Lipidomic profiling of human serum enables detection of pancreatic cancer

Pancreatic cancer has the worst prognosis among all cancers. Cancer screening of body fluids may improve the survival time prognosis of patients, who are often diagnosed too late at an incurable stage. Several studies report the dysregulation of lipid metabolism in tumor cells, suggesting that changes in the blood lipidome may accompany tumor growth. Here we show that the comprehensive mass spectrometric determination of a wide range of serum lipids reveals statistically significant differences between pancreatic cancer patients and healthy controls, as visualized by multivariate data analysis. Three phases of biomarker discovery research (discovery, qualification, and verification) are applied for 830 samples in total, which shows the dysregulation of some very long chain sphingomyelins, ceramides, and (lyso)phosphatidylcholines. The sensitivity and specificity to diagnose pancreatic cancer are over 90%, which outperforms CA 19-9, especially at an early stage, and is comparable to established diagnostic imaging methods. Furthermore, selected lipid species indicate a potential as prognostic biomarkers.

Estimating sedimentation rates in small reservoirs - Suitable approaches for local municipalities in central Europe

Small reservoirs, as the preferred blue-green engineering infrastructure for use against intensive runoff processes, have risen in number in Central Europe during the past three decades. However, the modelling of sediment siltation is not included in reservoir planning. The unknown temporal sedimentation of a reservoir can lead to the lifespan of the construction being uncertain. The aim of this study is to present a relatively simple process for local managers to model siltation and, consequently, accurately estimate the lifetime of a small reservoir. Three empirical models (USLE, RUSLE and USPED) were applied to two small catchments in Central Europe. This paper takes advantage of real measured and modelled sedimentation during 2012 and 2017, presenting two different terrain measurement approaches. Our study emphasizes the importance of the R-factor value. The temporal development of the R-factor is dependent on climate change, and the R-factor value has been rising steadily during the last decades. The annual mean R-factor has increased 1.04-times due to changes in precipitation patterns between the periods 1961-1980 and 1997-2016. These changes can explain possible growth in the levels of incoming sediment into reservoirs. We identified the correlation (R > 0.7) between observed sedimentation, the R-factor, and precipitation, and we concluded that the supposed rise of precipitation in Central Europe due to climate change will lead to an increase in the levels of stored sediment in reservoirs. Therefore, it is recommended for reservoir managers to use USPED model and to include the estimation of modelling of siltation rate into reservoirs' maintenance projects.

[Prognostic and Predictive Factors for Pancreatic Adenocarcinoma]

BACKGROUND

Pancreatic ductal adenocarcinoma is a highly aggressive disease with 5-year overall survival not exceeding 5%. In the Czech Republic, the incidence of this tumor has been increasing; according to recent statistics, the Czech Republic is already number one worldwide in the occurrence of this malignancy. Delayed diagnosis due to asymptomatic course of the disease in the early stages is characteristic for this disease.

AIM

The objective of this article is to give an overview of the most important factors, which according to current knowledge of pancreatic adenocarcinoma have a prognostic and predictive potential. This work describes both traditional prognostic factors, such as tumor resectability, its extent and localization, application of adjuvant chemotherapy, microscopically positive resection margin, presence of metastases in lymph nodes, histological grade, vascular and perineural invasion. Further, the paper lists a number of different biological markers that could contribute to early detection of cancer, better prognosis and optimization of treatment, for example hENT1 (human equilibrative nucleoside transporter-1), SPARC (secreted protein acidic and rich in cysteine), AGR2, Bcl-2, VEGF, Ki-67, COX-2 and more. Also, genetic mutations and significance of microRNA are discussed.

CONCLUSION

Despite great efforts that have been devoted to the research of biological markers, so far the only clinically accepted and used marker is CA 19-9. Its use is primarily in patients already diagnosed with adenocarcinoma of the pancreas. A lot of attention has recently been focused on other potential biomarkers, their application in clinical practice would however still require further research.Key words: carcinoma pancreatic ductal biological tumor markers prognosis prognostic factorsThe authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Submitted: 16. 2. 2016Accepted: 17. 2. 2016.

[A case report: patient with metastatic goblet cell carcinoid]

BACKGROUND

Goblet cell carcinoid represents a unique entity of appendiceal neoplasia. Its pathological features and clinical behavior are distinct from the classic carcinoid tumor as well as primary adenocarcinoma of the appendix. Correct histopathological classification and diagnosis provide guidelines for treatment and prognosis. Morphological transformation of the Goblet cell carcinoid from typical Goblet cell carcinoid to adenocarcinoma morphology is likely associated with accumulation of additional genetic changes that is why subclassification of this group of tumors is needed. Investigation of molecular genetic changes could increase our understanding of this exotic but clinically important group of tumors.

CASE

We present the case of a patient with metastatic goblet cell carcinoid involving terminal ileum, ascendent colon, ovary, omentum and peritoneal spreading, treated with debulking surgery and chemotherapy (FOLFOX4 regimen) with good response, reduction of disease on CT and PET complete remission. Improvement of clinical symptoms as well as quality of life was reached by combined palliative treatment.

CONCLUSION

Correct diagnostics and therapeutic efforts bring patient benefit even in metastatic setting. Better knowledge of rare tumors and understanding of their biology help improve therapeutic approaches.

[Concomitant chemoradiotherapy in tumors of the pancreas]

Pancreatic tumors are malignancies with poor prognosis. The total five-year survival is achieved only in 1-2% of patients of all stages. Only the surgical approach represent a curative treatment. Unfortunately, in the time of diagnosis, only 10-20% of tumours are in the resectable stages. The main reason is probably the low specificity of initial symptoms. Local control of this disease can be improved by adjuvant chemoradiotherapy, however, without effects on the overall survival. In potential resectable tumours the concomitant chemoradiotherapy can increase the probability of curative resection. Treatment of locally advanced inoperable tumours is considered as palliative treatment and therefore it is focused namely on the improvement of the quality of the patient's life. Supporting care must become an inseparable part of the concomitant chemoradiotherapy.

[Diagnosis and therapy of pancreatic tumors]

Pancreatic tumours belong among oncological diseases with a very poor prognosis. The total five-year survival is 1-2%. Surgical resection with a curative intention increases the probability of five-year survival to 10-20%. However only some 10% tumours are diagnosed in the resectable stage. The reason is the low specificity of initial symptoms. Earlier diagnosis and improvement of survival could be promoted by improvement of imaging methods and endoscopic techniques. Improvement of therapeutic results in selected indications can be achieved by adjuvant treatment (chemotherapy, radiotherapy, possibly their combination). Treatment of inoperable stages of the disease is focused in particular on improvement of the quality of the patient's life. Its aim is specially to mitigate pain and reduce the consumption of analgesics, to ensure bile derivation or release the passage through the digestive tract. This can lead also to improvement of the patient's general condition. Despite advances in molecular biology of pancreatic cancer the results of systemic treatment remain unsatisfactory in advanced tumours. Nevertheless therapeutic nihilism must not prevail nowadays. It is necessary to use new findings in diagnosis and therapy. Patients with this disease should be included in clinical trials investigating optimal therapeutic procedures.

Pressurised liquid extraction of ketones of polycyclic aromatic hydrocarbons from soil

Pressurised liquid extraction (PLE) was used in the extraction of three ketones of polycyclic aromatic hydrocarbons from the sample of a soil highly contaminated with polycyclic polyaromatic compounds. The choice of solvent was the only factor that considerably influenced the extraction efficiency of PLE under the conditions recommended in Method 3545A promulgated by the United States Environmental Protection Agency. The dichloromethane-ethanol solvent mixture was found to be the most efficient solvent. PLE using this mixture provided better recoveries of all analysed ketones relative to Soxhlet extraction.

[Regional chemotherapy of liver tumors]

Based on experience with regional intrahepatic chemotherapy in 67 patients with inoperable primary, and in particular secondary liver tumours, which comprises several hundred administered cycles of mostly continuous regional regimens, the authors summarize briefly the main principles and possibilities of this treatment. In a review of randomized studies they provide evidence for the advantage of regional chemotherapy, as compared with systemic treatment, in particular with regard to the higher percentage of therapeutic responses. In correctly indicated, and if possible early cases of hepatic tumourous affections, it is possible to potentiate the effect of regional chemotherapy by local destruction of tumourous foci by alcoholization, cryodestruction or resection. An integral part of this treatment is also monitoring of the effect by following up the dynamics of serum levels of tumour markers and by imaging methods. Because the most frequent cause of failure of this method are extrahepatic secondaries and secondary chemoresistance of the tumourous foci, improvement of results can be expected in particular from a combination of regional and systemic chemotherapy and the inclusion of cytokines into the therapeutic schemes.

[Cytokines in regional immunochemotherapy of liver tumors]

Regional intrahepatic chemotherapy of inoperable primary and secondary liver tumours can achieve, as compared with the little effective systemic chemotherapy, a higher percentage of therapeutic responses. The objective of regional chemoimmunotherapy, i.e. the use of cytokines, in particular interferon alpha (IFN-a) and interleukin-2 (IL-2) in the therapeutic regimens is to improve the survival of patients with malignant liver tumours. One of the main prerequisites of the effect of locally administered cytokines is activation of hepatic lymphocytes (LAL)-liver associated lymphocytes, effectors with specific phenotype and potential anti-tumourous effect directly in the target area. Although in regional monotherapy the effectiveness of cytokines is low, regimens combining the administration of cytostatics with IL-2 achieve a 50-70% therapeutic response. The authors summarize basic data on the regional administration of cytokines and present an review of combined regimens of regional chemoimmunotherapy, including their own protocol of the Masaryk Oncological Institute in Brno.