Plasminogen activator ihnibitor (PAI 1) belongs to the plasminogen activator system, which is part of the metastatic cascade and significantly contributes to invasive growth and angiogenesis of malignant tumors. Its plasma level is normally low but 4G/4G homozygotes have higher concentrations of PAI 1. This genotype may be associated with worse prognosis and proximal location of colorectal cancer than 5G/5G homozygotes. In our prospective evaluation we examined plasma level PAI 1 (using photometric microplate method ELISA) pre-surgery and, subsequently, 6-8 weeks later, from 80 patients. For the PAI 1 rs1799889 -675 4G/5G polymorphism test the PCR amplification was used.Analysis of collected data was confirmed that significantly higher plasma levels of PAI 1 were found in patients before starting therapy, which decreased (p=0.004) after initiation of treatment. Patients with higher plasma level PAI 1 before (p=0.013) and after therapy (p=0.004) had significantly shorter survival. We found no relationship between polymorphisms of PAI 1 (-675 4G/5G) in relation to stage, survival or tumor location. PAI 1 is useful as a negative marker of prognosis and could be advantageous when planning adjuvant treatment of patients with colorectal carcinoma. Although opinions on the importance of polymorphisms of PAI 1 in relation to the prognosis are not uniform, it does seem that their role in the prognosis of patients with colorectal cancer is not essential.
Urokinase (uPA) plays an essential role in the activation of plasminogen to plasmin, and together with its receptor (uPAR), tissue activator (tPA) and urokinase inhibitors (PAI 1, PAI 2, PAI 3 and protease nexin) forms the plasminogen activator system (PAS), a component of metastatic cascade importantly contributing to the invasive growth and angiogenesis of malignant tumours. In our project we examined the expression of uPA, uPAR, PAI 1 and PAI 2 in tumor tissue and we also studied the plasma levels of PAI 1 before and after the initiation of therapy in patients with colorectal carcinoma in relationship to grade of tumor and the treatment response. In our prospective evaluation we included 80 patients treated for adenocarcinoma of the colon and rectum. Analysis of collected data revealed statistically significant evidence of a relationship between the level of PAI 1 in plasma before treatment and grade of the tumor, which increases with tumor grade (p=0.025). We demonstrated that there exists a statistically significant relationship between the expression of PAI 2 (p<0.001) and uPAR (p=0.031) and grade of tumor. We also confirmed a statistically significant relationship between soluble levels of PAI 1 before treatment and therapeutic response (p=0.021). In our group of patients the expression of uPA, uPAR, PAI 1 and 2 in tumor tissue in relation to response to treatment was also assessed. Our results suggest that the greater expression of these parameters in tumor tissue is linked to a worse response to therapy. In conclusion, PAS factors help as a prognostic indicators and could also act as a predictive factor in colorectal carcinoma.
- MeSH
- adenokarcinom metabolismus sekundární terapie MeSH
- aktivátor plasminogenu urokinasového typu metabolismus MeSH
- dospělí MeSH
- imunoenzymatické techniky MeSH
- inhibitor aktivátoru plazminogenu 1 metabolismus MeSH
- inhibitor aktivátoru plazminogenu 2 metabolismus MeSH
- kolektomie MeSH
- kolorektální nádory metabolismus patologie terapie MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- prospektivní studie MeSH
- protokoly antitumorózní kombinované chemoterapie terapeutické užití MeSH
- receptory urokinázového aktivátoru plazminogenu metabolismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- staging nádorů MeSH
- výsledek terapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Krvácení do gastrointestinálního traktu je častou náhlou příhodou břišní. Závažnost jeho příčiny a důsledky krevní ztráty vyžadují co možná nejčasnější přesnou diagnózu i určení místa krvácení s následnou kauzální léčbou. Autoři kladou důraz na komplexní terapii a interdisciplinární spolupráci především chirurga, endoskopisty, radiologa, gastroenterologa, popřípadě hematologa. Nastiňují racionální diagnosticko-terapeutický postup s ohledem na dostupnost a výtěžnost jednotlivých vyšetřovacích metod. Na základě několika kazuistik je ilustrován jejich diagnostický přínos. Z chirurgického hlediska je vyzdvižen význam peroperačně prováděné enteroskopie klasickým gastrofibroskopem zavedeným přes gastrotomii nebo enterotomii.
Haemorrhage into the gastrointestinal tract is a frequent form of acute abdomen. The serious character of its cause and the consequences of blood loss call, as soon as possible, for an accurate diagnosis and assessment of the site of haemorrhage with subsequent causal treatment. The authors emphasize comprehensive therapy and interdisciplinary collaboration in particular of the surgeon, endoscopist, radiologist, gastroenterologist, possibly haematologist. They outline a rational diagnostic and therapeutic procedure with regard to the availability and yield of different examination methods. Based on several case-histories they illustrate their diagnostic contribution. From the surgical aspect they emphasize the importance of peroperative enteroscopy by means of a classical gastrofibroscope inserted via the gastrotomy or enterotomy.
- MeSH
- chybná diagnóza MeSH
- diagnostické techniky gastrointestinální MeSH
- dospělí MeSH
- idiopatické střevní záněty diagnóza etiologie farmakoterapie MeSH
- lidé MeSH
- Peutzův-Jeghersův syndrom diagnóza etiologie chirurgie MeSH
- polypy tlustého střeva etiologie chirurgie MeSH
- ulcerózní kolitida diagnóza MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- přehledy MeSH
- Klíčová slova
- GINKOR FORT,
- MeSH
- aplikace lokální MeSH
- aplikace orální škodlivé účinky MeSH
- cévy patologie MeSH
- dietoterapie MeSH
- hemoroidy farmakoterapie MeSH
- lidé MeSH
- způsoby aplikace léků MeSH
- Check Tag
- lidé MeSH
