Strict Standards: call_user_func_array() expects parameter 1 to be a valid callback, non-static method JModuleHelper::renderModule() should not be called statically in /home/vasginek/public_html/libraries/joomla/cache/handler/callback.php on line 99

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 143

Strict Standards: Non-static method JRequest::getCmd() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 144

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 255

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JFactory::getLanguage() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 188

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRequest::getBool() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 219

Strict Standards: Non-static method JRequest::getVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 217

Strict Standards: Non-static method JRequest::_cleanVar() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 151

Strict Standards: Non-static method JFilterInput::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/environment/request.php on line 577

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/advancedmodules.php on line 132
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Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 71

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JLoader::load() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 161

Strict Standards: Non-static method JLoader::register() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 138

Strict Standards: Non-static method JModuleHelper::getLayoutPath() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/mod_mainmenu.php on line 42

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/plugins/system/advancedmodules/modulehelper.php on line 266

Strict Standards: Non-static method JDispatcher::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 511

Strict Standards: Non-static method modMainMenuHelper::render() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/tmpl/default.php on line 82

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 345

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getUser() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 346

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JFactory::getSession() should not be called statically in /home/vasginek/public_html/libraries/joomla/factory.php on line 163

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JComponentHelper::getComponent() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 23

Strict Standards: Non-static method JComponentHelper::_load() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/component/helper.php on line 39

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_contact/router.php on line 24

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 401

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 295

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JSite::getMenu() should not be called statically in /home/vasginek/public_html/components/com_content/router.php on line 19

Strict Standards: Non-static method JApplication::getMenu() should not be called statically in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

Strict Standards: Non-static method JFactory::getApplication() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 90

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 394

Strict Standards: Non-static method JURI::base() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 109

Strict Standards: Non-static method JRegistryFormat::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/registry.php on line 373

Strict Standards: Non-static method JFilterInput::clean() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/registry/format.php on line 45

Strict Standards: Non-static method JRoute::_() should not be called statically in /home/vasginek/public_html/modules/mod_mainmenu/legacy.php on line 107

Strict Standards: Non-static method JFactory::getApplication() should not be called statically in /home/vasginek/public_html/libraries/joomla/methods.php on line 41

Strict Standards: Non-static method JFactory::getConfig() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 372

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JRouter::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 674

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 675

Strict Standards: Non-static method JSite::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/router.php on line 419

Strict Standards: Non-static method JApplication::getMenu() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/includes/application.php on line 345

Strict Standards: Non-static method JLoader::import() should not be called statically in /home/vasginek/public_html/libraries/loader.php on line 186

Strict Standards: Non-static method JMenu::getInstance() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 720

Strict Standards: Non-static method JError::isError() should not be called statically, assuming $this from incompatible context in /home/vasginek/public_html/libraries/joomla/application/application.php on line 721

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BMI Kalkulator

Translate text

Kalkulator kalorija

Starost(god)
Visina(cm)
Težina(kg)
Pol
Aktivnost

Kalkulator trudnoce

Unesite datum poslednjeg ciklusa:
Rak grlića materice
Ocena korisnika: / 8
LošeNajbolje 
Napisao dr Dragan Ćirović, spec. ginekologije i akušerstva   

Po učestalosti kod žena je na trećem mestu iza raka dojke i kolorektalnog raka (debelog creva). Najučestaliji je između 26 i 29. godine života (ranije oko 35.). Razlikuju se u osnovi dva tipa raka grlića materice: ·         Rak površine grlića - planocelularni karcinom; ·         Rak unutrašnjosti grlića - adenokarcinom.

RAK POVRŠINE GRLIĆA: Prema brzini razvoja postoje: SPORI TIP koji prolazi kroz postepene razvojne oblike (tzv prekancerozne stadijume) CIN 1, CIN2, CIN3 ili po novijoj klasifikaciji L-SIL I H-SIL koji se mogu jednostavno i potpuno izlečiti ukoliko se redovno kontroliše i na vreme otkrije. Obično je prisutan kod mlađih od 30 godina.  BRZI TIP koji nema uobičajene razvojne oblike i često se pojavljuje iznenada i ima brzi tok. Obično se javlja kod pacijenata starijih od 30 godina. Godišnje se kod 50 miliona žena u svetu otkrije neki od razvojnih oblika raka grlića, od toga pola miliona oboli od raka a oko 240 000 umre od posledica ove teške bolesti.

RAK UNUTRAŠNJOSTI GRLIĆA: Nastaje iz žlezdanog tkiva koje stvara sluz. Nisu izraženi prelazni stadijumi kao kod raka površine grlića, vrlo brzo prestaje da bude lako izlečiv pa ima ozbiljniju prognozu i manje vremena za reakciju. U 50% slučajeva prelazni oblici ovog karcinoma prisutni su istovremeno i prelazni oblici karcinoma površine grlića.

UZROCI:


Smatra se da 96% svih slučajeva raka grlića materice izazivaju HUMANI PAPILOMA VIRUSI (HPV) i to maligni tipovi: tip 16 je češći kod raka površine grlića, a tip18 je češći kod raka unutrašnjosti grlića, kao i tipovi 45 i 56. Tipovi 31, 33, 35 imaju srednje-maligni potencijal i zajedno sa ova prva dva tipa nalaze se u pomenutih 96% slučajeva raka. 
Postoje i benigni (gotovo bezopasni) tipovi virusa koji izazivaju promene na sluznici genitalija oba pola - tzv. kondilome, koji ipak u oko 5% slučajeva mogu da se pretvore u prekancerozne oblike i rak. Utešno je da u prve dve godine infekcije kod mlađih od 30 godina, 90% HPV infekcije doživi samoizlečenje, a kod starijih od 30 godina samo 40%.(preciznije u prvoj godini 30%, u drugoj 80% preostalih tako da 20% preostalih dobije neki prelazni oblik raka ili rak).

Drugi mikroorganizam koji može da izazove hronične upalne promene na grliću sa opasnošću da one pređu u prekancerozne oblike i konačno rak grlića jeste CHLAMIDIJA TRACHOMATIS. Zato je neophodno kod svake promene na grliću da se ispita prisustvo ovog mikroorganizma, i u tom slučaju izvede jednostavno lečenje antibioticima.

Ostali faktori rizika su: pušenje, započinjanje seksualnih odnosa pre 17. godine života, česta promena partnera, loši ekonomski uslovi (slaba i nekvalitetna ishrana), problematičan muški partner (promiskuitet, posete prostitutkama, loša polna higijena, genitalne infekcije, rak penisa, bivša partnerka sa rakom grlića materice).

OTKRIVANJE:


Redovne kontrole nakon prvog odnosa pa sve do starosti. Za mlađe od 25 godina jednom u 2 godine, za starije 1 puta godišnje ili češće prema nalazu.

- PAPA bris spoljašnjosti i unutrašnjosti grlića

- Kolposkopija

- Tipizacija virusa

- Cervikalni bris na Hlamidiju

- Biopsija grlića materice

- Eksplorativna kiretaža kanala grlića materice


PAPA bris treba da pregleda ginekolog i po potrebi da zatraži mišljenje Histopatologa koji daje konačnu ocenu svih sumnjivih nalaza.

LEČENJE PREMALIGNIH RAZVOJNIH STADIJUMA:


Vaporizacija grlića (uništavanje površinskih promena u prvom razvojnom obliku koji je dijagnostikovan prethodnom biopsijom.


Konizacija - hirurško odstranjivanje obolelog dela grlića materice u drugom i trećem razvojnom obliku prekanceroze koji su dijagnostikovani prethodnom biopsijom

LEČENJE RAKA GRLIĆA:


U PRVOM kliničkom stadijumu: OPERACIJA I ZRAČENJE


U DRUGOM kliničkom stadijumu: SAMO ZRAČENJE jer daje isti efekat kao i operacija
Teži stadijumi su veliki problem za lečenje: pokušava se kombinovano hirurško i zračno lečenje, a prognoza je mnogo lošija i neizvesnija

GLAVNI KRITERIJUM IZLEČENJA JE PREŽIVLJAVANJE NAKON PUNIH 5 GODINA, kada se smatra da je pacijent izlečen, ukoliko su klinički, biohemijski i histopatološki nalazi uredni.


dr Dragan Ćirović, spec. ginekologije i akušerstva, DZ "Dijagnostika"

 

 
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