TV Prima<\/p>\n\n\n\n
S<\/strong>linivka je \u017eivotn\u011b d\u016fle\u017eit\u00fd org\u00e1n, p\u016fsob\u00ed na tr\u00e1ven\u00ed \u017eivin, a to d\u00edky produkci tr\u00e1vic\u00edch enzym\u016f, tak\u00e9 reguluje hladiny cukru v krvi, a to d\u00edky produkci inzulinu, \u0159\u00edd\u00ed metabolismus v na\u0161em t\u011ble, upravuje PH st\u0159evn\u00edho obsahu a tak\u00e9 podporuje hormon\u00e1ln\u00ed rovnov\u00e1hu v na\u0161em organismu. A j\u00e1 u\u017e tady v\u00edt\u00e1m sv\u00e9ho dal\u0161\u00edho hosta, kter\u00fdm je pan prof. Tom\u00e1\u0161 Hucl, p\u0159ednosta kliniky hepatogastroenterologie z Institutu klinick\u00e9 a experiment\u00e1ln\u00ed medic\u00edny, se kter\u00fdm se pr\u00e1v\u011b o slinivce, zejm\u00e9na v souvislosti s rakovinou slinivky, budu bavit.<\/p>\n\n\n\n Monika Arenbergerov\u00e1, moder\u00e1torka, dermatolo\u017eka<\/strong>Paneprofesore, poj\u010fme si na za\u010d\u00e1tek \u0159\u00edct, pro\u010d je rakovina slinivky b\u0159i\u0161n\u00ed tolik z\u00e1ke\u0159n\u00e1. My v\u00edme, \u017ee v \u010cesk\u00e9 republice postihne ro\u010dn\u011b zhruba 2300 nov\u00fdch pacient\u016f a v\u011bt\u0161ina z nich bohu\u017eel nem\u00e1 dobrou progn\u00f3zu, \u010d\u00edm to je? <\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> V\u011bt\u0161ina z nich nem\u00e1 dobrou progn\u00f3zu D\u00e1 se sou\u010dasn\u011b \u0159\u00edct, \u017ee z t\u011bch 2300 pacient\u016f zhruba 2200 ve stejn\u00e9m roce zem\u0159e, tak\u017ee ta progn\u00f3za je opravdu nep\u0159\u00edzniv\u00e1. Mysl\u00edm si, \u017ee to m\u00e1 takov\u00e9 t\u0159i hlavn\u00ed d\u016fvody. Ten prvn\u00ed d\u016fvod je ten, \u017ee pacienti s karcinomem slinivky maj\u00ed na po\u010d\u00e1tku sp\u00ed\u0161e takov\u00e9 nespecifick\u00e9 obt\u00ed\u017ee, obt\u00ed\u017ee, kter\u00e9 mohou m\u00edt p\u0159i mnoha jin\u00fdch chorob\u00e1ch, ty obt\u00ed\u017ee nejsou z\u00e1va\u017en\u00e9 a na ten karcinom d\u00edky tomu p\u0159ich\u00e1z\u00edme pozd\u011b. D\u00e1 se to asi z\u010d\u00e1sti vysv\u011btlit vlastn\u011b anatomii t\u00e9 slinivky, kdy\u017e se pod\u00edv\u00e1me na ten obr\u00e1zek, tak tady vid\u00edme tu slinivku, kter\u00e1 je asi 20 cm dlouh\u00e1 \u017el\u00e1za, kter\u00e1 je tady obklopen\u00e1 duodenem, prvn\u00ed \u010d\u00e1st\u00ed tenk\u00e9ho st\u0159eva, ale takhle to ve skute\u010dnosti v tom organismu nevypad\u00e1, tady jsou odd\u011blen\u00e9 ty ostatn\u00ed org\u00e1ny a ve skute\u010dnosti to sp\u00ed\u0161 vypad\u00e1 takto, kdy\u017e se pod\u00edv\u00e1me na tu dutinu b\u0159i\u0161n\u00ed a vlastn\u011b ta slinivka je ulo\u017een\u00e1 v hloubce, d\u00e1 se \u0159\u00edct, dokonce za tou dutinou b\u0159i\u0161n\u00ed a p\u0159ed n\u00ed jsou v\u0161echny tyto org\u00e1ny a z toho vlastn\u011b plyne to, \u017ee ty symptomy jsou pozdn\u00ed. Nen\u00ed tam nikde nic, co by zp\u016fsobilo n\u011bjak\u00fd velk\u00fd probl\u00e9m, na kter\u00fd bychom p\u0159i\u0161li, t\u0159eba, \u017ee by do\u0161lo ke krv\u00e1cen\u00ed ze za\u017e\u00edvac\u00edho traktu nebo byl utla\u010den\u00fd n\u011bjak\u00fd org\u00e1n.A tak\u00e9 to zp\u016fsobuje to, \u017ee ty b\u011b\u017en\u00e9 vy\u0161et\u0159ovac\u00ed metody, kter\u00e9 m\u00e1me k dispozici, jako je hlavn\u011b ultrasonografie, b\u011b\u017en\u00fd ultrazvuk b\u0159icha, pr\u00e1v\u011b ty \u010dasn\u00e9 f\u00e1ze toho n\u00e1doru neodhal\u00ed. Druh\u00fd d\u016fvod je ten, \u017ee kdy\u017e u\u017e ten karcinom slinivky diagnostikujeme, tak je velmi pozd\u011b. Ten n\u00e1dor je bu\u010f u\u017e lok\u00e1ln\u011b pokro\u010dil\u00fd, to znamen\u00e1 p\u0159\u00edli\u0161 velk\u00fd a \u010dasto infiltruje okoln\u00ed org\u00e1ny, v\u010detn\u011b c\u00e9v, a t\u00edm se st\u00e1v\u00e1 vlastn\u011b chirurgicky neodstraniteln\u00fd, anebo m\u00e1 dokonce vzd\u00e1len\u00e9 metast\u00e1zy, a to z n\u011bj tak\u00e9 d\u011bl\u00e1 jaksi chirurgicky neodstraniteln\u00fd n\u00e1dor a chirurgie je vlastn\u011b jedin\u00e1 mo\u017enost, kter\u00e1 d\u00e1v\u00e1 t\u011bm pacient\u016fm \u0161anci na n\u011bjak\u00e9 dlouhodob\u00e9 p\u0159e\u017eit\u00ed a ten posledn\u00ed d\u016fvod je ten, \u017ee bohu\u017eel ty n\u00e1dorov\u00e9 bu\u0148ky karcinomu pankreatu jsou rezistentn\u00ed na sou\u010dasn\u00e9 mo\u017enosti onkologick\u00e9 l\u00e9\u010dby, to znamen\u00e1 na radioterapii a chemoterapii. <\/p>\n\n\n\n Monika Arenbergerov\u00e1, moder\u00e1torka, dermatolo\u017eka<\/strong> Pane profesore, \u010cesk\u00e1 republika je bohu\u017eel na \u0161pici t\u011bch zem\u00ed, kde se vyskytuje rakovina slinivky b\u0159i\u0161n\u00ed. \u010c\u00edm si to m\u00e1me vysv\u011btlit? <\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> J\u00e1 mysl\u00edm si, \u017ee obecn\u011b je to nejenom \u010cesk\u00e1 republika, ale je to cel\u00fd z\u00e1padn\u00ed sv\u011bt, kter\u00fd m\u00e1 vysok\u00fd v\u00fdskyt karcinomu, pankreatu. A je\u0161t\u011b, co je na tom o tro\u0161ku hor\u0161\u00ed, je to, \u017ee toho karcinomu pankreatu po\u0159\u00e1d tro\u0161ku p\u0159ib\u00fdv\u00e1. Mysl\u00edm si, \u017ee se to \u00fapln\u011b nev\u00ed. Jeden z d\u016fvod\u016f asi tak\u00e9 bude to, \u017ee um\u00edme l\u00e9pe ten karcinom slinivky diagnostikovat, to znamen\u00e1, \u017ee d\u0159\u00edve byli pacienti, kte\u0159\u00ed m\u011bli n\u011bjak\u00e9 generalizovan\u00e9 n\u00e1dorov\u00e9 onemocn\u011bn\u00ed, nev\u011bd\u011bli jsme, \u017ee to je zrovna karcinom pankreatu, dneska, to um\u00edme l\u00e9pe, ale ur\u010dit\u011b tam bude n\u011bjak\u00fd vliv t\u011bch rizikov\u00fdch faktor\u016f, to znamen\u00e1, p\u0159ib\u00fdv\u00e1 t\u011bch rizikov\u00fdch faktor\u016f, kter\u00e9 jsou zodpov\u011bdn\u00e9 za vznik karcinomu pankreatu.<\/p>\n\n\n\n mluv\u010d\u00ed 1,<\/strong> A kdo by se m\u011bl m\u00edt na pozoru, jak d\u016fle\u017eit\u00e1 je tady genetick\u00e1 dispozice. <\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> Tak genetick\u00e1 dispozice je d\u016fle\u017eit\u00e1, nicm\u00e9n\u011b je men\u0161inov\u00e1, genetickou dispozici se odhaduje, \u017ee m\u00e1 asi jenom 10 % pacient\u016f, co\u017e je pom\u011brn\u011b m\u00e1lo. Je to d\u016fle\u017eit\u00e9. My se te\u010f sna\u017e\u00edme t\u011bmto pacient\u016fm v\u011bnovat v n\u00e1rodn\u00edm screeningov\u00e9m programu, ale v\u011bt\u0161ina pacient\u016f m\u00e1 ten klasick\u00fd sporadick\u00fd karcinom bez t\u00e9 genetick\u00e9 predispozice a tam je pot\u0159eba se soust\u0159edit na ty rizikov\u00e9 faktory, to znamen\u00e1, ti pacienti, kte\u0159\u00ed ty rizikov\u00e9 faktory maj\u00ed, by m\u011bli ud\u011blat n\u011bco pro to, aby se jim vyhnuli. <\/p>\n\n\n\n Monika Arenbergerov\u00e1, moder\u00e1torka, dermatolo\u017eka<\/strong> A existuje v \u010cesk\u00e9 republice n\u011bjak\u00fd screeningov\u00fd program pro z\u00e1chyt \u010dasn\u00fdch f\u00e1z\u00ed rakoviny slinivky b\u0159i\u0161n\u00ed. <\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> Tak obecn\u011b se d\u00e1 \u0159\u00edct, \u017ee v \u010cesk\u00e9 republice to riziko, \u017ee n\u011bkdo onemocn\u00ed karcinomem pankreatu, je zhruba asi 1,5 %, to, \u017ee onemocn\u00ed b\u011bhem \u017eivota, co\u017e je vlastn\u011b po\u0159\u00e1d mal\u00e9 riziko na to, abychom mohli ud\u011blat plo\u0161n\u00fd screeningov\u00fd program pro v\u0161echny tyto pacienty, to by dob\u0159e nefungovalo, sou\u010dasn\u011b nem\u00e1me \u017e\u00e1dn\u00fd jednoduch\u00fd test, t\u0159eba z krve, n\u011bjak\u00fd n\u00e1dorov\u00fd marker, kter\u00fd by n\u00e1m pomohl, a proto se m\u016f\u017eeme ve screeningov\u00e9m programu zam\u011b\u0159it jenom na n\u011bjakou skupinu pacient\u016f, u kter\u00fdch by to riziko bylo v\u011bt\u0161\u00ed ne\u017e t\u011bch 1,5 %, a to jsou pr\u00e1v\u011b ti pacienti s tou genetickou predispozic\u00ed. V \u010cesk\u00e9 republice za\u010dal v posledn\u00edch m\u011bs\u00edc\u00edch n\u00e1rodn\u00ed program, kter\u00fd se v\u011bnuje pr\u00e1v\u011b t\u011bm pacient\u016fm s genetickou predispozic\u00ed, u kter\u00fdch to riziko je v\u011bt\u0161\u00ed, p\u0159esahuje 5 % a d\u00e1v\u00e1 smysl je do takov\u00e9ho screeningov\u00e9ho programu za\u0159adit a pravideln\u011b sledovat a vy\u0161et\u0159ovat ve snaze naj\u00edt u nich ten n\u00e1dor, pokud by se vyvinul v n\u011bjak\u00e9 mal\u00e9 velikosti, kdy potom ta \u0161ance na l\u00e9\u010dbu a p\u0159e\u017eit\u00ed je v\u00fdrazn\u011b v\u011bt\u0161\u00ed. <\/p>\n\n\n\n Monika Arenbergerov\u00e1, moder\u00e1torka, dermatolo\u017eka<\/strong> A j\u00e1 bych te\u010f z\u016fstala u toho krevn\u00edho testu. Jestli byste n\u00e1m pov\u011bd\u011bl n\u011bco o v\u00fdzkumu, kter\u00fd prob\u00edh\u00e1 na univerzit\u011b v Pardubic\u00edch, kde se tzv. lipidomick\u00fd test, aby odhalil p\u0159edn\u00e1dorov\u00e9 zm\u011bny ze vzorku krve, m\u00e1te pocit, \u017ee to je test, kter\u00fd m\u016f\u017ee znamenat posun z\u00e1chytu tohoto onemocn\u011bn\u00ed. <\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> Tak kdyby fungoval, to by bylo \u00fa\u017easn\u00e9. Jak u\u017e jsem nazna\u010dil, my v sou\u010dasn\u00e9 dob\u011b v t\u00e9 b\u011b\u017en\u00e9 klinick\u00e9 praxi nikde na sv\u011bt\u011b nem\u00e1me test n\u00e1dorov\u00fd marker, kter\u00fd by dok\u00e1zal dob\u0159e naj\u00edt pacienty s karcinomem pankreatu. A kolegov\u00e9 na univerzit\u011b v Pardubic\u00edch ud\u011blali velk\u00fd pokrok a velk\u00fd objev a na\u0161li nebo zjistili, \u017ee pacienti s karcinomem pankreatu maj\u00ed tro\u0161ku odli\u0161n\u00e9 spektrum lipid\u016f v krvi ne\u017e pacienti, kte\u0159\u00ed jsou zdrav\u00ed. A v sou\u010dasn\u00e9 dob\u011b prob\u00edh\u00e1 takov\u00e1 valida\u010dn\u00ed studie, d\u00e1 se \u0159\u00edct, celon\u00e1rodn\u00ed, kter\u00e1 se sna\u017e\u00ed tento jejich objev potvrdit, tak\u017ee pokud by se ten objev potvrdil, bylo by to \u00fa\u017easn\u00e1 zpr\u00e1va.<\/p>\n\n\n\n mluv\u010d\u00ed 1,<\/strong> A pane profesore, jak dneska vypad\u00e1 modern\u00ed l\u00e9\u010dba rakoviny slinivky b\u0159i\u0161n\u00ed? U \u0159ady n\u00e1doru se dneska uplat\u0148uje imunoterapie, ale bohu\u017eel imunoterapie pr\u00e1v\u011b u rakoviny slinivky b\u0159i\u0161n\u00ed \u00fapln\u011b nesplnila ta o\u010dek\u00e1v\u00e1n\u00ed. Jak je to mo\u017en\u00e9.<\/p>\n\n\n\n mluv\u010d\u00ed 6,<\/strong> Tak k t\u00e9 prvn\u00ed \u010d\u00e1sti ot\u00e1zky nejprve, jak u\u017e jsem \u0159ekl, pokud chceme d\u00e1t pacientovi \u0161anci na n\u011bjak\u00e9 p\u0159e\u017eit\u00ed, tak je pot\u0159eba, aby podstoupil operaci, to znamen\u00e1, mus\u00ed n\u00e1dor b\u00fdt lokalizovan\u00fd bez vzd\u00e1len\u00fdch metast\u00e1z. A pak m\u00e1 tu \u0161anci nejlep\u0161\u00ed, co se t\u00fdk\u00e1 t\u011bch ostatn\u00edch onkologick\u00fdch l\u00e9\u010debn\u00fdch mo\u017enost\u00ed, to znamen\u00e1 chemoterapie, zase, jak u\u017e jsem \u0159ekl, ty n\u00e1dory jsou rezistentn\u00ed, sp\u00ed\u0161e ne\u017e imunoterapie by bylo zaj\u00edmav\u00e9, kdyby pacienti mohli dost\u00e1vat c\u00edlenou l\u00e9\u010dbu tak jako u jin\u00fdch n\u00e1dor\u016f, to znamen\u00e1, je to n\u011bjak\u00e1 chemoterapie, kter\u00e1 c\u00edl\u00ed p\u0159\u00edmo na n\u011bjak\u00fd molekul\u00e1rn\u00ed defekt, kter\u00fd je v t\u011bch n\u00e1dorov\u00fdch bu\u0148k\u00e1ch a \u0161et\u0159\u00ed ty ostatn\u00ed bu\u0148ky, p\u0159esto\u017ee v\u00edme hodn\u011b o molekul\u00e1rn\u00ed biologii karcinomu, pankreatu, tak takov\u00e1to c\u00edlen\u00e1 l\u00e9\u010dba bohu\u017eel u n\u011bj neexistuje. A to posledn\u00ed je to, co jste zm\u00ednila, a to je imunoterapie, ta tak\u00e9 u karcinomu pankreatu nefunguje, imunoterapie spo\u010d\u00edv\u00e1 v tom, \u017ee se sna\u017e\u00edme vlastn\u011b zaktivovat ty imunitn\u00ed bu\u0148ky, aby za\u010daly rozpozn\u00e1vat ty bu\u0148ky n\u00e1dorov\u00e9 a sami je zni\u010dily.Ten probl\u00e9m u karcinomu pankreatu je ten, \u017ee on t\u011bch imunitn\u00edch bun\u011bk, imunokompetentn\u00edch bun\u011bk v sob\u011b m\u00e1 velmi m\u00e1lo, a proto se to neda\u0159\u00ed. <\/p>\n\n\n\n TV Prima Slinivka je \u017eivotn\u011b d\u016fle\u017eit\u00fd org\u00e1n, p\u016fsob\u00ed na tr\u00e1ven\u00ed \u017eivin, a to d\u00edky produkci tr\u00e1vic\u00edch enzym\u016f, tak\u00e9 reguluje hladiny cukru v krvi, a to […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":24987,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-60333","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/60333","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=60333"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/60333\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/24987"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=60333"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=60333"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=60333"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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