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Volume 53, Issue 4, 2025
Online ISSN: 2560-3310
ISSN: 0350-8773
Volume 53 , Issue 4, (2025)
Published: 30.06.2025.
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01.12.2014.
Professional paper
HISTOLOŠKO-CITOLOŠKA KORELACIJA NALAZA I POUZDANOST PAPANICOLAU TESTA U OTKRIVANJU PREMALIGNIH I MALIGNIH PROMENA NA GRLIĆU MATERICE
Stopa incidence cervikalnog karcinoma u Srbiji je među najvišima u Evropi i iznosi 23,8 na 100000. Papanicolau test, dopunjen kolposkopijom i histologijom, osnovna je metoda sekundarne prevencije cervikalnog karcinoma. Cilj rada je bio ispitati histološko-citološku korelaciju i pouzdanost Papanicolau testa u detekciji cervikalnih lezija. Analizirani su cervikalni razmazi (Papanicolau test) kod 3868 žena. Suspektne nalaze imalo je 190 žena i kod njih je urađena cervikalna biopsija. Kod 77 žena detektovane su premaligne ili maligne promene na cerviksu. LSIL (CIN1) je imalo 43(22,6%), HSIL(CIN2/3) 25(13,2%), a planocelularni karcinom 9 (4,7%) žena. Između histološkog i citološkog nalaza ispitanica postoji statistički značajna pozitivna povezanost (Spearman r=0,829, p<0,001). Najviše ocene dijagnostičkih performansi Papanicolau testa u diskriminaciji LSIL-a(CIN1), HSIL-a(CIN2/3) i planocelularnog karcinoma od cervicitisa su za citološki nalaz ASCH (PA IIIa) (Sp=90,6%, a Sn=100% za Ca planocellulare, Sn=96% za HSIL i Sn=86% za LSIL). U diskriminaciji HSIL-a od LSIL-a najbolja diskriminativnost postiže se za nalaz LSIL (PAIIIb) Papanicolau testa (Sn=72,0%, Sp=67,4%), a u diskriminaciji Ca planocellulare od LSIL najbolja diskriminativnost postiže se za nalaz HSIL (PA IIIb/IV) Papanicolau testa (Sn=77.8%, Sp=97.7%). Na osnovu naših rezultata možemo zaključiti da postoji pozitivna histološko-citološka korelacija nalaza i da je Papanicolau test pouzdaniji u detekciji težih premalignih promena. Citološke dijagnoze ASCH (PAIIIa) i LSIL (PAIIIb) mogu pouzdano ukazati na postojanje premalignih cervikalnih lezija kod žena, pa pacijentkinje sa tim nalazima treba češće kontrolisati i lečiti.
L. Vitkovic, M. Mijovic, D. Vukicevic, B. Djerkovic, N. Mitic, A. Ilic, G. Trajkovic, S. Jakovljevic
01.12.2014.
Professional paper
DESKRIPTIVNO-EPIDEMIOLOŠKE KARAKTERISTIKE KARCINOMA GRLIĆA MATERICE
Karcinom grlića materice je ozbiljan javno zdravstveni problem kako u svetu tako i kod nas. Kontrola karcinoma grlića materice pored prevencije podrazumeva ranu dijagnostiku i lečenje, ali i preciznu registraciju i praćenje obolelih žena. Da bi bila obezbeđena dobra kontrola bolesti, svi ovi delovi sistema moraju funkcionisati paralelno. Cilj rada je sagledavanje osnovnih deskriptivno-epidemioloških karakteristika obolelih i umrlih žena od raka grlića materice u svetu, Evropi i Srbiji. Poseban osvrt i detaljan epidemiološki prikaz usmeren je na područje centralne Srbije za period od 1999. do 2011. godine. U radu je primenjen deskriptivno-epidemiološki metod. Kao izvor podataka korišćeni su podaci Globocan-a (softver za procenu opterećenja bolesti populacije, pokrenut od strane WHO), kao i podaci Registra za rak centralne Srbije za analizirani period. U svetu, broj novoobolelih slučajeva za 2012. g. je 527624 (standardizovana stopa incidencije je 14,0 na 100000 žena). U pogledu mortaliteta, za dotičnu godinu broj umrlih žena je 265653 (standardizovana stopa mortaliteta je 6,8 na 100000 žena). Od karcinoma grlića materice na svaka 2 minuta u svetu umre jedna žena (720 dnevno). U Evropi, ukupan broj novoobolelih žena za 2012. g. je 58348 (11,44 na 100000 žena). Ukupan broj umrlih žena je 24378 (3,75 na 100000 žena). U Srbiji, ukupan broj novoobolelih žena za 2012. g. je 1501 (23,8 na 100000 žena). Ukupan broj umrlih žena je 609 (7,7 na 100000 žena). Pozicija Srbije u Svetu u pogledu obolevanja je 62 (od 182. zemlje), dok je 84. u pogledu mortaliteta, što nas svrstava u gornju polovinu liste svih zemalja u svetu. Prema podacima Registara za rak za centralnu Srbiju, prosečna standardizovana stopa incidencije od 23,9/100000 žena i mortaliteta od 7,2/100000 za period 1999-2011. godine ukazuju na nepovoljnu epidemiološku situaciju ovog malignoma u centralnoj Srbiji. Mada se analizom pomenutog vremenskog intervala registruje blagi pad trenda obolevanja u centralnoj Srbiji (y=27,13-0,47x; p>0,05, otprilike jedan slučaj karcinoma grlića materice na 100000 žena manje za sledeće dve godine). Naprotiv, za isti analizirani period, beleži se porast umiranja (y=7,16+0,01x; p>0,05).
D. Vukicevic, R. Mitic, M. Mijovic, N. Mitic, L. Vitkovic, B. Djerkovic, V. Nedeljkovic
01.12.2013.
Professional paper
FIBROADENOM AKCESORNOG TKIVA DOJKE U AKSILI
Development of accessory breast tissue is a consequence the lack of regression remanths of milk line during embryogenesis. These remanths can be found anywhere on the ventral side of the body, extending from the axilla to the pubic region and most of them can be found in the axillary region. On such a tissue may appear almost identical changes that affect the normal breast, from benign non-tumor changes to malignant tumors. In our case report, the case is a 23 year-old woman who had a unilateral solitary lesions in the axilla, which was surgically removed. Starting diagnosis was " Limphadnopathia axillaris lateris sinistri." After removal and histopathological evaluation of the change, it was found that there is a tumor - fibroadenoma. There were also performed immunohistochemical ( IHH ) staining, with finding of a conventional fibroadenoma of the breast as expected. Accessory breast tissue in the axilla is a rare finding, and the tumors in this tissue even rarer. Histopathological confirmation is mandatory, with the need to exclude malignant tumors which are more common in these cases, and they occur at an earlier age.
B. Djerkovic, N. Mitic, D. Vukicevic, V. Nedeljkovic, L. Vitkovic
01.12.2013.
Professional paper
PROGNOSTIČKI ZNAČAJ GLEASON SCORE-A 7 (3+4) I GLEASON SCORE-A 7 (4+3) U ADENOKARCINOMU PROSTATE U ODNOSU NA KLINIČKI STADIJUM, TKIVNI ANDROGEN STATUS I STEPEN NEUROENDOKRINE DIFERENCIJACIJE
Prognoza i izbor terapije adenokarcinoma prostate (ADKP) direktno zavise od brojnih prediktivnih faktora, među kojima su najznačajniji zbirni histološki gradus tumora (Gleason score, koji predstavlja zbir prvog i drugog dominantnog histološkog gradusa) i klinički stadijum. Novija istraživanja u ove faktore ubrajaju i tkivni androgen status i neuroendokrinu diferencijaciju. Važnost prvog i drugog dominantnog histološkog gradusa naročito postaje značajan kod ADKP Gleason score-a 7. Smatra se da goru prognozu imaju ADKP višeg Gleason score-a, uznapredovalog kliničkog stadijuma, androgen nezavisni tumori i tumori koji pokazuju veći stepen neuroendokrine diferencijacije. Cilj rada je odrediti prediktivni značaj ADKP Gleason score-a 7 (3+4) i ADKP Gleason score-a 7 (4+3) u odnosu na klinički stadijum, tkivni androgen status i stepen fokalne neuroendokrine diferencijacije. Istraživanje je obuhvatilo 33 ADKP Gleason score-a 7, odnosno 26 (78,79%) ADKP 7 (3+4) i 7 (21,21%) ADKP 7 (4+3). Svi tumori su najčešće dijagnostikovani u stadijumu D2 kada su već postojale udaljene metastaze. ADKP Gleason score-a 7 (4+3) dijagnostikovani su u većem procentu u ovom stadijumu, među njima ima više androgen nezavisnih tumora i pokazuju veći stepen fokalne neuroendokrine diferencijacije. Svi dobijeni rezultati u saglasnosti su sa podacima iz literature i navode na zaključak da ADKP Gleason score-a 7 (4+3) imaju goru prognozu od ADKP Gleason score-a 7 (3+4).
M. Mijovic, D. Vukicevic, B. Djerkovic, V. Nedeljkovic, L. Vitkovic
01.12.2013.
Professional paper
ZNAČAJ PERIACINUSNIH PUKOTINA KAO POMOĆNOG KRITERIJUMA U DIJAGNOZI ADENOKARCINOMA PROSTATE GLEASON SCORE-A 7 (3+4) I GLEASON SCORE-A 7 (4+3) I NJIHOV ODNOS PREMA PARAMETRIMA OD PREDIKTIVNOG ZNAČAJA
Dijagnostikovanje različitih patohistoloških promena u prostati u najvećem broju slučajeva bazira se na sigurnim benignim, odnosno malignim karakteristikama. Periacinusne pukotine (PP) spadaju u pomoćne dijagnostičke kriterijume i opisuju se kao nesigurne maligne karakteristike. Na osnovu prisusutva i obima PP, pregledanih na velikom mikroskopskom povećanju (400x), žlezde su svrstane u 3 grupe: grupa 1–žlezde bez periacinarnih pukotina ili kod kojih su periacinarne pukotine prisutne u ≤50% žlezdane cirkumferencije; grupa 2–žlezde sa periacinarnim pukotinama prisutnim u >50% žlezdane cirkumferencije, a nalaze se u <50% prisutnih žlezda i grupa 3-žlezde sa periacinarnim pukotinama prisutnim u >50% žlezdane cirkumferencije, a nalaze se u ≥50% prisutnih žlezda. Cilj našeg rada bio je da se utvrdi značaj prisustva PP u adenokarcinomu prostate (ADKP) Gleason score-a 7(3+4) i 7(4+3) i da se korelacionom analizom njihovog odnosa prema parametrima od prediktivnog značaja (preoperativne vrednosti serumskog prostata specifičnog antigena, tumorski volumen, klinički stadijum i stepen fokalne neuroendokrine diferencijacije) utvrdi postojanje razlike u njihovoj pojavi u navedenim ADKP. Istraživanje je obuhvatilo 33 ADKP Gleason score-a 7, odnosno 26 (78,79%) ADKP 7(3+4) i 7 (21,21%) ADKP 7(4+3). Kod ADKP Gleason 7(3+4) periacinusne pukotine se češće javljaju kod tumora koji su manji, bolje diferentovani (stvaraju više PSA), koji se dijagnostikuju u manje uznapredovalim kliničkim stadijumima i koji pokazuju manji stepen fokalne neuroendokrine diferencijacije. Kod ADKP Gleason 7(4+3) periacinusne pukotine se češće javljaju kod tumora kod kojih se stvara manja količina serumskog PSA (slabije diferentovani) i kod tumora koji su dijagnostikovani u uznapredovalim kliničkim stadijumima. Periacinusne pukotine predstavljaju češći nalaz kod adenokarcinoma prostate Gleason score-a 7(4+3) koji imaju goru prognozu, što PP svrstava u red važnih pomoćnih kriterijuma za dijagnozu adenokarcinoma prostate.
Milica Mijovic, D. Vukicevic, B. Djerkovic, V. Nedeljkovic, L. Vitkovic
01.01.2011.
Original scientific paper
CORRELATION BETWEEN DURATION AND DIAMETER OF DIFFERENT HISTOPATHOLOGICAL TYPES OF SKIN CANCER
The two most common types of skin cancer are basal cell and squamous cell carcinoma, well known as nonmelanoma skin cancers. These cancers are the most common malignant tumors in white population and its incidence is increasing
dramatically. Information about the time of occurrence and cancer growth rate is a significant segment in establishing the primary skin cancer diagnosis. The aim of this prospective study is to determine the correlation between the size of basocellular and squamous cell carcinoma, represented through the function of cancer diameter and time period elapsed from their occurrence up to the surgical intervention. Apart from general anamnestic data, it was also insisted on as precise as possible datum referring to the cancer occurrence time. All cancers have been hystopathologically confirmed. Linear regressive analysis was used for establishing the interdependence between the diameters of tumors and their duration. The average growth of basocellular carcinoma in our patients was 4.3 mm on annual basis, i.e. 6.1 mm annually for squamous cell carcinoma. Tumor duration is a significant anamnestic datum for establishing diagnosis which can indicate a biological aggressiveness or skin cancer type.
G. Videnović, D. Vukićević, I. Tripković
01.01.2011.
Professional paper
ENDOMETRIAL HYPERPLASIA AND POLYPS
Endometrial hyperplasia appears like a result of continues, not mortified stimulation of endometrial by estrogenically hormones. Endometrial becomes nub which histological mirrors in endometrial gland multiplication, in smaller amount even endometrial strom. Endometrial polyp represents focal overmuch growth of gland stromas endometrial and its considered a focal endometrial hyperplasia. Therefore we will examine them at the same time. Medical faculty of Prishtina - Kosovska Mitrovica did an analysis of biopsy and operational material in pathology institute in the period from 2005 to 2008 out of 3696 histological proved cases, its recorded that 210 cases have endometrial hyperplasia and endometrial polyp, which is 5,68%. According histological type the most often seen is endometrii hyperplasia simplex who is spotted in 127 cases (60,48% - D= 0,195; p<0,001), endometrii hyperplasia complex in 19 cases (9,09%), cases where endometrial hyper-plasia and endometrial polyps are united are spotted in 14 cases (6,67%), while endometrii polypus in 50 cases (23,81%). By analysis of all types of endometrial hyperplasia and endometrial polyps we came to conclusion that all of these changes are mostly made at the age of 41-50 (60,48%) compared to other ages. (D=0,267; p<0,001). In between all patients the youngest was 22 years old (endometrii hyperplasia simplex) and the oldest 78 years old (endometrii polypus). On the basics of studied values, regression's analysis it's been confirmed that the numbers of cases with endometrial hyperplasia and endometrial polyps are growing for 8,6 every year, which points at bigger and bigger problem in the whole pathology.
D. Vukićević, N. Mitić, M. Mijović, B. Đerković
01.01.2010.
Original scientific paper
CONNECTION OF TUMOR BUDDING, LYMPHATIC VESSEL INVASION AND LYMPH NODE METASTASIS IN COLORECTAL CARCINOMAS
Tumor budding refers to an isolated cell or a cluster of up to five undifferentiated tumor cells, located in the stroma close to the invasion frontline of a carcinoma. It has been observed that tumor budding invariably precedes both an invasion into the lymphatic vessels surrounding a tumor and the development of metastases in lymphatic nodes. The aim of this paper is to determine the link between tumour budding, lymphatic vessel invasion and presence o lymph node metastasis in colorectal carcinomas. The study involved 92 cases of colon and upper rectum cancers removed at the Trebinje General Hospital and the Medical Centre in Kosovska Mitrovica. High-grade tumour budding was diagnosed in 66 (71.7%) cases, and lowgrade tumour budding in 26 (20.3%) cases. Lymphatic invasion was detected in 63 (68.5%) cases (55 (87.3%) of these cancers showed high-grade tumour budding, while on the other hand 8 (12.7%) had low-grade tumour budding). Lymphonodal metastases were found in 45 (48.9%) cases (of which 36 (80.0%) were high-grade and 9 (20.0%) low-grade incidents). Based on the ÷2-test, it may be concluded that the distribution of tumour budding in relation to lymphatic invasion (p<0.001) is statistically very significant, which was not confirmed in the case of metastases developing in lymphatic nodes (p>0.05). In conclusion, tumour budding is highly linked to lymphatic invasion, which it most probably precedes.
B. Đerković, M. Vančentović-Mijović, D. Vukićević, N. Mitić
01.12.2010.
Original scientific paper
PERIACINAR CLEFTINGS IN PROSTATIC ADENOCARCINOMA, PROSTATIC INTRAEPITHELIAL NEOPLASIA AND BENIGN HYPERPLASIA OF PROSTATE
Diagnosis of different pathohystological diseases of prostate in the most cases based on common benignant and malignant characteristics. The presence of periacinar cleftings (PC) is an additional criterion favouring prostatic adenocarcinoma. The aim of our work was to examine the presence of PC around glands in prostatic adenocarcinoma (PA), prostatic intraepithelial neoplasia (PIN) and benign hyperplasia of prostate (BHP) and to determinate specificity and sensitiveness for their presence in PA. We analysed biopsy material of Institute of pathology, Medical faculty Priština and Department of pathology and forensic medicine Clinical center of Kragujevac from begining of 2007. till the end of 2008. According to the presence and extent of PC, analysed on high power field (400x), glands were classified as: group 1 - glands without PC or with PC affecting ≤50% of gland circumference; group 2 - glands with PC affecting >50% gland circumference in <50% examined glands and group 3 - glands with PC affecting >50% gland circumference in ≥50% examined glands. By the analyse of our material we found PC around glands in PA, PIN and BHP: the most glands in PA were group 2 (34 or 48,6%) and group 3 (31 or 44,3%), in PIN group 1 (12 or 60%) and group 2 (8 or 40%), in BHP glands at all 100% cases were group 1. We found sensitiveness 92,9% and specificity 73,3% for glands with PC at prostatic adenocarcinoma, which indicate that periacinar cleftings represent a reliable criterion in diagnosis prostatic adenocarcinoma.
M. Vančentović-Mijović, D. Vukićević, N. Mitić, B. Ðerković, M. Knežević
01.01.2009.
Original scientific paper
THE MOST OFTEN PATHOLOGICAL CHANGES OF VULVA CAUSED WITH HUMAN PAPILLOMA VIRUSES (HPV)
Vulva can easily be examined, therefore it could be expected that any changes that may emerge at it would be easy
to notice and treat quickly and efficiently. Despite that, the incidence of pre-malignant and malignant changes is increasing.
Many risk factors connected to the emerging of these changes have been discovered, but many explanations have become
available only when the theory of the participation of HPVin oncogenesis has been set. The goal of the study is to identify all
the pathological changes at vulva - benignant, pre-malignant and malignant, according to the age of the patients, and
therefore, both biopsy and operational material collected from 1331 patients treated at GAK “Narodni Front” Belgrade, has been used. There have been 46 diagnoses of benignant changes, of which 20 (43,48%) had been diagnosed as condylomata acuminata, a change including a HPV infection. Most of these changes have occurred at patients aged 31-40. In 17 cases of pre-malignant changes, VIN I has occurred in 2 cases (11,76%), and VIN II and VIN III as more serious pre-malignant lesions were noticed in 8 samples. In 7 cases (41,18%), VIN III was discovered to be moving into a starting invasion phase. It can be concluded that VIN is most often at patients aged over 60. Malignant vulva tumors occurred in 14 cases, 13 of those where diagnosed as invading planocellular carcinoma, and one of them was metastatic. Vulva carcinomas seem to occur most often at patients aged over 60.
D. Vukićević, Ž. Perišić, V. Plešinac-Karapandžić, M. Vančentović-Mijović, B. Đerković, L. Vitković, N. Mitić