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Caracterización de los casos de tumores gliales del sistema nervioso central en un hospital de referencia de alta complejidad en la ciudad de Tunja, departamento de Boyacá - Colombia

dc.rights.licenseReconocimiento 4.0 Internacional
dc.contributor.advisorBastos Pardo, Victor Hugo
dc.contributor.authorRincón Carreño, Cristhian
dc.contributor.authorMartínez Suárez, Eber Arturo
dc.date.accessioned2023-01-24T12:48:54Z
dc.date.available2023-01-24T12:48:54Z
dc.date.issued2023
dc.identifier.urihttps://repositorio.unal.edu.co/handle/unal/83079
dc.descriptionilustraciones, graficas
dc.description.abstractObjetivo: Describir las características de los tumores gliales de la población del Hospital de San Rafael de Tunja entre 2017 y 2021. Metodología: Estudio observacional, unicéntrico y retrospectivo de 51 casos del periodo 2017 - 2021, las variables demográficas, clínicas, imagenológicas, funcionales y de supervivencia fueron analizadas. Se empleó RStudio v2022.07.2 para análisis estadístico. Resultados: Hay menor sobrevida en pacientes con glioma grado IV (sobrevida media 505.18 dias SD +/-169.3) comparado con gliomas de menor grado (grado III sobrevida media 1862.3 SD +/- 668.7) (Log Rank <0.0001). No hay diferencias entre el tipo de cirugía, quimioterapia, radioterapia, lateralidad, invasión cuerpo calloso, mRankin de ingreso entre los diferentes grados tumorales (Kruskal Wallis p > 0.05) El tratamiento oncológico está asociado a mayor sobrevida independientemente del subtipo histológico (Kaplan Meier Log Rank 0.023) y mayor duración con puntaje mRankin menor o igual a 2 (Log Rank 0.0023). Hay menor sobrevida para el escenario Glioblastoma IDH no mutado (p 0.012 Log Rank). A menor valor ADC, mayor puntaje en el mRankin de ingreso (Tau Score -0.249 p 0.029, Spearman Rho -0.324 p 0.028) y a mayor valor ADC, mayor sobrevida (Tau Score 0.199 p 0.046, Spearman Rho 0.310 P 0.032). Conclusiones: Uno de los primeros estudios en Colombia que documenta que la presencia de la mutación del gen IDH, mayor valor ADC y el tratamiento oncológico (independiente del tipo) están asociados a una mayor sobrevida y funcionalidad (Texto tomado de la fuente)
dc.description.abstractObjective: To describe the characteristics of glial tumors in the population of Hospital de San Rafael de Tunja between 2017 and 2021. Methodology: Observational, single-center and retrospective study of 51 cases from the period 2017 - 2021, demographic, clinical, imaging and functional survival variables were analyzed. RStudio v2022.07.2 was used for statistical analysis. Results: There is lower survival in patients with grade IV glioma (mean survival 505.18 days SD +/-169.3) compared with lower grade gliomas (grade III mean survival 1862.3 SD +/- 668.7) (Log Rank <0.0001). There are no differences in the type of surgery, chemotherapy, radiotherapy, laterality, corpus callosum invasion, and admission mRankin between different tumor grades (Kruskal Wallis p > 0.05) Oncology treatment is associated with greater survival regardless of the histological subtype (Kaplan Meier Log Rank 0.023) and longer duration with mRankin score less than or equal to 2 (Log Rank 0.0023). There is lower survival for the non-mutated IDH glioblastoma scenario (p 0.012 Log Rank). Lower ADC values are correlated with higher admission mRankin score (Tau Score -0.249 p 0.029, Spearman Rho -0.324 p 0.028) and higher ADC values, with greater survival rates (Tau Score 0.199 p 0.046, Spearman Rho 0.310 P 0.032). Conclusions: One of the first studies in Colombia to document that the presence of the IDH mutation, a higher ADC value, and cancer treatment (regardless of the type) are associated with higher survival and functionality outcomes.
dc.format.extent97 páginas
dc.format.mimetypeapplication/pdf
dc.language.isospa
dc.publisherUniversidad Nacional de Colombia
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subject.ddc610 - Medicina y salud::616 - Enfermedades
dc.subject.ddc610 - Medicina y salud::617 - Cirugía, medicina regional, odontología, oftalmología, otología, audiología
dc.subject.otherCuerpo Calloso
dc.subject.otherGlioblastoma
dc.subject.otherGlioma
dc.subject.otherMutación
dc.subject.otherQuimioterapia
dc.subject.otherRadioterapia
dc.subject.otherSupervivencia
dc.subject.otherCorpus Callosum
dc.subject.otherDrug Therapy
dc.subject.otherGlioblastoma
dc.subject.otherMutation
dc.subject.otherRadiotherapy
dc.subject.otherPopulation
dc.titleCaracterización de los casos de tumores gliales del sistema nervioso central en un hospital de referencia de alta complejidad en la ciudad de Tunja, departamento de Boyacá - Colombia
dc.typeTrabajo de grado - Especialidad Médica
dc.type.driverinfo:eu-repo/semantics/masterThesis
dc.type.versioninfo:eu-repo/semantics/acceptedVersion
dc.publisher.programBogotá - Medicina - Especialidad en Neurocirugía
dc.contributor.hostingInstitutionHospital Universitario San Rafael de Tunja
dc.coverage.cityhttp://vocab.getty.edu/page/tgn/7005077
dc.description.degreelevelEspecialidades Médicas
dc.description.degreenameEspecialista en Neurocirugía
dc.description.methodsTIPO DE ESTUDIO Descriptivo tipo retrospectivo POBLACIÓN OBJETIVO Población con patología oncológica glial del sistema nervioso central. Se incluirán todos los pacientes que cuenten con diagnóstico histopatológico y/o dentro del criterio CIE-10 de tumor glial manejado en el hospital San Rafael de Tunja en el periodo de 2017 a 2021 cuyos datos estén almacenados en los archivos de la institución. CRITERIOS INCLUSIÓN Paciente con tumor glial de SNC tratado en el Hospital San Rafael de Tunja Que haya recibido diagnóstico y/o tratamiento quirúrgico definitivo para su respectiva patología en el Hospital San Rafael de Tunja. CRITERIOS EXCLUSIÓN - Pacientes que no cuenten con confirmación histopatológica (o radiológica cuando la confirmación histopatología no es pertinente o factible ej. tumores difusos de línea media del tallo) en el Hospital San Rafael de Tunja. Pacientes de los que no se disponga de la totalidad de la Historia Clínica. RECOLECCIÓN DE DATOS La recolección de datos clínico patológicos se obtuvieron a partir del censo quirúrgico del servicio de Neurocirugía del Hospital San Rafael de Tunja, así como el filtro CIE-10 para tumores de sistema nervioso central clasificación WHO dentro del repositorio de patología del Hospital San Rafael de Tunja y de las historias clínicas determinadas en archivo físico y en el software de soporte que actualmente opera en la institución. La obtención de las variables imagenológicas se obtuvieron a partir de las imágenes almacenadas en el servicio principal de radiología de dicha institución. Para el cálculo de los valores del mapa ADC de las lesiones se estableció el punto con el valor más bajo así como el promedio empleando el corte de la circunferencia del mayor diámetro de la lesión en el T1 con gadolinio y que no incluyese áreas de hemorragia o necrosis vista en T2 eco gradiente/SWI. Se contó con aval del comité de ética del Hospital San Rafael de Tunja para la obtención, interpretación y publicación de los datos del presente estudio. ANÁLISIS ESTADÍSTICO Se realizó un estudio descriptivo correlacional y se realizó un análisis de supervivencia utilizando el software libre RStudio versión 2022.07.2 576. La clasificación las variables mencionadas en la tabla fueron de tipo cualitativo o cuantitativo y si eran de carácter nominal u ordinal en el primer escenario y el caso de las cuantitativas éstas últimas a su vez se definieron si tenían distribución normal con la prueba de Shapiro Wilky y su el grado de homogeneidad con las pruebas de Bartlett, Fligner y Levene. Para la comparación de grupos independientes cuyas variables fueron de tipo cualitativo nominal y ordinal se empleó la prueba de Chi cuadrado, en el caso de que los grupos en la contaran con variables de distribución normal se realizó ANOVA de una vía y cuanto eran de distribución no normal se realizó la prueba de Kruskal Wallis. Para la correlación de variables tipo ADC se emplearon los coeficientes de Spearman o Kendall Tau. Para las variables con significancia estadística (tipo de tumor y terapia oncológica) se estimó supervivencia mediante análisis de Kaplan Meier. Se determinó como significancia estadística un valor p menor a 0.05.
dc.identifier.instnameUniversidad Nacional de Colombia
dc.identifier.reponameRepositorio Institucional Universidad Nacional de Colombia
dc.identifier.repourlhttps://repositorio.unal.edu.co/
dc.publisher.facultyFacultad de Medicina
dc.publisher.placeBogotá, Colombia
dc.publisher.branchUniversidad Nacional de Colombia - Sede Bogotá
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dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.subject.proposalMapa de coeficiente de difusión aparente
dc.subject.proposalmRankin Score
dc.subject.proposalEscala de Rankin Modificado
dc.subject.proposalSurvival rate
dc.subject.proposalTasa de supervivencia
dc.subject.proposalTunja
dc.subject.proposalTunja
dc.subject.proposalColombia
dc.subject.proposalGlial Tumour
dc.subject.proposalTumor glial
dc.subject.proposalColombia
dc.subject.proposalApparent Coefficient Diffusion Map
dc.subject.proposalADC
dc.subject.proposalADC
dc.title.translatedCharacterization of glial tumors cases of central nervous system in a high complexity referral hospital in Tunja, Boyacá - Colombia
dc.type.coarhttp://purl.org/coar/resource_type/c_bdcc
dc.type.coarversionhttp://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.contentText
dc.type.redcolhttp://purl.org/redcol/resource_type/TM
oaire.accessrightshttp://purl.org/coar/access_right/c_abf2
dcterms.audience.professionaldevelopmentEstudiantes
dcterms.audience.professionaldevelopmentInvestigadores
dcterms.audience.professionaldevelopmentMaestros
dcterms.audience.professionaldevelopmentResponsables políticos
dc.contributor.orcidRincón Carreño, Cristhian [0000-0002-7968-7604]


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