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Does the assesment of tumor markers in the context of the last negative conclusions still have any impact in ovarian cancer?
Svoboda, Tomáš ; Fínek, Jindřich (advisor) ; Skalický, Tomáš (referee) ; Hes, Ondřej (referee) ; Vyzula, Rostislav (referee)
Does the assessment of tumor markers in the context of the last negative conclusions still have any impact in ovarian cancer? Svoboda T.: Dept. Of Oncology and Radiotherapy, Univ.Hospital, Plzen, Czech Republic Summary: The incidence of ovarian cancer is very high in Europe and there is still a lot of encertainaity about the best screening method today. The regular use of ultrasound investigation and CA125 testing is not established as a screening, so the greatest number of patients diagnosed with this tumor has a locally advanced disease. Their prognosis is unfavourable even with the treatment by chemotherapy. We describe the role of main factors associated with the primary tumor (staging, grading, histological type) and it's treatment (surgery type and the influence of residual tumor, type and regimen of chemotherapy and inclusion of radiation therapy in the primary treatment) for disease-free and overall survival. We also confirmed that tumor markers (CA125 incl.) used in screening, during treatment measuring response to chemotherapy and for folow-up as an early predictor of disease recurrence have low specificity and sensitivity to be used today. They have role of a prognostic factor - at least some of them - unfortunately with no impact on survival even when palliative chemotherapy can start...
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The Role of Genetic Mutations in Breast Cancer
Šustr, Jan ; Fínek, Jindřich (advisor) ; Petráková, Katarína (referee) ; Prausová, Jana (referee)
Introduction: About 5 - 10% of breast carcinomas are caused by genetic mutations. The most common genetic mutation that is involved in the development of this malignancy is a mutation in the tumor suppressor genes BRCA1/2 whose carriers have approximately a 70% lifetime risk of developing breast cancer. The prognosis of patients with BRCA1/2-asociated breast carcinoma, compared to patients with sporadic breast carcinoma is the subject of many studies with ambiguous results. Aim: The aim of the theoretical part of this work was to approach the issue of breast cancer and the most common genetic syndromes associated with it. In the practical part of this work a retrospective study was carried out in order to compare BRCA1/2 mutated breast cancer patients with non-mutated breast cancer patients in the tumor profile, methods of treatment and prognosis. Methods: We retrospectively analyzed the data of 134 patients who were tested for the presence of BRCA1/2 mutation at the Institute of Medical Genetics, University Hospital in Pilsen during the years 2013-2018 and at the same time were treated for early breast cancer at the University Hospital in Pilsen during the years 2000-2020. 32 patients were BRCA1 positive (24%), 10 BRCA2 positive (7%) and 92 without BRCA1/2 mutation (69%). The follow- up time was...
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The Utilization of Ultrasound-guided Biopsy in the Management of Ovarian Tumors
Vlasák, Pavel ; Presl, Jiří (advisor) ; Fínek, Jindřich (referee) ; Zikán, Michal (referee)
Study objectives: To compare the diagnostic reliability, accuracy and safety of ultrasound-guided biopsy and ascites puncture in patients with primarily inoperable malignant tumor of the ovary. Study design: Retrospective and prospective data analysis Settings: Department of Obstetrics and Gynecology, Medical Faculty and Teaching Hospital in Pilsen Methods: We retrospectively analyzed a group of patients with primarily inoperable ovarian tumor, who underwent an ascites puncture with subsequent cytologic examination as a part of tumor verification before neoadjuvent chemotherapy commencement. The results were compared to a group of patients, who underwent an ultrasound-guided biopsy with subsequent histopathologic examination for determining of their diagnosis. We compared the adequacy, i.e. possibility to verify biologic nature, origin and histologic subtype of the tumor, accuracy, i.e. agreement between the result of the diagnostic method and final postoperative histology, and safety, i.e. recorded complications of the procedure. To validate the result of this comparative study we prospectively evaluated a group of patients where both methods were used. Results: In the ascites puncture group, a total of 55 procedures were performed. Adequate sample was obtained in in all patients and one severe...
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Thyroid Dysfunction after Radiotherapy of Head and Neck Cancer
Bernát, Ladislav ; Hrušák, Daniel (advisor) ; Fínek, Jindřich (referee) ; Jenča, Andrej (referee)
Objectictives: Radiation therapy is often applied to patients with head and neck cancer because of a high sensitivity to these cancers. It improves treatment outcomes and permits the preservation of functions and physical form. However, it has been shown that various complications can result from radiation therapy. Hypothyroidism can be one of them as the thyroid gland is frequently included in radiation fields. In spite of that, thyroid hypofunction is not commonly considered a complication of radiotherapy for head and neck cancer. The purpose of this retrospective study was to determine the frequency of thyroid dysfunction in patients after radiotherapy, to compare thyroid hormone levels in irradiated patients with control group and to predict development of thyroid hypofunction in time. Material and method: Thyroid function was measured by means of thyroid stimulating hormone (TSH), free thyroxine (FT4) and free triiodthyronine (FT3) in 43 patiens who had nonthyroid head-neck carcinomas treated by radiotherapy or radiotherapy in combination with other treatment modalities. These data were compared with hormone levels of 40 control group patients treated solely by surgery. Results: In median follow-up period 34 months after radiation, hypothyroidism was found in 35% of irradiated patients. In...
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Cutaneous Side Effects of Targeted Oncological Treatment
Říčař, Jan ; Cetkovská, Petra (advisor) ; Fínek, Jindřich (referee) ; Salavec, Miloslav (referee)
1 Abstract Introduction In recent years, new oncological treatments with targeted effects on cellular level have been introduced into the clinical practice. Some of these agents can cause specific changes affecting skin, skin appendages and mucosa. Currently, the most significant cutaneous side effects in the clinical practice are observed during treatment with inhibitors of the epidermal growth factor receptor (EGFR). Papulopustular exanthema is the most frequent adverse effect of EGFR inhibitors. Skin changes have a crucial impact on the quality of life can cause an interruption or even termination of the oncological treatment, thus worsening the patient prognosis. Objectives The objective of this study was to evaluate the incidence, severity and time of onset of papulopustular exanthema in patients with non-small cell lung cancer (NSCLC) treated with erlotinib. The study also aimed to assess the correlation between papulopustular exanthema and patient prognosis and the incidence of EGFR gene mutations. Another objective was to create informational materials for patients with EGFR inhibitors skin toxicity, its prevention, treatment and recommended regime measures. Methods This was a prospective, open-label, uncontrolled study in which patients with non- small cell lung cancer stage III B and IV treated...
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The Utilization of the Molecular-Biology Method One-Step Nucleic Acid Amplification (OSNA) for Examination of Sentinel Lymph Nodes in Endometrial Cancer Patients
Kosťun, Jan ; Presl, Jiří (advisor) ; Fínek, Jindřich (referee) ; Roztočil, Aleš (referee)
Hypothesis The One-Step Nucleic Acid Amplification method could represent an effective intraoperative tool for detection of metastatic involvement of lymphatic nodes on the level of ultrastaging in endometrial cancer patients. Objective Utilization of the One-Step Nucleic Acid Amplification (OSNA) molecular biology method for the detection of the micrometastatic and macrometastatic involvement of sentinel lymph nodes in endometrial cancer patients. The objective is a comparison with the conclusion of the histopathological ultrastaging of sentinel lymph nodes and a description of the clinical consequences of this method. Methods Patients indicated for the surgical treatment of endometrial cancer underwent the detection of sentinel lymph nodes that was executed using the intracervical application of a tracer. Nodes larger than 5 mm were cut into sections 2 mm thick parallel to the short axis of the node. Odd sections were examined using the OSNA method, while even ones were examined by hematoxylin and eosin (H&E) and immunohistochemical examination to detect cytokeratin 19 antibody (IHC CK19) based on an ultrastaging-relevant protocol. Nodes of the size of 5 mm and smaller were divided into halves along the longitudinal axis with one half being examined using the OSNA method and the other half by...
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Utilisation of New Biomarkers for the Optimalization of Diagnostics and Therapy of Tumors of the Gastrointestinal Tract
Šafanda, Martin ; Kučera, Radek (advisor) ; Fínek, Jindřich (referee) ; Svobodová, Šárka (referee)
Utilisation of New Biomarkers for the Optimalization of Diagnostics and Therapy of Tumors of the Gastrointestinal Tract Introduction: Tumor markers are standard diagnostic tools. They are mainly used to monitor the course of the disease and to check the efficacy of the treatment. It is important to observe dynamics. Changing the level of the biomarker can prevent clinical manifestation and lead to early diagnosis of relapse, which in turn means improving the quality of life, including prolonging survival. Recently, we have encountered a number of diagnostic algorithms that suggest algorithms for estimating the risk of tumor presence or the risk of progression of cancer, using statistical methods. Objectives: The aim of this work is to verify new biomarkers for the diagnosis of gastric cancer and to develop an optimal algorithm for their use. Further, to evaluate the importance of cytokeratin markers - Tissue Polypeptide Antigen (TPA) and Tissue Polypeptide Specific Antigen (TPS) for the diagnosis of metastatic colorectal carcinoma in the liver. To carry out a pilot study of FGF23 levels in people with colorectal carcinoma and other gastrointestinal tumors. Methods and patients: Patient samples were analyzed using immunoradiometric, chemiluminescence and fluorescence assays. For each solved problem,...
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Breast cancer in young women: correlation of molecular-genetic, clinical and morphological features
Metelková, Alena ; Fínek, Jindřich (advisor) ; Tesařová, Petra (referee) ; Ryška, Aleš (referee)
In the first part of the dissertation the author summarizes the current knowledge of breast cancer, which is the most frequent malignancy in female population. The author deals with etiology, classification, diagnostics, biological behaviour, therapeutical forms ranging from surgical treatment and radiotherapy, to systemic therapy. In the following part of the manuscript the author describes specifics of breast cancer diagnosed in premenopausal women. She describes how the risk factors, treatment and prognosis differ from the disease in postmenopausal women. Next section of the dissertation includes a retrospective case series evaluating group of patients with breast cancer ≤ 35 years. There were 16 294 cases of breast cancer proven histologically in Biopticka lab Pilsen, ltd. and Sikl's Department of Pathology, Faculty Hospital Pilsen, during 2006-2015. The cohort of patients in our retrospective study includes 356 young women (2,2%) with breast cancer, under 35 years of age by the time of setting the diagnosis. We sorted out a group of 93 patients from the basic cohort, that were or have been treated in the Department of Oncology and Radiotherapy, Faculty Hospital in Pilsen. A control group consists of 100 postmenopausal women ≥ 65 years of age, chosen randomly from all patients treated in the...
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Analysis of the cytosol of thyroid gland and its contribution in the differential diagnosis of nodular lesions
Pikner, Richard ; Topolčan, Ondřej (advisor) ; Fínek, Jindřich (referee) ; Třeška, Vladislav (referee)
Thyroid nodules represent the most frequent endocrine lession in our population and it is neccessary to differentiate malignant lessions from them. The aim of the study was to validate determination of selected angiogenic, proliferative, and appptotic markers in cytosol tissue extracts. We analysed 166 tissue samples (85 goitres, benign adenomas and 10 malignat tumours in which VEGF, bFGF, Endostatin, Thymidinkinase ans TPS were determined. Main limitation of cytosolic analysis is tissue sample volume, that must be about 1cm3 and interindividual variability caused by tissue sample heterogeneity. Best way is to compare normal with pathological tissue samples from one patient. We fund significant differences amog histological groups in VEGF, bFGF, Endostatin and maily Tymidinkinase and TPS. These differences are not sufficiently huge to distinguish goitres and benign lessions . We also did not find any correlation between cytosolic markers and iminuhistochemistry markers . Cytosol analysis is not able to measure local expression and its differences in anylysed tissue, but it is able to quantitatively determine mean levels of selected markers.
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