Laboratorijska dijagnostika jetrenih bolesti i usporedba s histološkim promjenama u bioptatima jetrenog parenhima

master's thesis

• Title (english): Laboratory evaluation of liver diseases and correlation with liver biopsy findings
• Author: Iva Džolan
• Mentor: Stela Bulimbašić (mentor)
• Committee member: Stela Bulimbašić (predsjednik povjerenstva)
• Committee member: Ana-Marija Domijan (član povjerenstva)
• Committee member: Ivica Horvatić (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; Zagreb
• Defense date and country: 2020-09-29, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

U radu su analizirane jetrene biopsije učinjene pacijentima sa sumnjom na jetrenu bolest, a bili su hospitalno ili ambulantno liječeni u KBC Zagreb tijekom 2018. godine. Histološki nalaz u bioptatima jetre je uspoređen s kliničkom manifestacijom (hepatocelularno, miješano ili kolestatsko oštećenje) i težinom oštećenja (blago, umjereno, teško oštećenje) temeljenom na rezultatima učinjenih laboratorijskih testova.
Nađeno je ukupno 236 biopsija u 129 (54.7%) muškaraca i 107 (45.3%) žena, starosti od 4 mjeseca do 84 godine. Netumorsko oštećenje bilo je indikacija za 120, a tumorska parologija za 116 biopsija. Pacijenti s netumorskom patologijom bili su svih dobnih skupina, a pacijenti s tumorskom patologijom su u prosjeku bili starije životne dobi (84% starije od 50 godina).
Hepatocelularno oštećenje bilo je najčešći tip prezentacije pacijenata s netumorskom patologijom i nađeno je u 52% slučajeva. Najčešće dijagnoze bile su vjerojatno toksično oštećenje, autoimune bolesti i različite metaboličke bolesti nađene u 22, 16 i 12 slučajeva.
Blago kolestatsko ili miješano oštećenje bilo je najčešća prezentacija pacijenata s tumorskom patologijom. Najčešći tumor u biopsiji jetre bio je metastatski karcinom dojke nađen u 16% slučajeva, slijede metastatski kolorektalni adenokarcinom, hepatocelularni karcinom i karcinomi bilijarnog epitela, svaki nađen u 10% slučajeva.
Teško oštećenje jetre nađeno je u 18 pacijenata s netumorskom patologijom i u jednog pacijenta s tumorskom patologijom. Iako su ovakvi slučajevi rijetki, kod njih je potrebno što preciznije postaviti dijagnozu kako bi se pravovremeno započelo s optimalnom terapijom u cilju sprečavanja dodatnog oštećenja jetre.

Abstract (english)

This study evaluated use of liver biopsy in patients with suspected liver pathology hospitalized in University Hospital Centre Zagreb during 2018. or seen through Outpatient Clinic. Histological features seen on liver biopsy were correlated with type (hepatocellular, mixed or cholestatic damage) and severity (mild, moderate severe) of presentation based on performed liver tests.
There were were in total 236 liver biopsies in 129 (54.7%) male and 107 (45.3%) female patients, age range from 4 months to 84 years. Non-tumorous pathology was indication for 120, and tumor pathology for 116 biopsies. Patients with non-tumorous liver pathology were from all age groups. Patients with tumor pathology tend to be older; 98 (84%) of them were older than 50 years.
Hepatocellular damage was more common in patients with non-tumorous pathology, accounting for 52% of all cases. The most common diagnoses in non-tumorous pathology were probable toxic injury, autoimmune liver disease and various metabolic diseases found in 22, 16 and 12 cases respectively.
Mild cholestatic or mixed injury was the most common presentation in patients with tumor pathology. The most common type of suspected tumor found on liver biopsy was metastatic breast cancer found in 16% of cases, followed by metastatic colorectal adenocarcinoma, primary hepatocellular carcinoma and adenocarcinoma of biliary origin, each accounting for 10% of cases.
A severe liver injury was seen in 18 patients with non-tumorous pathology and in one patient with tumorous pathology. Although rare in overall number of biopsies, in such cases are highly important to establish precise diagnosis in order to start with optimal therapy as soon as possible and limit the further extent of liver damage.

• Keywords: jetrene bolesti; laboratorijska dijagnostika; jetrena biopsija
• Keywords (english): liver diseases; laboratory tests; liver biopsy
• Language: croatian
• URN:NBN: urn:nbn:hr:163:436873
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije i laboratorijske medicine (magistar/magistra medicinske biokemije i laboratorijske medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-04-29 11:41:52