in clinical application and direct the treatment of patients with unfavorable response to current therapy.
Parallel keywords (Croatian)difuzni B-velikostanični limfom DLBCL dijagnostika prognoza rituksimab
Resource typetext
Access conditionAccess restricted to students and staff of home institution
Terms of usehttp://rightsstatements.org/vocab/InC/1.0/
URN:NBNhttps://urn.nsk.hr/urn:nbn:hr:184:003778
CommitterBosa Licul