Title KLASIFIKACIJA CITOLOŠKIH NALAZA PUNKTATA DOJKE
Title (english) THE CLASSIFICATION OF FINE NEEDLE ASPIRATES OF THE BREAST
Author Lucia Marincel
Mentor Irena Seili-Bekafigo (mentor)
Committee member Elvira Mustać (predsjednik povjerenstva)
Committee member Koviljka Matušan Ilijaš (član povjerenstva)
Committee member Irena Seili-Bekafigo (član povjerenstva)
Granter University of Rijeka Faculty of Health Studies (Department of Laboratory and Radiological Diagnostics) Rijeka
Defense date and country 2018-06-19, Croatia
Scientific / art field, discipline and subdiscipline BIOMEDICINE AND HEALTHCARE Clinical Medical Sciences Clinical Cytology
Abstract Dojka je parni ţljezdani organ smješten s prednje strane prsnoga koša. To je mliječna ţlijezda, građena od 15 do 25 režnjeva, čija je uloga proizvodnja mlijeka u doba laktacije. Dojku mogu zahvatiti brojni patološki procesi koji su najčešće benigni (upalne promjene, ciste, fibrocistična promjena). Tumori dojke mogu biti benigni i maligni. Najčešći benigni tumori su fibroadenom i filoidni tumor, a primarni maligni tumori su uglavnom adenokarcinomi, među kojima najčešći duktalni invazivni karcinom. Smrtnost od raka dojke čini oko 20% ukupne smrtnosti u žena i predstavlja veliki zdravstveni problem u cijelome svijetu pa i kod nas. S ciljem što ranijeg otkrivanja raka dojke što neinvazivnijom metodom, izvodi se citološka punkcija dojke tankom iglom (FNAB – Fine–needle aspiration biopsy) koja je brza, jeftina i pouzdana metoda te manje invazivna od iglene biopsije. Uzorak dobiven citološkom punkcijom boji se standardnom metodom po May – Gruenwald - Giemsi (MGG) i promatra pod mikroskopom te se može tekstualno različito opisati. Nacionalni institut za rak (National Cancer Institute - NCI) u suradnji sa Svjetskom zdravstvenom organizacijom (WHO) 1996. godine predložio je standardiziranu klasifikaciju citoloških nalaza dojke. Citološki nalazi svrstani su u 5 kategorija. C1 je kategorija neadekvatnih uzoraka, nedostatnih za analizu. C2 kategoriju karakteriziraju uzorci benignih promjena dojke. C3 je kategorija u koju se svrstavaju uzorci s atipičnim karakteristikama, najvjerojatnije benignog podrijetla. C4 je kategorija koja obuhvaća uzorke kod kojh je atipija naglašenija te su suspektni na malignitet. U kategoriju C5 uključuju se nedvojbeno maligni uzorci. Zastupljenost pojedinih kategorija nalaza u pojedinim citološkim laboratorijima ovisi o više čimbenika. Cilj je postići što manji udio neadekvatnih uzoraka. Kategorije nalaza C3 i C4 često su predmet diskusije, jer kriteriji nisu uvijek potpuno jasno definirani, ali podaci iz literature opravdavaju postojanje te dvije odvojene kategorije jer se unutar grupe C3 nađe oko 35% karcinoma, a u grupi C4 čak 81-86% karcinoma.
Uvođenje standardiziranih klasifikacija svih morfoloških nalaza, pa tako i citoloških, vrlo je značajno radi standardizacije daljnjih dijagnostičkih i terapijskih postupaka, lakšeg sporazumijevanja i uspoređivanja između laboratorija, i bolje kontrole kvalitete.
Abstract (english) The breast is a double glandular organ located on the front side of the chest. It is a mammary gland that consists of 15-25 lobes, of which the main role is producing milk in the lactation period. There are many pathological processes that can occur in breasts and they are mainly benign (inflammatory changes, cysts, fibrocystic changes). Breast tumours can be benign or malignant. The most common benign breast tumors are fibroadenoma and the philloid tumor, and a primary malignant tumor is mostly adenocarcinoma (the most common - ductal invasive carcinoma). The death rate from breast cancer makes up around 20% of the total death rate when it comes to women, and it is a great public health issue in the whole world. With the aim of detecting breast cancer by using a non-invasive method, the FNAB (Fine-needle aspiration biopsy) is a fast, inexpensive and reliable method, and less invasive than core biopsy. Obtaining a sample by cytologic puncture is a standard diagnostic method after which the sample is stained according to May - Gruenwald - Giemsa method (MGG) and analysed under a microscope. Cytological findings are descriptive, and do not always end with a definite diagnosis. The National Cancer Institute (NCI) in collaboration with the World Health Organization (WHO) in 1996 proposed a standardized classification of cytological reports of the breast. The cytological reports are classified into 5 categories. C1 is a category of inadequate samples that are insufficient for analysis. The C2 category is characterized by patterns of benign breast changes. C3 is a category that comprises samples with atypical characteristics, most probably of benign origin. C4 is a category that includes samples where the atypia is more pronounced and is suspicious for malignancy. The C5 category includes undoubtedly malignant patterns. The ratio of certain categories of findings in different cytological laboratories depends on several factors. The goal is to achieve as few inadequate samples as possible. The C3 and C4 categories are often the subject of discussion because the criteria are not always fully defined, but data from literature justifies the existence of these two distinct categories, because within C3 there is about 35% of malignant tumours and in group C4 there is as much as 81-86% of cancers on final PH diagnosis.
The implementation of standardized classifications and reporting of various morphological analyses, including cytology, is very important in order to standardize further diagnostic and therapeutic procedures, facilitate understanding and comparison between laboratories and ensure better quality control.
Keywords
dojka
klasifikacija
citološka analiza
FNAB
Keywords (english)
breast
classification
cytological analysis
FNAB
Language croatian
URN:NBN urn:nbn:hr:184:477403
Study programme Title: Professional study of Medical and Laboratory Diagnostics (Biomedicine and Healthcare; clinical medical sciences) Study programme type: professional Study level: undergraduate Academic / professional title: stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinsko laboratorijske dijagnostike (stručni/a prvostupnik/prvostupnica (baccalaureus/baccalaurea) medicinsko laboratorijske dijagnostike)
Type of resource Text
File origin Born digital
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Created on 2018-11-15 13:23:33