Spelling suggestions: "subject:"psychogenic"" "subject:"echogenic""
1 |
Association of Epstein-Barr virus (EBV) and human papilomavirus (HPV) with bronchogenic carcinomas and cervical carcinoma in Hong Kong Chinese.January 1989 (has links)
by Ka-chun Yiu. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1989. / Bibliography: leaves 162-192.
|
2 |
Bone metastases in lung cancer a clinical study in 200 consecutive patients with bronchogenic carcinoma and its therapeutic implications for small cell carcinoma /Hansen, Heine Høi. January 1974 (has links)
Thesis--Copenhagen. / Summary in Danish. Includes bibliographical references (p. 202-221) and index.
|
3 |
Časová náročnost ošetřovatelské péče o pacienta na JIP po operaci bronchogenního karcinomu / Duration of nursing care for patients in the ICU after surgery Lung CancerKarasová, Veronika January 2020 (has links)
Introduction: This thesis deals with the time management of nursing care for patients in the ICU after bronchogenic carcinoma surgery. The treatment of patients with this diagnosis requires a multidisciplinary approach by all members of the medical team. Aims and methodology: The aim of this thesis was to map the time demands of nursing care for a patient who is the first day after lung cancer surgery, about current recommended procedures of nursing care. Furthermore, the aim was to find out whether a methodical guideline or a standard defining postoperative care of a patient after lung cancer surgery is available for the nurses. The way nurses perceive their working conditions and relationships in the workplace was also investigated. Finally, the aim of the diploma thesis was to map time management in nursing care for patients with lung cancer, all in the intensive care unit from nine medical facilities that participated in the research survey. Results: The research group consisted of nurses working in surgical intensive care units of the 1st, 2nd and 3rd degree and cardiac surgical intensive care unit from four university hospitals, 3 regional hospitals and 2 other hospitals. A total of 330 questionnaires were distributed. The return rate was 209 questionnaires (63.3%). The research results were...
|
4 |
Automated sputum screening using the BD FocalPointTM Slide Profiler : correlation with transbronchial and transthoracic needle aspirates in a high risk populationNeethling, Greta Sophie 04 1900 (has links)
Thesis (MMed)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Background:
Sputum is a non-invasive, economic investigation whereby bronchogenic carcinoma
can be identified. Manual cytological screening is labour intensive, time-consuming
and requires a continuous high level of alertness. Automation has recently been
successfully introduced in gynaecological cytology. Since sputum samples are similar
to cervical smears, the question arises as to whether they are also suitable for
automated screening.
Objective:
This study presented with various objectives: 1) To test automated sputum screening
using the BD FocalPoint™ Slide Profiler (FP) and compare with manual sputum
screening. 2) To determine the sensitivity and specificity of sputum in identification of
bronchogenic carcinoma. 3) To ascertain if any clinical, radiological or bronchoscopy
findings would be predictors for bronchogenic carcinoma. 4) To determine the
significance of adequacy.
Method: Sputum samples were collected prospectively from patients attending the Division of
Pulmonology at Tygerberg hospital for a transbronchial fine needle aspiration biopsy
(TBNA) or a transthoracic fine needle aspiration biopsy (TTNA) for the period from
2010 to 2012. A pre-bronchoscopy sputum was collected and submitted for
processing. Stained slides were put through the FP for automated screening. After
slides were qualified, sputum slides were put back in the routine screening pool.
Correlation was done using the TBNA/TTNA result as the standard to evaluate the
sputum results. Results:
108 sputum samples were included in this study. Of the 84.3% malignant (n=91) and
15.7% benign (n=17) cases confirmed with a diagnostic procedure, sputum cytology
had a sensitivity of 38.5% (35/91 malignant cases), and a specificity of 100% (17/17
benign cases). Automated screening had a better sensitivity of 94.3% (33/35 positive
sputum cases), while manual screening showed a sensitivity of 74.3% (26/35 positive
sputum cases) when compared to the final sputum result.
Individual parameters with a significant association with positive sputum included the
presence of an endobronchial tumour, partial airway obstruction / stenosis, round
mass, spiculated mass (negative association), loss of weight (negative association)
and squamous cell carcinoma as the histological subtype. Adequacy was not as
significant as hypothesised since 85.3% of true positive sputum, but also 65.5% of
false negative sputum, had large numbers of alveolar macrophages present.
Conclusion:
Sputum cytology remains an important part of the screening programme for
bronchogenic carcinoma in the public health sector of South Africa. Results confirm
that sputum cytology is very specific, and automated screening improves sensitivity.
Automated screening proved to be more time efficient, resulting in 83.1% reduction
(p<0.0001) in the screening time spent per case by a cytotechnologist.
Results confirm that the quantity of alveolar macrophages is not directly proprtional to
pathology representation. Positive sputum results did however improve with sputum
adequacy, but had no significant association.
Recommendations from this study include adopting automated sputum screening. / AFRIKAANSE OPSOMMING: Agtergrond:
Die verkryging van ‘n sputummonster is ‘n nie-indringende, ekonomiese ondersoek
waardeur bronguskarsinoom identifiseer kan word. Nie-geoutomatiseerde sitologiese
ondersoek is arbeidsintensief, tydrowend en vereis ‘n deurlopende hoë vlak van
konsentrasie en fokus. Outomatisering is onlangs suksesvol geïmplementeer in
ginekologiese sitologie-ondersoeke. Aangesien sputummonsters soortgelyk aan
servikale monsters is, het die vraag ontstaan of sputummonsters ook geskik sou
wees vir geoutomatiseerde sifting.
Doelwit:
Hierdie studie het verskeie doelwitte gehad: 1) Om geoutomatiseerde sifting van
sputummonsters te toets deur gebruik te maak van BD Focal Point ™ Slide Profiler
(FP), en te vergelyk met nie-geoutomatiseerde sputum sifting. 2) Om die sensitiwiteit
en spesifisiteit van sputum in die identifikasie van bronguskarsinoom te bepaal. 3)
Om vas te stel of enige kliniese, radiologiese of brongoskopiese bevindings
bronguskarsinoom sou kon voorspel. 4) Om die belang van ‘n verteenwoordigende
monster te bepaal.
Metode:
‘n Prospektiewe studie van die pasiënte wat die Divisie van Pulmonologie by
Tygerberg Hospitaal vir transbrongiale nodale aspirasie (TBNA) of ‘n transtorakale
aspirasie (TTNA) vanaf Julie 2010 tot Mei 2012 bygewoon het, is gedoen. ‘n Prebrongoskopiese
sputum is geneem en gestuur vir prosessering. Die gekleurde
skuifies is deur die FP gestuur vir geoutomatiseerde ondersoek. Indien die
sputumskuifies gekwalifiseer het vir geoutomatiseerde sifting, is hulle in die groep vir
ondersoek ingesluit. ‘n Korrelasiestudie, om die sputumresultate te evalueer, is
uitgevoer deur die TBNA/TTNA bevindings as standaard te gebruik. Resultate:
Vir hierdie studie is 108 sputummonsters ingesluit. Vanuit die 84.3% maligne (n=91)
en 15.7% benigne (n=17) gevalle, bevestig deur ‘n diagnostiese prosedure, het
sputumsitologie ‘n sensitiwiteit van 38.5% (35/91 maligne gevalle) en ‘n spesifisiteit
van 100.0% (17/17 benigne gevalle), getoon. Geoutomatiseerde sifting het ‘n beter
sensitiwiteit met 94.3% (33/35 maligne gevalle), terwyl nie-geoutomatiseerde
(ondersoek) ‘n sensitiwiteit van 74.3% (26/35 maligne gevalle) wanneer met die finale
resultaat vergelyk, gevind.
Individuele parameters met ‘n betekenisvolle assosiasie het die teenwoordigheid van
‘n endobrongiale tumor, gedeeltelike lugwegobstruksie / stenose, ronde massa, ‘n
spekuleerde massa (negatiewe assosiasie), gewigsverlies (negatiewe assosiasie) en
plaveiselkarsinoom as die histologiese subtipe, ingesluit. Geskiktheid van die
monster was nie so betekenisvol as wat in die hipotese gestel is nie: aangesien
85.3% van ware positief gediagnoseerde sputummonsters, maar ook 65.5% van die
vals negatiewe sputummonsters, groot hoeveelhede alveolêre makrofae ingesluit het.
Gevolgtrekking:
Sputumsitologie bly steeds ‘n belangrike deel van die siftingsprogram vir
bronguskarsinoom in die openbare gesondheidssektor in Suid-Afrika. Resultate van
hierdie studie bevestig dat sputumsitologie baie spesifiek is en dat geoutomatiseerde
sifting die sensitiwiteit verbeter. Ge-outomatiseerde sifting het bewys dat dit meer
tydsbesparend is, met ‘n 83.1% vermindering (p<0.0001) in die siftingstyd wat deur
een sitotegnoloog per geval bestee word.
Resultate het bevestig dat die hoeveelheid alveolêre makrofae nie direk
proporsioneel verwant is tot die patologie nie. Hoe meer verteenwoordigend die
sputummonster was, hoe groter was die kanse om ‘n akkurate positiewe diagnose te
maak. Die assosiasie van die geskiktheid van die sputummonster en die positiewe
resultate het egter nie ‘n statisties betekenisvolle resultaat getoon nie.
Aanbevelings vir hierdie studie sluit in die aanwending van geoutomatiseerde
sputumondersoeke.
|
5 |
Prognostički faktori za preživljavanje kod gerijatrijskih bolesnika sa uznapredovalim stadijumom nemikrocelularnog karcinoma bronha / Prognostic factors for survival in geriatric patients with advanced stage of non-small cell lung cancerSazdanić-Velikić Danica 23 September 2016 (has links)
<p>UVOD: Savremenim dijagnostičkim i terapijskim dostignućima, kao i unapređenjem preventivnih mera produžen je životni vek ljudi. Starenje stanovništva je fenomen koji zahvata ceo svet. Povećanje broja starijeg stanovništva je udruženo sa porastom broja obolelih od karcinoma u ovoj starosnoj grupi, jer je starenje samo po sebi riziko faktor za nastanak karcinoma. Incidenca pojave karcinoma naglo raste od 50-te godine života sa vrhom u 80-toj godini života. U osoba starijih od 65 godina se dijagnostikuje 58% svih karcinoma, a 30% u starijih od 70 godina. Godine starosti nisu kontraindikaciija za sprovođenje hemioterapije kod starih bolesnika sa karcinomom. Starenje je povezano sa izmenjenom farmakodinamikom i farmakokinetikom antitumorskih lekova i povećanom osetljivošću normalnog tkiva na toksične komplikacije, te je odluka kliničara kod davanja hemioterapije ovoj starosnoj kategoriji bolesnika sa karcinomom uvek vrlo kompleksna i zahteva dobru procenu i odgovarajuću selekciju bolesnika za ovaj tretman. MATERIJAL I METODE: Doktorska disertacija obuhvata rezultate delom restrospektivnog, a delom prospektivnog opservacionog istraživanja sprovedenog u periodu 01.01.2011. do 31.12.2013.godine u Institutu za plućne bolesti Vojvodine u Sremskoj Kamenici, u kojem je praćeno 152 bolesnika starosti 65 i više godina kod kojih je dijagnostikovan nemikrocelularni karcinom bronha u uznapredovalom stadijumu bolesti, a koji su lečeni kombinovanim hemioterapijskim režimom na bazi platine. Kao prognostički faktori su uzeti: starosna dob bolesnika (grupa mlađih od 75 godina i starih 75 i više godina), pol, navika pušenja cigareta (pušač, nepušač, bivši pušač), navika konzumiranja alkohola, performans status (prema ECOG-Eastern Cooperative Oncology Group skali) u momentu postavljanja dijagnoze, patohistološki tip tumora (adenokarcinom, skvamozni karcinom, drugo), stadijum bolesti (IIIb, IV), veličina tumora (manje od 6 cm i 6 cm i više), TNM status prema klasifikaciji tumora (7.revizija), parametri krvne slike (vrednosti leukocita, hemoglobina, trombocita), biohemijski parametri (vrednosti laktat-dehidrogenaze (LDH), alkalne fosfataze, aspartat- aminotransferaze (AST), alanin-aminotransferaze (ALT), kalijuma, natrijuma, bilirubina) na početku terapije, komorbiditeti u momentu postavljanja dijagnoze (broj komorbiditeta po sistemima, Charlson index), simptomi bolesti (kašalj, hemoptizije, otežano disanje, bol u grudnom košu, promuklost, smetnje gutanja, sindrom gornje šuplje vene, bol u kostima, simptomi od strane centralnog nervnog sistema, povišena telesna temperatura), gubitak na telesnoj masi (više od 5% u prethodnih 6 meseci), indeks telesne mase (<18,5kg/m² pothranjen, 18,5-24,9kg/m² normalno uhranjen, 25-29,9kg/m² prekomerna telesna masa, ˃30kg/m² gojaznost). Svi potencijalni prognostički faktori su evaluirani univarijantnom analizom, a potom su svi faktori rizika za koje je utvrđena značajnost analizirani primenom multivarijantne logističke regresije, u cilju prepoznavanja nezavisnih prediktora za dvogodišnje preživljavanje. Za otkrivanje nezavisnih prediktora preživljavanja na dve godine je primenjena binarna logistička regresiona analiza, a kao potencijalni prediktori su bile sledeće varijable: starost ispod 75 godina, pušačka navika, patohistološki tip karcinoma, stadijum bolesti IV, T4 status, M1b status, prisustvo respiratornog komorbiditeta, otežano disanje, bol u grudima. Kumulativno preživljavanje je prikazano Kaplan-Meier-ovim krivama. Primenom multivarijantne Cox- regresione analize su dobijeni nezavisni prediktori kumulativnog preživljavanja. Iz dobijenih prognostičkih faktora koji se izdvajaju kao nezavisni prediktori za preživljavanje su kreirani matematički modeli za dvogodišnje preživljavanje. CILJ ISTRAŽIVANJA: Utvrditi uticaj pojedinih prognostičkih faktora na dvogodišnje preživljavanje ovih bolesnika i iz toga izvesti matematički model za stratifikaciju ovih bolesnika u odnosu na dvogodišnje preživljavanje. REZULTATI: Analizom prognostičkih faktora je utvrđeno da grupa bolesnika starih 75 godina i više ima nešto duže dvogodišnje preživljavanje od grupe bolesnika mlađih od 75 godina, ali bez statističke značajnosti, bolesnici sa tumorom veličine 6 cm i više imaju kraće dvogodišnje preživljavanje u odnosu na bolesnike sa tumorom manjim od 6 cm, bolesnici kod kojih je u momentu postavljanja dijagnoze T status tumora bio T4, a M status M1b imaju kraće dvogodišnje preživljavanje, bolesnici kod kojih je na početku tretmana u laboratorijskim nalazima bila prisutna anemija i povišene vrednosti LDH imaju kraće dvogodišnje preživljavanje, prisustvo više komorbiditeta utiče na kraće preživljavanje, bolesnici sa gubitkom na telesnoj masi većim od 5% u periodu 6 meseci pre postavljanja dijagnoze bolesti imaju kraće dvogodišnje preživljavanje. Kreirana su dva matematička modela (jedan za preživljavanje na 2 godine i jedan za kumulativno preživljavanje) za stratifikaciju gerijatrijskih bolesnika sa uznapredovalim stadijumom nemikrocelularnog karcinoma bronha lečenih hemioterapijom na bazi platine u odnosu na dvogodišnje preživljavanje. ZAKLJUČAK: Dobijeni matematički modeli za preživljavanje gerijatrijskih bolesnika sa uznapredovalim stadijumom nemikrocelularnog karcinoma bronha lečenih hemioterapijom na bazi platine na jednostavan način stratifikuju bolesnike u odnosu na preterapijske prognostičke faktore za razliku od sveobuhvatne gerijatrijske procene koja je vremenski zahtevna procedura i zahteva obučen kadar.</p> / <p>INTRODUCTION: Nowadays life expectancy is prolonged due to modern diagnostic and therapy achievements, as well as promotion of preventive measurements. Aging of population is a phenomenon in the whole world. Increasing number of elderly population is accompanied with the increased number of diagnosed cancer in this age group, because the aging themselves is a risk factor for development of cancer. The appearance of cancer rapidly rises from the age of fifty with the peak at the age of eighty. 58% of cancer diagnoses are in the people older than sixty-five years and 30% in people older than seventy years. The age is not contraindication for chemotherapy treatment in older patient with cancer. The aging is associated with disturbed pharmacodynamics and pharmacokinetics of antitumor drugs and increased susceptibility of normal tissue for toxic complications, therefore clinical decision for introducing chemotherapy is very complex and requires good assessment and proper selection of the patients for this treatment. MATERIAL AND METHODS: This doctoral thesis includes results of partly retrospective and partly prospective observational research conducted in the period 01.01.2011. until 31.12.2013. at the Institute for pulmonary diseases of Vojvodina in Sremska Kamenica, which includes 152 lung cancer patients 65 and more years old with diagnosed non-small cell lung cancer in advanced stage treated with combined platinum based chemotherapy regimen. These prognostic factors are included: age of patients (group <75 years, group ≥75 years old), sex, smoking cessation (smoker, former smoker, non smoker), alcohol consuming habit, performance status (according to the ECOG-Eastern Cooperative Oncology Group scale) in the moment of confirmed diagnosis, pathohistological type of tumor (adenocarcinoma, squamous cell carcinoma, other), stage of disease (IIIb, IV), tumor size (<6cm and ≥6cm), TNM status according tumor classification (7th revision), blood count parameters (leucocyte, hemoglobin level, thrombocyte), biochemical parameters (lactate-dehydrogenase level (LDH), alkaline phosphatase level, aspartate aminotransferase level (AST), alanine aminotransferase level (ALT), potassium level, sodium level, bilirubin level) on the start of the chemotherapy, comorbidities at the moment of diagnosis (number of comorbid conditions, Charlson index), symptoms of the disease (cough, hemoptysis, dyspnea, chest pain, hoarseness, swallowing difficulties, caval venae compression symptoms, bone pain, central nervous symptoms, increased body temperature), weight loss (˃ 5% in the previous 6 months), body mass index (<18,5kg/m² underweight 18,5-24,9kg/m² normal weight, 25-29,9kg/m² overweight , ˃30kg/m² obese). All potential prognostic factors were evaluated with univariante analysis, and after that all factors with confirmed significance were analysed with multivariante logistic regression, in order to identify independent predictors for 2-year survival. Binary logistic regression analysis was applied for identifying independent predictors for 2-years survival and those variables were analysed : age <75 years, smoking cessation, pathohistological type of cancer, stage of disease IV, T4 status, M1b status, presence of respiratory comorbidity, dyspnea, chest pain. Cumulative survival of those patients was shown with Kaplan-Meier prognostic curves. Two mathematical model for 2-year survival was created from the factors confirmed as independent predictors for survival. AIM: This research objectives were to determine the influence of certain prognostic factors on 2-years survival of those patients and to create mathematical model for stratification of those patients related to 2-years survival. RESULTS: Univariante analysis confirmed that the group of patients older than 75 years and more have had better 2-year survival than group of patient younger than 75 year, but without the statistically significance, patients with tumor size ≥6cm have had worst 2-year survival in comparison with patients with tumor size <6cm, patients with tumor status T4 at the moment of diagnosis and M status M1b have had the shorter 2-year survival, patients with anemia and increased LDH level on the start of the chemotherapy treatment have had shorter 2-year survival, the presence of more comorbid conditions at the moment of diagnosis influence on shorter 2-year survival, patients with weight loss more than 5% in the previous 6 months have had shorter 2-year survival. Two mathematical models were created (one for 2-year survival and the other for the cumulative survival) for stratification of elderly patients with advanced staged non-small cell lung cancer treated with combined platinum based chemotherapy regimen related to 2-year survival. CONSLUSION: Created mathematical models for stratification of elderly patients with advanced staged non-small cell lung cancer treated with combined platinum based chemotherapy regimen more easily stratify patients compared to pretreatment prognostic factors as opposed to comprehensive geriatric assessment which is time-consuming procedure and requires trained personnel.</p>
|
6 |
Uticaj demografskih faktora i karakteristika tumora na preživljavanje obolelih od karcinoma bronha u Vojvodini / Impact of demographic factors and tumor characteristics on the lung cancer patients survival in VojvodinaBokan Darijo 15 October 2020 (has links)
<p>Širom sveta, karcinom bronha je i dalje vodeći po incidenci i mortalitetu, sa 2,1 milion novih slučajeva i predviđenih 1,8 smrtnih ishoda u 2018. godini. Karcinom bronha predstavlja skoro petinu (18,4%) svih smrtnih ishoda od karcinoma. Istraživanje je sprovedeno kao retrospektivna studija za period 2010-2016 godine. Svi podaci potrebni za sprovođenje ovog istraživanja direktno su prikupljeni iz zdravstvenog informacionog sistema i registra za karcinom bronha Instituta za plućne bolesti Vojvodine (IPBV), koji je referentna ustanova za pacijente sa karcinomom bronha za celu Autonomnu Pokrajinu Vojvodinu. Cilj rada je bio da se utvrdi uticaj demografskih i kliničko-patololoških karakteristika na ukupno vreme preživljavanja kod bolesnika sa karcinomom bronha, kao i da se izradi geoprostorna analiza incidencije i mortaliteta od karcinoma bronha na teritoriji Vojvodine. Podaci o broju novoobolelih i broju umrlih pacijenata potrebni za analizu incidencije i mortaliteta prikupljeni su od lokalnih Instituta za javno zdravlje za svaki od sedam okruga. Za potrebe analize overall survivall, survival rate ukupno je obuhvaćeno 8142 bolesnika lečenih u IPBV, od kojih je nakon provere uključujućih i isključujućih kriterijuma, u konačnu analizu ušlo njih 7540. Za potrebe analize incidencije i mortaliteta prikupljeni su podaci od lokalnih Instituta za javno zdravlje za svaki od sedam okruga i ukupno je uključeno 21915 pacijenata. Od ukupno 7540 bolesnika, bilo je 5456 (72,4%) muškaraca i 2084 (27,6%) žena. Prosečna starost bolesnika iznosila je 63,4±8,85 godina, Najveći broj bolesnika su bili pušači, njih 4911 (65,1%), bivših pušača je bilo 1995 (26,5%), dok je najmanje bilo nepušača, svega 634 (8,4%). Srednja vrednost indeksa paklo-godina (pack-years) iznosila je 50,57±28,80. Posmatrano prema bračnom statusu, najviše bolesnika je bilo oženjeno/udato, njih 5348 (70,9%). Najveći broj bolesnika je ocenio svoj socioekonomski status kao osrednji, njih 4912 (65,1%). Broj bolesnika sa ECOG performans statusom 1 bio je 5679 (75,3%), njih 840 (11,1%) je imalo ECOG performans status 2, dok je ECOG performans status 0 imao 451 (6,0%) bolesnik. Najveći broj bolesnika bio je dijagnostikovan u IV stadijumu bolesti 3108 (41,2%), zatim u IIIB 1886 (25,0%), IIIA 1401 (18,6%), dok je u IA stadijumu dijagnostikovano najmanje bolesnika, njih 234 (3,1%). Najveći broj bolesnika imao je potvrđenu dijagnozu adenokarcinoma, njih 3342 (44,3%), zatim skvamoznog karcinoma 2472 (32,8%), mikrocelularnog karcinoma 1386 (18,4%). Od ukupnog broja bolesnika, tokom perioda praćenja preminulo je njih 6420 (85,1%), dok je 1120 (14,9%) bolesnika bilo živo. Prosečno vreme preživljavanja muškaraca bilo je 17,116 meseci, a žena 23,193 meseca. Muškarci oboleli od karcinoma bronha statistički značajno (p=0,000) kraće su živeli u odnosu na žene. Analiza kumulativnog preživljavanja bolesnika pokazala je da je postojala statistički značajna razlika u preživljavanju u odnosu na pol kod podtipova adenokarcinom (p=0,000), skvamozni karcinom (p=0,000) i mikrocelularni karcinom (p=0,001). Statistički značajna razlika u preživljavanju postojala je i u odnosu na starost, mesto stanovanja, tip tumora, stadijum bolesti, ECOG, pušački status i TNM stadijum bolesti (p=0,000). Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 32,5%, skvamoznog karcinoma 37,3%, adenokarcinoma 33,4% i mikrocelularnog karcinoma 20,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 9,2%, skvamoznog karcinoma 10,8%, adenokarcinoma 10,7% i mikrocelularnog karcinoma 2,0%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha iznosilo je 5,0%, kod skvamoznog karcinoma 6,1%, adenokarcinoma 5,4% i mikrocelularnog karcinoma 1,3%. Ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 78,1%, u 1B stadijumu 73,2%, 2A stadijumu 70,4%, 2B stadijumu 52,1%, 3A stadijumu 42,3%, 3B stadijumu 28,3%, dok je u 4 stadijumu bolesti ukupno jednogodišnje preživljavanje bilo 17,9%. Ukupno trogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 40,8%, u 1B stadijumu 37,5%, 2A stadijumu 31,2%, 2B stadijumu 21,6%, 3A stadijumu 9,7%, 3B stadijumu 5,5%, dok je u 4 stadijumu bolesti ukupno trogodišnje preživljavanje bilo 2,9%. Ukupno petogodišnje preživljavanje obolelih od karcinoma bronha u 1A stadijumu iznosilo je 32,1%, u 1B stadijumu 19,3%, 2A stadijumu 16,2%, 2B stadijumu 13,3%, 3A stadijumu 4,4%, 3B stadijumu 2,6%, dok je u 4 stadijumu bolesti ukupno petogodišnje preživljavanje bilo 1,6%. Kao nezavisni prediktori preživljavanja izdvojeni su muški pol, starost preko 60 godina, ECOG performans status veći od 2, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikrokarcinom kao tip tumora (p=0,000). Incidencija karcinoma bronha za muškarce iznosila je 118,9 na 100000 stanovnika, a za žene 43,3 na 100000 stanovnika. Standardizovana stopa incidencije karcinoma bronha za muškarce iznosila je 65,4 na 100000 stanovnika, a za žene 21,7 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Stopa mortaliteta od karcinoma bronha za muškarce iznosila 125,1 na 100000 stanovnika, a za žene 43,8 na 100000 stanovnika. Standardizovana stopa mortaliteta od karcinoma bronha za muškarce iznosila 67,6 na 100000 stanovnika, a za žene 20,9 na 100000 stanovnika. Prema okruzima je postojala statistički značajna razlika (p=0,001). Analizom prikupljenih podataka utvrđeno je da postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odnosu na pol (p=0,000), starosnu dob (p=0,000), mesto stanovanja (p=0,014), pušački status (p=0,001), ECOG performans status (p=0,000) i socioekonosmski status (p=0,000). Postoji statistički značajna razlika u ukupnom vremenu preživljavanja pacijenata sa dijagnostikovanim karcinomom bronha u odsnosu na tip tumora (p=0,000), stadijum bolesti (p=0,000), T-deskriptor (p=0,000), N-deskriptor (p=0,000) i M-deskriptor (p=0,000). Utvrđeno je da ukupno jednogodišnje preživljavanje obolelih od karcinoma bronha iznosi 32,5%, trogodišnje preživljavanje obolelih od karcinoma bronha iznosi 9,2%, a petogodišnje preživljavanje iznosi 5,0%. Utvrđeno je da su nezavisni prediktori preživljavanja muški pol, starost preko 60 godina, ECOG performans status 2 i veći, pušačka navika, lošiji socioekonomski status, stadijum IV bolesti, T4 status, M1b status i mikroculularni karcinom kao tip tumora. Urađena je analiza incidencije i mortaliteta od karcinoma bronha na teritoriji AP Vojvodine i utvrđeno je da postoje značajne regionalne razlike u incidenciji i mortalitetu od karcinoma bronha na teritoriji AP Vojvodine.</p> / <p>Worldwide, lung cancer remains the leading cause of cancer incidencije and mortality, with 2.1 million new lung cancer cases and 1.8 million deaths predicted in 2018. Methodology: For the purpose of this retrospective study we collected data of 21915 patients from seven Public Health Institutes, one for each district. This data was categorized by five-year age groups during 2010–2016. Survival analysis data of 8142 patients was collected from the Institute for Pulmonary Diseases of Vojvodina Hospital Information System and the Lung Cancer Registry. The primary objective was to determine the impact on overall survival by assessing demographic and clinical pathological characteristics in these patients. The secondary objective was to analyze the incidencije and mortality of lung cancer in the region of Vojvodina. Incidencije and mortality rates were directly age-standardized to the World and Europe Standard Population. A total of 7540 patients were eligible for the survival analysis, 5456 (72.4%) males and 2084 (27.6%) females. The average survival time, including all stages and cancer types was 17.1 months for men and 23.2 months for women (p = 0.000). There was statistically significant difference in survival time by gender in subtypes of adenocarcinoma (p = 0.000), squamous cell carcinoma (p= 0.000) and microcellular carcinoma (p = 0.001). Analysis showed significant difference in survival by age (p = 0.000), cancer type (p = 0.000), stage of the disease (p = 0.000), ECOG performance status (p = 0.000), smoking status (p = 0.001), TNM stage of disease (p = 0.000) and among districts (p = 0.014). Male gender (p = 0.000), age over 60 (p = 0.000), ECOG performance status 2 and greater (p = 0.000), smoking habit (p = 0.002), lower socioeconomic status (p = 0.000), stage IV of disease (p = 0.000) and small cell lung cancer as tumor type (p = 0.000) were identified as independent prognostic factors. One-year survival in 1A stage was 78.1%, in 1B stage 73.2%, 2A stage 70.4%, 2B stage 52.1%, 3A stage 42.3%, 3B stage 28.3 %, while in stage 4 was 17.9%. Three-year survival in 1A stage was 40.8%, in 1B stage 37.5%, 2A stage 31.2%, 2B stage 21.6%, 3A stage 9.7%, 3B stage 5.5 %, while in stage 4 was 2.9%. Five-year in 1A stage is 32.1%, in 1B stage 19.3%, 2A stage 16.2%, 2B stage 13.3%, 3A stage 4.4%, 3B stage 2.6 %, while in stage 4 was 1.6%. The incidencije rate was 118.9 per 100000 for males and 43.3 per 100000 for women. The standardized incidencije rate was 65.4 per 100000 for males and 21.7 per 100000 for females. There was a statistically significant difference by districts (p = 0.001). Mortality rate was 125.1 per 100000 for males and 43.8 per 100000 for females. The standardized mortality rate was 67.6 per 100000 for males and 20.9 per 100000 for females. There was also a statistically significant difference by district (p = 0.001). There was a statistically significant difference in overall survival by gender (p = 0.000), age (p = 0.000), place of residence (p = 0.014), smoking status (p = 0.001), ECOG performance status (p = 0.000), and socioeconomic status (p = 0.000). There was also a statistically significant difference in the overall survival by tumor type (p = 0.000), stage of disease (p = 0.000), T-descriptor (p = 0.000), N-descriptor (p = 0.000), and M-descriptor (p = 0.000). One-year survival rate was 32.5%, three-year survival was 9.2%, and five-year survival rate was 5.0%. Incidencije and mortality rates data were analyzed for the territory of Vojvodina, and it was found that there were significant regional differences.</p>
|
Page generated in 0.0399 seconds