Současné trendy v diagnostice karcinomu pankreatu

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Autoři: Petr Vanek ^1,2; Michal Eid ³; Robert Psar ^2,4,5; Vincent Zoundjiekpon ^1,2; Ondrej Urban ^1,2; Lumír Kunovský ^1,2,6,7
Působiště autorů: Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic ²; Department of Hematology, Oncology and Internal Medicine, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic ³; Department of Radiology, University Hospital Olomouc, Olomouc, Czech Republic ⁴; Department of Radiology, Vitkovice Hospital, Ostrava, Czech Republic ⁵; Department of Surgery, University Hospital Brno, Faculty of Medicine, Masaryk University, Brno, Czech Republic ⁶; Department of Gastroenterology and Digestive Endoscopy, Masaryk Memorial Cancer Institute, Brno, Czech Republic ⁷; nd Department of Internal Medicine – Gastroenterology and Geriatrics, University Hospital Olomouc, Olomouc, Czech Republic ¹²
Vyšlo v časopise: Vnitř Lék 2022; 68(6): 363-370
Kategorie: Hlavní téma
doi: https://doi.org/10.36290/vnl.2022.076

Souhrn

Duktální adenokarcinom pankreatu (pancreatic ductal adenocarcinoma – PDAC) je obávanou malignitou s velice nízkým 5letým přežíváním i přes veškeré snahy o zdokonalení léčebných strategií. V současnosti je včasná detekce považována za nejúčinnější způsob, jak zlepšit přežití, jelikož pouze radikální resekce představuje kurativní potenciál. PDAC se dělí do čtyř kategorií podle rozsahu onemocnění: resekabilní, hraničně resekabilní, lokálně pokročilý a metastatický. Většina pacientů je bohužel diagnostikována s lokálně pokročilým nebo metastatickým onemocněním, a tím pádem není způsobilá pro kurativní resekci. To je dáno především absencí průvodních příznaků či jejich nevýrazností v době, kdy ještě onemocnění není lokálně pokročilé. Vhodná indikace a rychlá dostupnost adekvátních diagnostických nástrojů je nicméně rovněž kritickým bodem vzhledem k agresivní povaze onemocnění. Nákladově efektivní biomarker s vysokou specificitou a senzitivitou umožňující včasnou detekci PDAC bez potřeby pokročilých a invazivních metod stále chybí. Diagnostika tak zůstává závislá na radiologických metodách a endoskopické ultrasonografii. V naší přehledové práci shrnujeme nejnovější epidemiologická data, rizikové faktory, klinickou manifestaci a současné diagnostické trendy se zaměřením na sérové biomarkery a zobrazovací modality. Kromě toho popisujeme aktuální terapeutické postupy.

Klíčová slova:

duktální adenokarcinom pankreatu – pankreas – karcinom pankreatu – diagnostika karcinomu pankreatu – management karcinomu pankreatu – léčba karcinomu pankreatu

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