Last year the field of immunotherapy was finally introduced to GI oncology, with several changes in clinical practice such as advanced hepatocellular carcinoma or metastatic colorectal MSI-H. At the virtual ASCO-GI symposium 2021, several large trial results have been reported, some leading to a change of practice. Furthermore, during ASCO-GI 2021, results from early phase trials have been presented, some with potential important implications for future treatments. We provide here an overview of these important results and their integration into routine clinical practice.

• MeSH
• analýza přežití MeSH
• cílená molekulární terapie MeSH
• gastrointestinální nádory farmakoterapie   metabolismus   MeSH
• imunoterapie metody   MeSH
• klinické zkoušky jako téma MeSH
• kongresy jako téma MeSH
• lidé MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

• MeSH
• adipokiny izolace a purifikace   metabolismus   MeSH
• cytokiny izolace a purifikace   metabolismus   MeSH
• diabetes mellitus 2. typu * epidemiologie   etiologie   komplikace   MeSH
• gastrointestinální nádory etiologie   komplikace   metabolismus   MeSH
• hyperglykemie komplikace   krev   metabolismus   MeSH
• hyperinzulinismus komplikace   krev   metabolismus   MeSH
• insulinu podobný růstový faktor I MeSH
• komplikace diabetu etiologie   metabolismus   MeSH
• leptin izolace a purifikace   metabolismus   MeSH
• lidé MeSH
• nádory endometria etiologie   komplikace   metabolismus   MeSH
• nádory ledvin etiologie   komplikace   metabolismus   MeSH
• nádory močového měchýře etiologie   komplikace   metabolismus   MeSH
• nádory prsu etiologie   komplikace   metabolismus   MeSH
• nádory * epidemiologie   etiologie   metabolismus   MeSH
• nehodgkinský lymfom etiologie   komplikace   metabolismus   MeSH
• obezita epidemiologie   etiologie   komplikace   MeSH
• statistika jako téma MeSH
• tuková tkáň * enzymologie   metabolismus   sekrece   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

Helicobacter pylori has been implicated in stimulation of immune system, development of autoimmune endocrinopathies as autoimmune thyroiditis (AT) and on other hand induction of immunosupresion activates gastric and extra-gastric diseases such as gastric ulcer or cancer. It causes persistent lifelong infection despite local and systemic immune response. Our results indicate that Helicobacter pylori might cause inhibition of the specific cellular immune response in Helicobacter pylori-infected patients with or without autoimmune diseases such as AT. We cannot also declare the carcinogenic effect in oropharynx. However the association of any infection agents and cancerogenesis exists. The adherence of Helicobacter pylori expression and enlargement of benign lymphatic tissue and the high incidence of the DNA of Helicobacter pylori in laryngopharyngeal and oropharyngeal cancer is reality. LTT appears to be a good tool for detection of immune memory cellular response in patients with Helicobacter pylori infection and AT. All these complications of Helicobacter pylori infection can be abrogated by successful eradication of Helicobacter pylori.

• MeSH
• autoimunitní tyreoiditida diagnóza   imunologie   metabolismus   MeSH
• gastrointestinální nádory diagnóza   imunologie   metabolismus   MeSH
• gastrointestinální trakt imunologie   metabolismus   patologie   MeSH
• Helicobacter pylori metabolismus   MeSH
• infekce vyvolané Helicobacter pylori diagnóza   imunologie   metabolismus   MeSH
• karcinogeneze imunologie   metabolismus   patologie   MeSH
• lidé MeSH
• nemoci štítné žlázy diagnóza   imunologie   metabolismus   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH

Non-B-bunkové nádory sú vzácnou príčinou hypoglykémie. Ide väčšinou o veľké a pomaly rastúce mezenchýmové alebo epitelové nádory produkujúce nadmerné množstvá inzulínu podobného rastového faktoru IGF2 (tzv. IGF2- ómy). Pri non-B-bunkových nádoroch býva prítomná hypoglykémia nalačno spojená so zvýšenými hladinami cel - kového a voľného IGF2, ako aj tzv. „big“ formy IGF2. Dôsledkom supresie bývajú znížené hladiny inzulínu, rasto - vého hormónu a IGF1 a typicky sa zvyšuje pomer IGF2/IGF1. Zvýšené hladiny IGF2 zapríčiňujú hypoglykémiu, ktorú v prípade veľmi veľkých nádorov potenciuje aj zvýšená utilizácia glukózy v nádore. Po úspešnej liečbe primárneho non-B-bunkového nádoru dochádza k vymiznutiu hypoglykémie.

Non-beta-cells tumours are rare cause of hypoglycaemia. There are usually characterized such mesenchymal or epithelial tumours with huge size, slow growth and increased production of insulin like growth factor IGF2 (IGF2- oma). In non-beta-cells tumours there is present fasting hypoglycaemia associated with increased levels of total and free IGF2 as well as big IGF2 form. Due to suppression effect there are decreased levels of insulin, growth hor - mone and IGF1 and ratio IGF2/IGF1 is typically increased. Hypoglycaemia is caused by increased IGF2 levels and in the case of very huge tumours also by increased glucose utilization in tumour tissue. Attacks of hypoglycaemia may be diminished after successful treatment of primary non-beta-cells tumour.

• MeSH
• gastrointestinální nádory * komplikace   metabolismus   patologie   MeSH
• glukokortikoidy terapeutické užití   MeSH
• hypoglykemie * epidemiologie   etiologie   farmakoterapie   MeSH
• insulinu podobný růstový faktor I metabolismus   MeSH
• insulinu podobný růstový faktor II * metabolismus   účinky léků   MeSH
• inzulinom komplikace   metabolismus   patologie   MeSH
• lidé MeSH
• Check Tag
• lidé MeSH

• MeSH
• antitumorózní látky farmakologie   terapeutické užití   MeSH
• cílená molekulární terapie metody   MeSH
• gastrointestinální nádory farmakoterapie   metabolismus   patofyziologie   MeSH
• klinické zkoušky, fáze III jako téma MeSH
• lidé MeSH
• myši MeSH
• nádory plic farmakoterapie   metabolismus   patofyziologie   MeSH
• nádory slinivky břišní farmakoterapie   metabolismus   patofyziologie   MeSH
• neuroendokrinní nádory farmakoterapie   metabolismus   patofyziologie   MeSH
• přežití po terapii bez příznaků nemoci MeSH
• randomizované kontrolované studie jako téma MeSH
• signální transdukce účinky léků   MeSH
• sirolimus analogy a deriváty   farmakokinetika   terapeutické užití   MeSH
• somatostatin analogy a deriváty   farmakokinetika   terapeutické užití   MeSH
• TOR serin-threoninkinasy účinky léků   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• myši MeSH
• zvířata MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal (GI) tract. They are believed to originate from the interstitial cells of Cajal (ICCs) or from the precursors of ICCs. Most GISTs show an activating mutation in either the c-kit or platelet-derived growth factor receptor alpha (PDGFRA) gene. Tumor size, mitotic rate, and anatomic location correlate with potential malignancy and recurrence rate. PATIENTS AND METHODS: A total of 12 patients were diagnosed to have GIST based on histology or immunohistochemistry of a biopsy or resection specimen obtained from the GI tract in the 2004-2009 period. The material was obtained using retrospective data collection. RESULTS: The male to female ratio was 1:1; mean age 68.2 +/- 7.0 years. The stomach was involved in seven cases (58.3%), the small intestine in four (33.3%), and from a lymph node without the finding of a primary tumor was material obtained in one case (8.3%). The course was asymptomatic in four patients (incidental findings). All 12 patients had surgery; a curative procedure was undertaken in 11 patients. A spindle-cell pattern was present in 8/12 of the specimens examined, epithelioid in 2/12 and a mixed pattern in two cases. Ten specimens were CD117 positive (83.3%), two were negative; all 10 examined specimens exhibited CD34 positivity while two were not examined. The findings were classified as GISTs with a high risk of progressive disease in three patients, with a moderate risk in one patient, and a low or very low degree of malignancy in five patients. GISTs smaller than 2 cm in three patients were regarded as essentially benign. All patients with low and very low risk of progressive disease survive for 1 to 5 years free of signs. Of the three patients with high degree of malignancy, one died within one year for dissemination, the two remaining patients survive for over two years and six month postoperatively on therapy with tyrosine kinase inhibitors. CONCLUSION: Tumors classified as GISTs with low and very low risk of progression are associated with a very good prognosis, with virtually all patients surviving 5 years. In patients with high risk or progressive diseases, the prognosis of 5-year survival is much poorer. The main therapeutic option is surgical removal of the tumor (resection or broad excision). Agents showing promise for patients with malignant forms of GISTs are tyrosine kinase receptor inhibitors. Although imatinib is currently used as a first line treatment for all patients with metastatic or unresectable GISTs, it is likely that this treatment will change in the future based on the underlying mutational status.

• MeSH
• adjuvantní chemoterapie MeSH
• antitumorózní látky terapeutické užití   MeSH
• délka pobytu MeSH
• gastrointestinální nádory farmakoterapie   metabolismus   mortalita   patologie   chirurgie   MeSH
• gastrointestinální stromální tumory farmakoterapie   metabolismus   mortalita   patologie   chirurgie   MeSH
• imunohistochemie MeSH
• inhibitory proteinkinas terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• piperaziny terapeutické užití   MeSH
• progrese nemoci MeSH
• pyrimidiny terapeutické užití   MeSH
• retrospektivní studie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Similar to growing and metabolically active tissues, tumors require a dense vasculature to gain access to oxygen and nutrients. However, blood vessels in tumors differ from vessels in normal tissues in many respects. In particular, the tumor vasculature is in an active state of angiogenesis or vasculogenesis, and it is immature and leaky. Blood vessels are multicellular tubes formed by polarized endothelial cells, which face the patent vascular lumen with their apical cell surface, whereas their basal cell surface faces extracellular matrix on the outside of the vessels. The same cell polarity can be found in other tubular structures, such as in the bronchial tubes of the lung or the kidney tubules. In contrast, blood vessels in invertebrates often have a vascular lumen lined by basal cell surfaces. These vessels are often formed by a process named 'ancestral vascular tube formation'. Here, we discuss the hypothesis that the supply of tumors with blood can be achieved by both endothelial cell-lined tubes as well as tubes formed by the tumor cells themselves using the ancestral vascular tube formation mechanism. We discuss this hypothesis with a particular focus on gastrointestinal tumors.

• MeSH
• cévní endotel cytologie   metabolismus   MeSH
• extracelulární matrix metabolismus   MeSH
• fyziologická neovaskularizace MeSH
• gastrointestinální nádory krevní zásobení   metabolismus   patofyziologie   MeSH
• lidé MeSH
• nádory krevní zásobení   metabolismus   patofyziologie   MeSH
• patologická angiogeneze MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• práce podpořená grantem MeSH
• přehledy MeSH

Gastroenteropancreatic (GEP) neuroendocrine tumours (NETs) are fairly rare neoplasms that present many clinical challenges. They secrete peptides and neuroamines that cause distinct clinical syndromes, including carcinoid syndrome. However, many are clinically silent until late presentation with mass effects. Investigation and management should be highly individualised for a patient, taking into consideration the likely natural history of the tumour and general health of the patient. Management strategies include surgery for cure (which is achieved rarely) or for cytoreduction, radiological intervention (by chemoembolisation and radiofrequency ablation), chemotherapy, and somatostatin analogues to control symptoms that result from release of peptides and neuroamines. New biological agents and somatostatin-tagged radionuclides are under investigation. The complexity, heterogeneity, and rarity of GEP NETs have contributed to a paucity of relevant randomised trials and little or no survival increase over the past 30 years. To improve outcome from GEP NETs, a better understanding of their biology is needed, with emphasis on molecular genetics and disease modeling. More-reliable serum markers, better tumour localisation and identification of small lesions, and histological grading systems and classifications with prognostic application are needed. Comparison between treatments is currently very difficult. Progress is unlikely to occur without development of centers of excellence, with dedicated combined clinical teams to coordinate multicentre studies, maintain clinical and tissue databases, and refine molecularly targeted therapeutics.

• MeSH
• gastrointestinální nádory metabolismus   patofyziologie   terapie   MeSH
• lidé MeSH
• molekulární biologie MeSH
• nádorové biomarkery MeSH
• nádory slinivky břišní metabolismus   patofyziologie   terapie   MeSH
• neuroendokrinní karcinom klasifikace   metabolismus   patologie   MeSH
• somatostatin analogy a deriváty   metabolismus   terapeutické užití   MeSH
• tyrosinkinasy antagonisté a inhibitory   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH

In this study, 60 gastrointestinal stromal tumors of the stomach were analyzed to elucidate the possible relation of their morphology to the mutation status of KIT and PDGFRA genes. The patients included 27 men and 33 women with a mean age of 63.8 years (range, 12-92 years). Only 1 tumor occurred before the age of 21 years. KIT mutations were detected in 31 cases (51.7%), PDGFRA mutations in 22 cases (36.7%), and 7 cases (11.7%) were KIT and PDGFRA wild type. When the mutation status was correlated with histologic features of the tumors, epithelioid or mixed epithelioid/spindle cell pattern and mast cell infiltration were found as the most reliable signs of PDGFRA mutation. Neoplastic rhabdoid cells and multinucleated giant cells, also previously reported as features of PDGFRA-mutated gastrointestinal stromal tumors, seemed to be less specific but still helpful markers in our study. Finally, tumor-infiltrating lymphocytes and myxoid stroma do not seem to be valuable histologic signs.

• MeSH
• dítě MeSH
• DNA nádorová genetika   MeSH
• dospělí MeSH
• gastrointestinální nádory diagnóza   genetika   metabolismus   patologie   MeSH
• gastrointestinální stromální tumory diagnóza   genetika   metabolismus   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mastocyty patologie   MeSH
• mladiství MeSH
• mutace genetika   MeSH
• nádorové biomarkery metabolismus   MeSH
• protoonkogenní proteiny c-kit genetika   metabolismus   MeSH
• regulace genové exprese u nádorů MeSH
• růstový faktor odvozený z trombocytů - receptor alfa genetika   metabolismus   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH

• MeSH
• cytokiny fyziologie   MeSH
• gastrointestinální nádory metabolismus   MeSH
• leptin analýza   fyziologie   MeSH
• lidé MeSH
• proteiny akutní fáze krev   MeSH
• tuková tkáň sekrece   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• srovnávací studie MeSH