520
HLAVNÍ506722701005185134178232252
TÉMA533422701003981147194
Current401733701003976100125160198225
trends42583370100255085123161190
in446433701001552
the453233701002664100
diagnosis46483370100375287125163202231246275
of493933701003858
pancreatic501333701003772110141165200234261277307
cancer533633701003065103133168192
|5584227010018
3635617227010059102136
/35568043010757
Vnitř36328043010771118137165192
Lék.3843804301074184122140
2022;68(6):363-3704003804301074487128172187232277301343365379424467510537578619660
/46838043010757
VNITŘNÍ47598043010792153173218267326347
LÉKAŘSTVÍ5127804301074185131189236280326378400
www.casopisvnitrnilekarstvi.cz42580430107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
https://doi.org/10.36290/vnl.2022.07643504480100376493132161177199218456744801004081994666448010015537711513748044480100287389124167204247293316355396414432470516552589607651682723
Current4259870275112237330421540668758
trends1254987027591185303432560665
in1990987027566194
the2256987027590219338
diagnosis26659870275129195316444572698802868972
of42512470275121212
pancreatic708124702751292503784795726918129029691069
cancer184912470275101222350452568662
Petr4251635013764120161204
Vanek1,2,6511635013770125190248308958164308036518910481635013729
Michal10991635013793124174239297327
Eid3,1448163501375990156160316430803616391635013729
Robert16901635013765129195253296338
Psar2,4,5,205016350137641111702122261164308036549211014824091635013729
Vincent24601635013770100165215273338378
Zoundjiekpon1,2,286016350137631261912563213533834415025696336983550164308036518936411635013729
Ondrej36921635013779144210252310342
Urban1,2,405616350137751171822403054354164308036518944441635013729
Lumir44951635013756119214245287
Kunovsky1,2,6,74804163501376712919425831536142148252851643080365189107144162198
12nd425179607833455178901335650917960783673
Department6051789013374129192245280319410465526561
of1190178901336092
Internal1305178901332687122176211272325350
Medicine16781789013389144207232280305365421
–21221789013355
Gastroenterology22001789013371125167204239299354415450504540599625686747800
and30231789013353113175
Geriatrics,32211789013372128163189241276312337386430453
University36971789013371131156209263298342367403457
Hospital41781789013371132175236262298351376
Olomouc,45781789013376102162254314374424446
Olomouc,50481789013375102162254314374423446
Czech4251939013364113167217277
Republic7251939013360115177238299326350399
2Faculty4252096078334582089013354102151211236272326
of807208901336192
Medicine9232089013388144206231280305365420
and13662089013353114176
Dentistry,15652089013373129189225249292329364419436
Palacky20252089013358110135187236287342
University23902089013371131156209262298342367403457
Olomouc,28702089013376103163254315375424447
Olomouc,33402089013376103163254315375424447
Czech38102089013364113167217277
Republic41112089013359114176237299325349398
3Department4252246078334592239013373129191244280319410465526561
of1043223901336192
Hematology,11582239013372128219271307366392452514566583
Oncology17642239013376138187245271331393445
and22332239013353113175
Internal2431223901332787122176212273325350
Medicine,28052239013388143206231280305365420441
University32702239013371131156208262298342366402457
Hospital37502239013372132175237262298351377
Brno,4150223901336095156217237
Faculty44112239013353102151210236272326
of4760223901336192
Medicine,48762239013388143206231280305365420441
Masaryk4252389013388141184237273328380
University,8282389013371131156209262298342367403457474
Brno,1325238901336096157217238
Czech15862389013364113167217277
Republic18862389013360115177238299326350399
4Department4252546078334592539013373129191244280319410465526561
of1043253901336192
Radiology,11582539013360113174199260285346408460477
University16582539013371131156209262298342367403457
Hospital21392539013371132175236262298351376
Olomouc,25392539013375102162254314374423446
Olomouc,30092539013375102162254314374423446
Czech34782539013364113168217277
Republic37792539013359114176237299325350399
5Department4252696078334582689013373129191244280319410465526561
of1042268901336192
Radiology,11572689013360113174199260285346408460477
Vitkovice1657268901336288124175233285310359413
Hospital,20932689013372132175237262298351377399
Ostrava,25152689013376119156191244295348370
Czech29092689013364112167217277
Republic32092689013359114177237299325350399
6Department4252846078334592839013373129191244280319410465526561
of1043283901336192
Surgery,11582839013355114149210265301356373
University15542839013371131156209263298342367403457
Hospital20352839013371132175236262298351376
Brno,2435283901335995156216237
Faculty26952839013354102151211236272327
of3045283901336092
Medicine,31602839013389144207232280305365420442
Masaryk36252839013389142184238273328380
University,40282839013371131156209262298342367403457474
Brno,4526283901335995156216237
Czech47862839013364113167217277
Republic50872839013359114176237299325350398
7Department4252996078334582989013373129191244280319410465526561
of1042298901336192
Gastroenterology11582989013371124166203239298354415450503539599625685747799
and19802989013353114176
Digestive2179298901337399160215258294319372425
Endoscopy,26282989013354114176236278328386449499516
Masaryk31672989013389142185238273328380
Memorial35702989013389144236296332357409435
Cancer40282989013364117177226280315
Institute,4367298901332686129166191226286322376398
Brno,4788298901335995156216237
Czech50492989013363112167216277
Republic4253139013359114177237299325350399
Pancreatic4253648012153102158204238289338371396441
ductal8893648012164120166203253277
adenocarcinoma11883648012157114166223279326375409454478535591676725
(PDAC)1935364801213790157216273303
is2261364801213171
a23553648012156
dreaded2433364801216598149198256308366
malignancy28213648012192141166190247303352409455506
with33493648012182106141197
a35683648012156
dismal3647364801216488129213262286
5-year3956364801215992141191240274
survival42523648012148103137189214264313338
rate4612364801214190124174
despite48093648012164116156214239273323
maximal51543648012192141190215299348373
efforts425378801215081115171204241283
on7303788012153110
optimizing8623788012153112146170254278322346403460
treatment1344378801213165116165198282334391424
strategies.1790378801213873106156189240297322373413436
Currently,22483788012156110144178229285319343391408
early2679378801214897131155204
detection29053788012155106140191237274298354410
is3338378801212161
considered3422378801214397154194218276327361412470
to3914378801213287
be40233788012155107
the4152378801213288139
most43133788012182138178213
effective4549378801214879112164210247271320370
way49413788012172121168
to5131378801213287
improve52403788012122106163197253425392801214898
survival545392801214399132184209258308332
as900392801215191
radical1013392801213686143168213263287
resection1323392801213686127178225261285341398
is1743392801212767
the1832392801213693144
only19983928012158115140188
potential22083928012160117151201258291315364389
cure.26193928012148104137188209
PDAC28503928012157123182239
is3111392801212767
often3200392801215888125176232
divided3455392801215983133157215266325
into3802392801212683116171
four3995392801213389145178
categories4196392801214897131181239295329354405445
based46633928012161110150202260
on49453928012158115
the5082392801213793144
extent52493928012153101138188245278
of425406801215586
disease:533406801216589129181231271323344
resectable,899406801214192133185232269319377402454475
borderline13964068012165123157214266300325349406457
resectable,1876406801214192133185232268318376402453474
locally2373406801213288135185210234283
advanced,26784068012157115164214271317367426448
and31494068012156113171
metastatic.33424068012192144179229269304354388412458481
Unfortunately,38464068012173129159216250287343400449483534559607625
the4493406801214198150
majority46654068012192141166223257282316367
of5054406801216494
patients51704068012166116150174225282316358
are425420801214983134
diagnosed582420801216590139197254311352404463
with10674208012183108143200
locally1289420801213289136187212236285
advanced15974208012157115165215273319370429
or2049420801216398
metastatic21694208012193145180230271307357391416462
disease,2654420801216589130182232273325346
which30234208012182140164211268
renders3313420801214293150209261295337
them3673420801214298151236
ineligible3932420801213289141166191248273331357409
for4363420801213895129
curative45154208012153110144194228253303353
resection.4891420801214193134186233270295351409431
This53454208012158117141182
is425434801212363
mainly5114348012189138163219243292
due8254348012163118170
to1017434801213994
the1133434801214096147
lack1303434801212978124172
of1497434801216191
or1610434801216296
vague17284348012154104161216268
symptoms2018434801214695180238272327412452
while24924348012180137161185236
the2751434801213995146
disease2920434801216287127178227267319
is3261434801213070
still3353434801214681105129153
localized,3528434801213086133183207231275326384406
although3956434801215579113169225282339395
appropriate43734348012155113171205260318352377426459509
utilization4905434801216195119144167211262296320376432
and53604348012154110168
prompt425448801215791146231289323
availability770448801214795144168193242299324348372406457
of1249448801215484
adequate13554488012148105157215271320353403
diagnostic1781448801215579128185241297338373397442
tools2246448801213287143168208
is2477448801212262
also2561448801214872112168
critical2751448801214478102136160206256280
given3053448801215579129179236
the3311448801213288139
aggressive34734488012147104161194245286326350399449
nature39444488012155104137193227278
of4244448801215484
the4350448801213288140
disease.4512448801215579120171220260312333
A48674488012160
cost-effective4949448801214499139174203257287321372419455479529579
biomarker425462801215781137221270303351400434
with881462801217195129185
high1088462801215377133189
specificity1299462801213794146192216246273319342376427
and17484628012145101158
sensitivity1928462801213889145185208242266315340373424
allowing237446280121457094149223247303360
early2756462801214796129154202
detection29804628012154105139189235271295351407
of3409462801215282
PDAC35134628012151117176232
without3767462801217195129185241297330
the4119462801213187138
need42794628012153104156214
for4515462801212682116
advanced46534628012145103152201257303352410
or5085462801215286
invasive5193462801212177124173213237286335
methods4254768012183135169225281340380
is827476801212161
still91147680121377296120144
not10774768012154110143
available.1243476801214693142167191240297322374395
This16604768012147105129169
leaves1851476801212273122169219260
the2133476801213187138
diagnosis2294476801215478127184240296336360400
dependent27164768012155106164216273330381438471
on32104768012152109
radiodiagnostic3341476801213180138162218276300349406462518559593617663
methods40264768012181133167223280338378
or4426476801215387
endoscopic45354768012148104162218258304359417442487
ultrasound.5045476801215277111144194234290346403460482
Here4254908012165117151202
we6494908012173123
summarize795490801213994178263312345370414465
the1282490801213288140
latest1444490801212372106156196231
epidemiological16984908012149107132189241325349406431487544569614664688
data,24094908012156105138188210
risk264149080121325797145
factors,2808490801212978124161216250291313
clinical314349080121446993149173219268293
manifestation,34584908012183132188212243294334369419453477533590611
and40924908012147104161
current42754908012145100134168219276309
diagnostic4606490801215680129186242298339373397443
trends5071490801213367117174232272
and53654908012148104162
implications4255048012123107165190214260310343367423480520
of967504801215888
PDAC10785048012156122182238
focusing1338504801213389135191231255311368
on17295048012158114
serum1866504801214294128184268
biomarkers2157504801216084140225274308356406439481
and26605048012151108165
imaging28485048012126110159216240297354
modalities.32245048012186143201250274298332356408448471
Additionally,37175048012164121179203237261317374423447471520537
up-to-date42765048012158116150185240274334383417467
management47655048012187136192241298349434485542575
and53635048012151107165
therapeutic425518801213389141175224282334390424448494
algorithms941518801214974131187221246280336420460
are1423518801214983134
outlined.15795188012156112146170194251302360382
Key4255356012358108158
words:6045356012375131167225267291
pancreas,9165358012158107162207240289338377398
pancreatic13355358012158107162207239289337370393437
cancer,1794535801214694149194243276292
pancreatic21085358012158106162207239289337369392437
ductal25665358012158113158193242265
adenocarcinoma,28525358012150106157212267313362394438461516572655703724
pancreatic35975358012158107162207240290338370393438
cancer4056535801214695150195244277
diagnosis,4354535801215881129185240295334357396417
pancreatic47925358012158107162207240290338370393438
cancer5251535801214695150195244277
management,4255498012183132187235291341425475531563584
pancreatic10305498012157106161206239289337369392437
cancer1488549801214594149194243276
therapy.1785549801213388139172220277323340
Současné4255750015063130198252317373441504
trendy966575001504898161229298367
v13705750015067
diagnostice14745750015068103168236305372427474508562624
karcinomu21355750015068132181235269338405505574
pankreatu27465750015068133201269319382447494563
Duktální4255948012167123170206255279334357
adenokarcinom8035948012156113163219275322372404449472527582666
pankreatu14915948012164113168215250300348381436
(pancreatic1948594801213693142197242275325373406429474
ductal24435948012164119164200249272
adenocarcinoma27375948012155112163218274320369401446469524580664712
–34705948012157
PDAC)35495948012160126184240270
je3840594801213182
obávanou39435948012162120169216264320375431
malignitou43955948012191139163186242297321354408464
s48805948012147
velice49485948012156105129152197246
nízkým5216594801216286129176226311
5letým425608801215174124157207292
přežíváním738608801216194143186210258307362385468
i12276088012128
přes1276608801216194144183
veškeré14806088012153102141188237270319
snahy1821608801214398146202247
o20896088012159
zdokonalení21696088012147104159206260316364387437493516
léčebných2706608801212878124173230286331375430
strategií.3157608801214478110159191241298321344364
V35436088012160
současnosti3624608801214399154199247287342397436470493
je4138608801212979
včasná4238608801215296144184239287
detekce45466088012160111144193241284333
považována49006088012161117164213256311358406462510
za5431608801214797
nejúčinnější4256228012155106130185229252307363413437476499
způsob,9456228012146103158197253310329
jak1295622801212876122
zlepšit1439622801214569119176216239272
přežití,1732622801216093142186209242265286
jelikož2039622801212778102125171225267
pouze23276228012160116171214264
radikální2613622801213584140164210260283338361
resekce2995622801213686125176223267316
představuje3332622801216093142200239273322368424447498
kurativní38516228012150105138186219242290346369
potenciál.42426228012160115148198253298321369392413
PDAC46766228012157122180236
se4933622801214393
dělí50476228012160110134157
do52256228012159114
čtyř5361622801214783132166
kategorií425636801214796129178235290323346369
podle8166368012156112169192243
rozsahu1080636801213286128170219274329
onemocnění:14306368012154110160244299344400450506529548
resekabilní,1999636801213282122172219268325349372427450471
hraničně2491636801215587136191214259314364
resekabilní,2877636801213281121171218268324348371426450470
lokálně3368636801212378126175198253304
pokročilý36936368012156112159193248294316340387
a41016368012148
metastatický.41706368012183133167215255288337370393438484534551
Většina47426368012155103136177200255303
pacientů50666368012156105150173223279311366
je5453636801212474
bohužel4256508012157112167221264313337
diagnostikována783650801215376123179233288327360383429483529577632680
s14846508012136
lokálně1541650801212074121170193248298
pokročilým18606508012153108155189243288311334381464
nebo23456508012152102158214
metastatickým25806508012179129162211250283331364386431477527610
onemocněním,32116508012151107157240294339394444499522605625
a38576508012145
tím3923650801212952135
pádem40796508012153101157207290
není43906508012152102157180
způsobilá4591650801213996151189244301324347395
pro5006650801215486140
kurativní5167650801214498131179211234281337360
resekci.425664801213383122172220263286307
To753664801214896
je871664801212272
dáno9656648012154102157212
především1199664801215487137194245292331355438
absencí16586648012146103142193248293316
průvodních1995664801215588144192246303358381426481
příznaků2497664801215588111154210258305360
či2878664801214366
jejich296566480121227296120164219
nevýrazností32066648012153104151202235284327383438477511534
v37616648012146
době,38286648012155110167218238
kdy40876648012145100148
ještě4256664801212373112146195
onemocnění44726648012153109159243298344399449505528
není50216648012154104160183
lokálně5225664801212277124173197252302
pokročilé.4256788012157113160194249294317340391411
Vhodná8576788012160117172229285333
indikace1211678801212883140163209259304353
a15856788012153
rychlá1659678801213788131187210258
dostupnost19386788012161116156189244301357412451485
adekvátních24446788012153110160207258307339395418462517
diagnostických2983678801216184132188243298337371394439486536580635
nástrojů36396788012160108147181214268292347
je4007678801212979
nicméně4107678801216184128212262318368
rovněž4496678801213892139196246289
kritickým4806678801215286110143166210257307391
bodem52196788012161117174224308
vzhledem425692801214893149172222280330414
k8606928012150
agresivní9316928012151107140190229252300357380
povaze13326928012160116163211255305
onemocnění.16586928012158114164248303349404454510533554
Nákladově22336928012169117164189237294349396445
efektivní2699692801215383133181216240288344367
biomarker3087692801216084139223271303350399432
s35406928012143
vysokou36046928012152102142197244298353
specificitou3979692801214299150196219248274319342375429484
a44846928012152
senzitivitou4557692801214393149192215248272320344377431486
umožňující50646928012159142197239295349373396441463
CORRESPONDING42574110954697138179218256295349401453471522573
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assoc.13297411095366696139176191
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