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Author: Ciobanu Veronica Degree: doctor of medicine Speciality:  14.00.14 - Oncology and Radiotherapy Year: 2007 Scientific adviser: Dumitru Sofroni doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology Scientific consultant: Iraida Iacovleva doctor habilitat, professor, Public Medical Sanitary Intitution Institute of Oncology Institution: Scientific council:

Status The thesis was presented on the 20 November, 2007 Approved by NCAA on the 20 December, 2007 Abstract – 0.37 Mb / in romanian Thesis CZU 618.216-006.5-07-08 6.06 Mb / in romanian 110 pages

Keywords

Summary

Although cancer of the vulva is a visual accessible form, more that 50% of patients address to curing with the widespread form of the ilness.Kraurosis of the vulva and leukoplakia tend to pretumour ilnesses, on the background of which malignant tumours arise.The aim of this work was to determine clinico-morphological aspects of leukoplakia, kraurosis and the mixed forms of ilness and appreciate the effeciency of different methods of given patology. To realize the aim, there had been studied clinical, morphological, electron-microscopic information data of 105 patients; 18 cases of kraurosis, 35 cases of leukoplakia and 52 cases of leukoplakia and kraurosis of the vulva which were treated with a conservativ method, with criodistructiv and having been put under vulvectomy. Taking into account the information got, it was revealed that at 83,8% patients the period start of illness made up from 7 to 11 months, at 71,4% of patients clynical manifestations were: itch, burning sensation and other parestezi in the exterior sphere of sexual organs. 57,1% of cases showed the diffuzi form of kraurosis and leukoplakia with the area of spreading process, in 65,3% of cases from 3 ≤ 4cm2. On the base of clynical manifestations we formed the selection criteria of one or another method of curing. It was established that leukoplakia and kraurosis being an independent process, very often combine and then the hearth is transformed into kraurosis. The cases of the itch, depigmentation and hiperkeratosis are linked with the accumulation of mastocit and their degranulation: melanosoms dissapear from melanocites and keranocites, there appear the early condensation of beam of keratin filament, the compact masses of keratohialin are formed, and disbalance in the collagenosyntetic – collagenolytic system. Leukoplakia is an affect with a high potential malignant which constitutes 17,1% for dysplasia and 13,5% for Ca in situ, but conservative therapy mustn’t surpass three courses of treatment: if it is not effective. The criodistruction of the hearth of leukoplakia and kraurozis of the vulva is in 80,0% effective, less traumatic and it doesn’t bring to any changes of exterior sexual organs, which is an important factor for women of reproductive ages. Dysplasia and ca in situ of the vulva needs vulvectomy, which in 95,0% cases has a radical method of treatment. In conclusion, the got results are an important factor in the prophylaxis, prevention of the disease of cancer of the vulva on the leukoplakia, kraurosis and mixed forms of illness background.

Oficial Reviewers

• Alexandru Gudima
  doctor habilitat, associate professor (docent), Public Medical Sanitary Intitution Institute of Oncology
• Valentin Friptu
  doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

 Theses