STRUČNI RAD (PROFESSIONAL PAPER)
Lucija Župan1, Melita Kukuljan1,2,3, Ena Mršić1,2
1 Sveučilište u Rijeci, Fakultet zdravstvenih studija.
2 Klinički zavod za dijagnostičku i intervencijsku radiologiju, KBC-a Rijeka.
3 Sveučilište u Rijeci, Medicinski fakultet.
Korespodentni autor:
DOI: https://doi.org/10.55378/rv.47.2.9
Sažetak
Cilj: Plućna tromboembolija (PTE) je hitno medicinsko stanje kod kojeg dolazi do okluzije jedne ili više grana plućnih arterija tromboembolusom. CT plućna angiografija (CTPA) je brza, neinvazivna radiološka metoda kojom se postavlja dijagnoza PTE. Glavni cilj ovog rada je odrediti incidenciju pozitivnih PTE nalaza kod 524 pacijenta podvrgnutih CTPA te odrediti učestalost zahvaćenih grana plućnih arterija. Nadalje, jedan od ciljeva je i odrediti incidenciju usputnih nalaza (plućni nodusi, tumor pluća, pneumonija, infarkt pluća, pleuralni izljev).
Ispitanici i metode: U ovom retrospektivnom istraživanju prikupljeni su podaci 524 bolesnika koji su zbog sumnje na PTE podvrgnuti CTPA pregledu na Kliničkom zavodu za dijagnostičku i intervencijsku radiologiju, na lokalitetu Sušak, u Kliničkom bolničkom centru (KBC) Rijeka, u razdoblju od siječnja do travnja 2023. godine. Svi potrebni podaci navedeni u nalazu radiologa prikupljeni su iz integriranog bolničkog informacijskog sustava (IBIS) i pripadajuće aplikacije (ISSA).
Rezultati: Od ukupno 524 bolesnika podvrgnutih CTPA, PTE je dokazana kod 97 ili 18,51% pacijenata. U našem istraživanju bio je podjednak broj ispitanika muškog i ženskog spola (260 ili 49,62% naprema 264 ili 50,39%). Nešto je veća incidencija PTE bila kod muškaraca (52 ili 53,61%) nego kod žena (45 ili 46,39%). Najveći broj bolesnika (262 ili 50,00%) pripadao je dobnom razredu između 61. i 80. godine života. Usputni nalazi opisani na CTPA, prema redoslijedu učestalosti su bili: pneumonije (37,15%), pleuralni izljevi (34,86%), plućni nodusi (16,79%), tumori pluća (6,87%) i plućni infarkti (4,33%).
Zaključak: CT plućna angiografija predstavlja zlatni standard za detekciju plućne tromboembolije. Pregledom dostupne literature, incidencija PTE je komparabilna s rezultatima našeg istraživanja. U našoj, kao i u većini recentnih studija, PTE je najčešće detektirana u segmentalnim i subsegmentalnim granama plućnih arterija, dok se incidencija usputnih nalaza detektiranih na CTPA ne podudara s rezultatima drugih istraživanja.
Ključne riječi: CT angiografija; Incidencija; Plućna tromboembolija
Incidence of pulmonary thromboembolism in patients who underwent CT pulmonary angiography in the first quarter of 2023 at CHC Rijeka
Abstract
Aim: Pulmonary thromboembolism (PTE) is an urgent medical condition in which one or more branches of the pulmonary arteries are occluded by an embolus. CT pulmonary angiography (CTPA) is a rapid, non-invasive radiological method used to diagnose PTE. The main goal of this research was to determine the incidence of positive PTE findings in 524 patients who underwent CTPA, and to determine the frequency of affected branches of the pulmonary arteries. Furthermore, one of the goals was to determine the frequency of incidental findings (lung nodules, lung tumor, pneumonia, lung infarction, pleural effusion).
Methods: In this retrospective study, data was collected on 524 patients, who due to suspicion of PTE, underwent CTPA at the Clinical Department for Diagnostic and Interventional Radiology, at the Clinical Hospital Center (CHC) Rijeka, in the period from January to April 2023. All the necessary data specified in the radiologist’s report was collected from the hospital database and the associated application (ISSA).
Results: A total of 147 diagnosed primary lung cancers were detected in this study. Lung cancer showed a male predominance with 65,3% while the proportion of female patients was 34,7%. The most common histological type of lung cancer was adenocarcinoma, confirmed in 40,8% of patients, followed by squamous cell carcinoma, which was diagnosed in 22,4% of patients. The male gender was more prevalent in patients with adenocarcinoma and squamous cell carcinoma, with the incidence of 63,3% and 75,5%. Analysis of the smoking status showed that 80% of patients with adenocarcinoma and 94% of patients with squamous cell carcinoma were smokers. The incidence of smokers among men diagnosed with adenocarcinoma and squamous cell carcinoma was approximately equal (92.2% vs. 92%). The proportion of smokers among women with adenocarcinoma was 59.1% while all women with squamous cell carcinoma were smokers.
Conclusion: Squamous cell carcinoma was the second most common histological type in patients diagnosed with lung cancer in 2022 at CHC Rijeka, after adenocarcinoma, with the incidence of 22.4%. Squamous cell carcinoma showed a significantly higher incidence in male patients (75,8% vs. 24,2%). Furthermore, the proportion of smokers was higher among the patients diagnosed with squamous cell carcinoma compared to those diagnosed with adenocarcinoma (94% versus 80%).
Keywords: CT, lung tumours, smoking tobacco, squamous cell carcinoma
