524
HLAVNÍ42522701005185134178232252
TÉMA69222701003981147194
Current42533701003976100125160198225
trends6663370100255085123161190
in87233701001552
the94033701002664100
diagnosis10563370100375287125163202231246275
of134733701003858
pancreatic142133701003772110141165200234261277307
cancer174433701003065103133168192
36419122701003477120
|326227010043
VNITŘNÍ4268043010746106127172220280301
LÉKAŘSTVÍ748804301074185130188236280325378400
/11688043010757
Vnitř12458043010771118137165191
Lék.1456804301074083122140
2022;68(6):363-3701615804301074487129173188233278301343366380425468511538579619661
/22968043010756
www.casopisvnitrnilekarstvi.cz442680430107651332012142542953293774274464795215705896176436927117307748128548809159449871007102310631101
včasnou42554701214892140179234290345
detekci791547012163114147196244287310
PDAC1122547012161126184240
bez1383547012164115158
potřeby1562547012164120153185235292338
pokročilých1921547012164120167201256301324348395439494
a2436547012155
invazivních251254701213186132181224248296352375420475
metod3008547012190141174228286
stále331554701214680129152203
chybí.3539547012152107152210233254
Diagnostika381454701217497145201257312351385408454504
tak433954701214089135
zůstává4496547012149104143177226273321
závislá4838547012150100146170209233281
na5140547012162110
radiologických52715470121408814516822342568701212479135159203250300344399
metodách845687012191141175229286334379434
a1300687012155
endoskopické1376687012157113170225264311364421445490536585
ultrasonografii.198268701216286119151200239294350405462494543572598621642
V2645687012163
naší2729687012162110149172
přehledové292368701216396146202225276333388435484
práci342868701216497146190213
shrnujeme3663687012146101134190244268318402452
nejnovější4137687012162112136192247294343367406429
epidemiologická4587687012157114138194244328351406430485542565610657706
data,5314687012163111144193214
rizikové4258270121335699123170224271320
faktory,76682701213786133169223256307323
klinickou111082701215479102158181226272326382
manifestaci1513827012191139194218247298337371420465488
a2023827012155
současné2099827012147102158203252291346397
diagnostické251782701216487135191246302341375398443490539
trendy307782701214073123179236283
se338282701214697
zaměřením3500827012150100184234266316372395479
na4000827012163111
sérové413282701214797130185232282
biomarkery443582701216488143227275308355404437488
a4944827012155
zobrazovací5021827012150104162195243287342389438483506
modality.425967012183139196244267290323373390
Kromě83696701215488143226277
toho113496701213387143198
popisujeme1353967012157113170194233287311361445495
aktuální187096701214894130185233257312335
terapeutické222696701213382115164221272327360383428474523
postupy.2770967012157113152186241298344361
Klíčová425113501236088115161220271324
slova:771113501235077136188241265
pankreas,10591137012166117174222258310360401423
karcinom15041137012156107141187211269326412
pankreatu,19391137012166116174222258310360394451473
duktální24341137012166122171208259284341365
adenokarcinom28221137012157116168226283332383417463487545602688
pankreatu,35331137012166117174222258310360394451473
diagnostika4028113701216690140198255313353389413462513
karcinomu45631137012156107141187211269326412469
pankreatu,50541137012167117175223259311361394451473
management4251277012183132187235291341425475531563
karcinomu1009127701214796129173196251306390445
pankreatu,14751277012157106161208242292340372427448
léčba1944127701212474120176225
karcinomu2190127701214796129173196251306390445
pankreatu.26561277012157105161207242291339372427448
Introduction425171401383296141188251315379429474508570634
Pancreatic565188301074688139181210255297326346389
cancer975188301074993143186230258
commonly1255188301074997174251301352373415
refers1691188301073580106152180216
to1928188301073785
pancreatic20351883010758102152195223269311340360403
ductal24591883010758107150182226246
ade‑27271883010749101147178
nocarcinoma425202301074999142185213254274324374451493
(PDAC),939202301073279138190241269283
which12442023010773124144186236
represents1501202301073479131159204239285335364400
the1922202301073686132
majority20762023010782124145195223244274318
of2415202301075782
malignant25182023010783125146165216266309359387
pancreatic425216301075093142183211255296324344386
neoplasms8312163010756102152203224265300374408
and1260216301074898148
has1429216301075698132
one15822163010755105150
of1753216301075681
the1854216301073685130
worst20052163010773122150185215
prognosis2241216301075785133185234283318337371
among26332163010748123173222273
solid425230301073484105125176
malignancies.6222303010782125145165216265308357400420465500518
Based1162230301075396131177229
on14122303010756107
the1540230301073686132
GLOBOCAN16932303010764106166214276330386445
20202160230301075296139184
estimates,2365230301075287118138213256284329364381
it2767230301072757
is2845230301072661
the425244301072980127
seventh574244301074390133179230260311
leading907244301072875117170191242294
cause1223244301075094144180227
of1472244301075784
cancer-related1578244301074993144188233262288318364386429458504557
death21572443010759105148178229
in2408244301072878
both25082443010760112142193
men27232443010784131182
and425258301074190140
women5862583010771119194240289
worldwide8952583010771120148168218284305355400
with1315258301077191120170
496,0001505258301075093139155200247294
new18192583010755100166
cases2005258301074789123168203
and2228258301074796147
mortality23952583010780129157189231251271300343
rate2759258301073275103146
almost425272301074161135184219249
identical694272301072474119168196215256299319
when10332723010770120165214
accounting1267272301074687127175224273300320369419
for1707272301072877104
466,0001832272301074995141158203250297
deaths2149272301075499140168217251
(1).242027230107297088102
Incidence2543272301072473114134184229278319362
and425286301074190140
mortality5852863010772121149180222242261290334
rates93928630107246795138172
have1132286301074687128172
been1324286301074893139188
steadily1532286301073261105145196215235275
rising18282863010724447897145195
in2044286301071765
many21302863010771113161201
countries,2351286301073885134183211238258303337354
likely272528630107173775119139180
reflecting42530030107267094118162204235254303353
the798300301072675120
increasing938300301071765106133177218252271319369
prevalence1327300301074875119160202222267315357400
of1747300301074670
obesity,1838300301074596141176195223267279
diabetes,2137300301074766107157203232275309326
and2483300301073987137
alcohol264130030107385899146195244265
consumption,425314301074088137171219293344372392441491507
although95231430107446493142191241291340
improvements1312314301072296147175223264308382428477504540
in1873314301072270
diagnostic1964314301075271113163212261296325345386
and2371314301074493143
cancer2535314301074385134176219246
re‑2802314301072973103
gistration425328301074969102132160202230250299348
practices794328301074876118160191211252295330
may11443283010772114154
also131832830107395993142
be1480328301074894
in1595328301071766
play1681328301074869110150
in1851328301071766
some1938328301073281156201
countries2160328301073885135184211239259304338
(1,251932830107226374
2).261432830107426579
Rates2714328301074385113157192
are425342301074168111
4-fold55634230107427196145165215
to791342301072572
5-fold88434230107417095143163213
higher1117342301074665115163208235
in1372342301071765
countries1457342301073885134183210237257302336
with1813342301076382111160
high1993342301074665115163
social-demographic2177342301073180121141182201230282326400449500527569619668687728
indices,425356301071966116135175217251268
with713356301076181109157
the890356301072574118
highest1028356301074564113161205239268
incidence1316356301071664105123172217265305348
rates168435630107236592135169
in1873356301071664
Europe,1957356301073985111158208253268
Northern22453563010755103130161209254280329
America,25943563010750123167194214254295312
and425370301074088137
Australia/New582370301074996129158185226245264304337395439504
Zealand1105370301074688128147187235284
(1).14093703010721617992
The1521370301073988132
time1673370301072544117161
trend185437030107245194142191
of2065370301074569
malignant21543703010770110129148197245285333360
pancreatic2534370301074688135176202245285312331371
neoplasms425384301074892142192212253287360394
in839384301071765
the924384301072574118
Czech1063384301074887131172221
Republic1304384301074387137186236256275315
is1640384301071649
demonstrated1709384301074791165214263296326353395422465516
in2245384301071665
Fig.2330384301073958107124
124743843010741
(3);253638430107216485100
in2656384301071765
20182741384301074185125164
it425398301071947
was4933983010762104138
the651398301072674119
seventh790398301073176117161210237286
most10963983010771120154184
frequently130039830107215093143192236285312332372
diagnosed1693398301074666106156205254288332383
malignancy20963983010771113132151201249290339380423
with2539398301076382111160
2,3322719398301074257103145186
new425412301074892156
cases601412301073778112156189
and810412301073886135
the965412301072573117
third110241230107257392118166
most12884123010770118152181
common1489412301073783157230278326
cause1835412301073779126159203
of2058412301074569
cancer2147412301073778126166209235
mortality24024123010770118145176218237255284326
with2748412301076281109157
2,159425426301074460100138180
deaths,6254263010756101142170219253270
which9164263010772121141182231
ranked1167426301073476125164208259
third1447426301073484103130179
in1647426301072674
Europe1742426301074996123171222268
(4).203142630107307395109
In2161426301072675
the2256426301073584129
United24064263010763112131160204255
States2681426301074976118146190224
PDAC4254403010745103154205
is650440301072255
currently726440301074391118147190239267287328
the1075440301073079124
third122044030107308099126175
leading1416440301072266107158177226276
cause1713440301074385134167212
of1946440301075176
cancer2042440301074385134176219246
death2309440301075296137166215
after2544440301074468101144171
lung2736440301072270119169
cancer425454301074083132173217244
and690454301074898148
colorectal859454301074795116165193237279310353373
cancer,1252454301074891140181225252265
and1538454301074897148
it1706454301072756
is1782454301072760
predicted1863454301075785129180200241273316367
to2251454301073583
be23554543010757103
the2479454301073584130
second2629454301074187129176226277
deadliest425468301074994135185205224269304334
cancer779468301074184132174217245
by1044468301075191
20301156468301074588131176
(5,135246830107256883
6).145546830107456883
Because3187174301074793135178228262308
of3515174301075782
the3617174301073686132
absence37691743010749101136181231273317
of4107174301075681
specific4209174301074192139182201226247289
symptoms,4519174301074184161212241289366400417
the4957174301073585131
majority51091743010782125144194222243272316
of5446174301075681
PDAC30471883010745102152202
are3269188301074470113
diagnosed3402188301075271111160208257290334385
late380618830107236390133
with3958188301076988116164
poor41421883010753102151178
prognosis,4340188301075380127177225273307325358374
as4733188301074478
most48301883010777126159188
patients5038188301075395122141184232259294
have5352188301075192132175
advanced3047202301074190132173221262304354
and3421202301074795145
incurable3586202301072573113161187229279298342
disease3948202301075674107151191225269
at4237202301074774
detection4331202301075599127170211241260308357
(7).470720230107317499112
The4839202301074898142
5-year5001202301075078118162202228
survival5249202301074087113157177218259278
rate304721630107277098142
for3209216301073180108
metastatic33372163010782128157199234263306334354395
disease3753216301075676110155196231276
is4049216301072760
3.0%,4130216301075167113182199
rising435021630107345488107156206
to4577216301073583
14.4%4681216301075191107152218
for4920216301073180108
regional5048216301073478130149198248290310
and5378216301074998149
41.6%304723030107448293138203
for327023030107247299
localized3389230301072068109150169188224267317
disease3726230301075069101146186219263
(8).400923030107256789103
The4131230301074393137
dismal4288230301074968101174215234
prognosis4541230301075178125175223272305323356
is4917230301071952
also498923030107426093141
due5150230301075097141
to5311230301072975
the5406230301072977121
aggressive3047244301074189138164206240272290331373
nature3440244301074485111159185227
of3686244301074468
the3773244301072572116
tumor3908244301072572145193219
and4146244301073885134
its429924430107164378
resistance439624430107236699117149177218266306347
to4763244301072470
chemotherapy4852244301073785128201249276323367393434483522
and5393244301073785134
radiotherapy3047258301072768118136184212260304330372422461
(9–11).3528258301072465113151186203216
Compared3764258301075299173222264290333383
to4167258301072875
other4262258301074876124168194
malignancies,44762583010774115134152202250290338379398441475491
there4987258301072876120147190
has5197258301074889122
been5339258301075095140188
little30472723010719376696115159
improvement3226272301071892141168215255299372416465491
in3737272301071966
the3823272301072876120
survival3963272301073380106150170211252271
rate425427230107266895137
of4411272301074872
patients4502272301075091118137181229256291
with4812272301076584112161
PDAC49922723010745102152202
in5213272301071967
recent5299272301072769111153201228
decades,3047286301074992133174223267300316
and3382286301073885134
radical3535286301072465114132172213232
surgical3786286301073077103151169209250269
resection407428630107236699143184214232280328
of4421286301074568
localized4509286301071663104145164182218261310
disease483928630107456496140179212256
remains5114286301072466139180198245278
the5411286301072573116
only3047300301074897115155
curative3222300301074088114156183202243286
approach3528300301074190140167214256297345
(12–14).3892300301072464101145183222244257
Screening3187314301074282109152197245263311361
with3567314301076382110159
detection3745314301074791119161203233252300348
of4113314301074670
asymptomatic4202314301073972113188238265312386427454473513
stages4735314301073160101151195228
of4983314301074670
PDAC50723143010743100151200
and5292314301073886136
its544831430107164479
precursors3047328301075077120161209235269318345379
has3445328301075394127
been3592328301075499144192
proposed3803328301075582129179228261306356
to4178328301073379
improve4277328301072396146173220260303
results.4600328301073174108155174202236253
At4873328301075783
present,4976328301075481124158202250277293
howe‑52893283010753101166209238
ver,3047342301074185112124
guidelines31923423010756104123173218238257305350385
recommend3597342301073477119167242317362411461
against4078342301074898140159208241271
unselected43693423010755104138183202247289320363414
screening4803342301074183110153199248267316366
for5189342301073179107
PDAC53163423010752110161212
in3047356301071968
asymptomatic3136356301074883125201252281329404446474494535
adults,3692356301074899148168196232249
concluding3961356301074896146188207256307326375426
that4407356301073685127155
the4583356301073584130
potential47333563010758108137180230257277318338
benefits50923563010757103153198223243272308
do54213563010756106
not3047370301074999127
outweigh31953703010756105134204248268318368
the3583370301073685131
potential37343703010758108137181230258278319339
harms,4093370301075798126202236253
and4366370301074999149
such4536370301074189131181
approach47373703010749100151179228270312362
is5119370301072660
reserved5200370301073378113158186231275327
for304738430107247198
high-risk3165384301075169119167195222241274312
individuals3497384301072169118137178198247294335354386
(15,3903384301072767104118
16).4041384301074686108121
Given4182384301075978119162210
the4412384301073179123
lack4555384301072262103141
of4715384301075175
highly4810384301075170119167186226
sensitive5055384301073781129162180208227268311
and5386384301074492141
specific3047398301073483128169188212231272
diagnostic3338398301075674115164212261294323342382
biomarkers,3740398301075675123198238265303346373407423
the4183398301073482127
diagnosis4329398301075674115164212261294312345
is4694398301072558
currently4771398301074795121148191240266285326
dependent51163983010756100149194243292336384411
on3047412301074897
advanced3163412301074292133174222263305356
imaging3538412301072094134184202250300
modalities;38574123010775124174214233252280299342376391
sometimes4268412301073483157201229248321365399
it4687412301072048
requires4754412301072871121169187214257290
preoperative5064412301075178121170220265291333360379420463
tissue304742630107284779113160204
acquisition.3270426301074182130177196228247275294342390406
The3187440301074292136
purpose3342440301075098124175224257301
of3663440301074771
this375444030107277694127
review3900440301072669110129173238
is4158440301071851
to4229440301072773
summarize4322440301073380154227268294314350393
the4735440301072775119
current4874440301074087114141184232259
diagnostic5153440301074867107156204253286315334374
approach3047454301074190141167215256297345
to3412454301073481
PDAC35124543010752109159209
in3740454301072674
the3833454301073583127
general3980454301075599148192218260279
population,42794543010756105155203222263290309357405421
reviewing4720454301073376116136180245264312361
clinical510145430107476584132150191232251
pre‑5372454301075683126155
sentation,3047468301073478126153194221240288337352
relevant341946830107327595139179221269296
conventional3734468301074793142181224273299318366415456475
and4228468301074795145
investigational4392468301072573112156189218237286327354373421469510529
biomarkers,4941468301075575123197238264302345372406422
and5383468301074795144
Fig.425509401134873125152
1.604509401135479
Incidence710510301071965102120166204250288324
and1050510301074592137
mortality12035103010772117143171214233251277316
trends153551030107275289135180210
of1761510301074568
malignant18455103010772117135154199245290336361
pancreatic2222510301074692138175200237282308326364
neoplasms2602510301074685130176194240270340369
in2988510301071864
the3068510301072772111
Czech3195510301074886122160206
Republic3417510301074482128173219237256293
(3)372651030107246485