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2. Long term results of follow-up after HPV self-sampling with devices Qvintip and HerSwab in women non-attending cervical screening programmeTeodora Bokan, Urška Ivanuš, Tine Jerman, Iztok Takač, Darja Arko, 2021, original scientific article Abstract: We are presenting the results of the Slovenian human papillomaviruses (HPV) self-sampling pilot study in colposcopy population of National Cervical Cancer Screening Programme ZORA for the first time. One-year and four-year follow-up results are presented for two different self-sampling devices. Participants and methods. A total of 209 women were enrolled in the study at colposcopy clinic. Prior to the gynaecological examination, all women performed self-collected vaginal swab at the clinic; 111 using Qvintip and 98 using HerSwab self-sampling device. After self-sampling, two cervical smears were taken by a clinician; first for conventional cytology and second for HPV test. After that, all women underwent colposcopy and a cervical biopsy if needed. We compared sensitivity, specificity, and predictive values of cytology (at the cut-off atypical squamous cells of undetermined significance or more [ASC-US+]) and HPV test (on self- and clinician-taken samples) for the detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) after one and four years of follow-up. Hybrid Capture 2 (HC2) assay was used for all HPV testing. Results. The mean age of 209 women was 37.6 years and HPV positivity rate 67.0% (140/209), 36.9 years and 70.3% (78/111) in the Qvintip group and 38.4 years and 63.3% (62/98) in the HerSwab group, respectively. Overall, percent agreement between self and clinician-taken samples was 81.8% (kappa 0.534) in the Qvintip and 77.1% (kappa 0.456) in the HerSwab group. In the Qvintip group, the longitudinal sensitivity, specificity, positive and negative predictive values were 71.8%, 75.0%, 83.6%, 60.0% for cytology; 83.1%, 51.3%, 75.6% and 62.5% for HPV test of self-taken samples and 94.4%, 57.5%, 79.8% and 85.2% for HPV test on clinician-taken samples. In the HerSwab group, the corresponding results were 71.7%, 46.7%, 61.3%, 58.3% for cytology; 75.0%, 47.7%, 62.9% and 61.8% for HPV test on self-taken samples and 94.3%, 44.4%, 66.7% and 87.0% for clinician-taken samples, respectively. Conclusions. The results confirm that HPV self-sampling is not as accurate as clinician sampling when HC2 is used. All HPV tests showed a higher sensitivity in detecting CIN2+ compared to cytology. Due to non-inferior longitudinal sensitivity of HPV self-sampling compared to cytology, HPV self-sampling might be an option for non-attenders to the National Cancer Screening Programme.
Keywords: HPV self-sampling, cytology, high-grade intraepithelial lesion, screening programmes
Published in DiRROS: 19.07.2024; Views: 110; Downloads: 39
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4. Spremljanje bolnic z ginekološkimi raki po zaključenem zdravljenjuDarja Arko, 2024, published professional conference contribution Abstract: Število žensk, ki so se zdravile zaradi ginekoloških rakov, se veča zaradi staranje populacije, zgodnjega odkrivanja bolezni in bolj uspešnih načinov zdravljenja. Rak in zdravljenje raka prizadenejo ženske na več nivojih, fizično in psihično. Najpogostejše težave so kronične bolečine, utrujenost, limfedem, nevropatija, anksioznost in depresija. Ginekološki raki in njihovo zdravljenje imajo dodatno še pomemben negativen vpliv tudi na spolno življenje. Spremljanje bolnic po zdravljenju raka zato ni namenjeno samo zgodnjemu odkrivanju morebitne ponovitve bolezni, ampak tudi zagotavljanju čim boljše kakovosti življenja. Pomembno in potrebno je, da pri bolnicah po zdravljenju ginekoloških rakov prepoznamo in lajšamo težave, ki so posledica bodisi bolezni same ali pa posledica zdravljenja raka. Načini in organizacija spremljanja bolnic z ginekološkimi raki se močno razlikuje med posameznimi centri in državami, jasnih dokazov, kateri je najboljši način dela, ni. Verjetnost ponovitve bolezni se razlikuje glede na vrsto raka, stadij bolezni, stanje bolnice in glede na to, kako je bila zdravljena, zato je tudi spremljanje smiselno prilagoditi posameznici, kar poudarja večina sodobnih smernic. Ginekološki raki predstavljajo heterogeno skupino bolezni. Mednarodna in domača priporočila o spremljanju so narejena za posamezne lokalizacije in so na kratko predstavljena v prispevku.
Keywords: rak (medicina), ginekologija, ponovitev bolezni, kakovost življenja, strokovna priporočila
Published in DiRROS: 04.06.2024; Views: 224; Downloads: 70
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5. Urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) in breast cancer : correlation with traditional prognostic factorsMaja Lampelj, Darja Arko, Nina Čas-Sikošek, Rajko Kavalar, Maja Ravnik, Barbara Jezeršek Novaković, Sarah Dobnik, Nina Fokter Dovnik, Iztok Takač, 2015, original scientific article Abstract: Background. Urokinase plasminogen activator (uPA) and plasminogen activator inhibitor type-1 (PAI-1) play a key role in tumour invasion and metastasis. High levels of both proteolytic enzymes are associated with poor prognosis in breast cancer patients. The purpose of this study was to evaluate the correlation between traditional prognostic factors and uPA and PAI-1 expression in primary tumour of breast cancer patients. Patients and methods. 606 primary breast cancer patients were enrolled in the prospective study in the Department of gynaecological oncology and breast oncology at the University Medical Centre Maribor between the years 2004 and 2010. We evaluated the traditional prognostic factors (age, menopausal status, tumour size, pathohistological type, histologic grade, lymph node status, lymphovascular invasion and hormone receptor status), together with uPA and PAI-1. We used Spearman%s rank correlation, Mann Whitney U test and X2 test for statistical analysis. Results. Our findings indicate a positive correlation between uPA and tumour size (p < 0.001), grade (p < 0.001), histological type (p < 0.001), lymphovascular invasion (p = 0.01) and a negative correlation between uPA and hormone receptor status (p < 0.001). They also indicate a positive correlation between PAI-1 and tumour size (p = 0.004), grade (p < 0.001), pathohistological type (p < 0.001) and negative correlation between PAI-1 and hormone receptor status (p = 0.002). Conclusions. Our study showed a relationship between uPA and PAI-1 and traditional prognostic factors. Their role as prognostic and predictive factors remains to be further evaluated.
Keywords: urokinase plasminogen activator, plasminogen activator inhibitor, breast cancer
Published in DiRROS: 17.04.2024; Views: 290; Downloads: 148
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6. Razvoj obravnave bolnic z rakom dojk v UKC MariborDarja Arko, 2022, published professional conference contribution Abstract: Kot najpogostejši rak žensk predstavlja rak dojk pomemben del onkološke dejavnosti v Univerzitetnem kliničnem centru Maribor (UKC Maribor.) Področje zdravljenja te bolezni, ki je sprva sodilo pod okrilje torakalnih kirurgov, smo sredi 90. let prejšnjega stoletja postopno prevzeli ginekologi in skoraj dve desetletji razvijali dejavnost na področju diagnostike, kirurškega in sistemskega
zdravljenja. S hitrim razvojem sistemskih zdravil in z uvedbo specializacije s področja internistične onkologije v Sloveniji se je dejavnost onkologije razvila v smeri samostojnega Oddelka za onkologijo, ki je leta 2016 prevzel najprej celotno sistemsko zdravljenje in kmalu zatem postopno tudi radioterapevtsko zdravljenje bolnic z rakom dojk.
Način obravnave žensk z rakom dojk v UKC Maribor se je bistveno spremenil z uvedbo programa DORA. Slikanje žensk v okviru tega programa se je v UKC Maribor začelo leta 2013, od konca leta 2018 pa je UKC Maribor tudi diagnostični center DORA, s čimer je diagnostika v veliki meri prešla v roke radiologov.
Danes poteka celostna obravnava bolnic z rakom dojk v UKC Maribor multidisciplinarno, v skladu s strokovnimi standardi in smernicami, od diagnostike in vseh oblik zdravljenja do rehabilitacije, sledenja in paliativne oskrbe na Oddelku za ginekološko onkologijo in onkologijo dojk in na Oddelku za onkologijo. Zdravljenje moških z rakom dojk ostaja na Oddelku za torakalno kirurgijo.
Keywords: rak dojk, diagnostika, zdravljenje, kirurško zdravljenje, radioterapija, sistemsko zdravljenje, rehabilitacija, raziskovalno delo
Published in DiRROS: 22.12.2022; Views: 578; Downloads: 172
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7. Postopki za obravnavo bolnic z rakom materničnega vratuBarbara Šegedin, Sonja Bebar, Olga Cerar, Branko Cvjetičanin, Barbara Gazić, Brigita Gregorič, Urška Ivanuš, Borut Kobal, Manja Šešek, Leon Meglič, Maja Pakiž, Nina Kovačević, Špela Smrkolj, Erik Škof, Iztok Takač, Helena Barbara Zobec Logar, 2019, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: ONKOLOGIJA-STOJIŠČE, onkologija, ginekologija
Published in DiRROS: 10.06.2020; Views: 1982; Downloads: 607
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8. Priporočila za obravnavo bolnic z rakom materničnega vratuBarbara Šegedin, Darja Arko, Sonja Bebar, Olga Cerar, Branko Cvjetičanin, Barbara Gazić, Brigita Gregorič, Urška Ivanuš, Borut Kobal, Manja Šešek, Leon Meglič, Maja Pakiž, Nina Kovačević, Špela Smrkolj, Erik Škof, Iztok Takač, Helena Barbara Zobec Logar, 2019, dictionary, encyclopaedia, lexicon, manual, atlas, map Keywords: diagnostika, kirurško zdravljenje, radikalno zdravljenje, kemoterapija, sledenje pacientov, nosečnice, zdravstvena obravnava, recidiv, paliativna oskrba, epidemiologija, histopatologija, smernice
Published in DiRROS: 10.06.2020; Views: 2080; Downloads: 697
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