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Pancreatic Neoplasms: HELP
Articles by Arnošt Martínek
Based on 11 articles published since 2010
(Why 11 articles?)

Between 2010 and 2020, A. Martínek wrote the following 11 articles about Pancreatic Neoplasms.
+ Citations + Abstracts
1 Review [Autoimmune pancreatitis - diagnostic consensus]. 2015

Dítě, Petr / Novotný, Ivo / Kianička, Bohuslav / Rydlo, Martin / Nechutová, Hana / Martínek, Arnošt / Uvírová, Magdalena / Bojková, Martina / Dvořáčková, Jana. · ·Vnitr Lek · Pubmed #25813253.

ABSTRACT: The autoimmune type of pancreatitis represents the specific disease of pancreas, with significant contribution of autoimmune processes in its etiopathogenesis. Currently, there are two proved subtypes of this particular pancreatopathy, which are defined clinically, histomorphologically and serologically. They have many histomorphological signs in common, but differ in the presence of so-called granulocytic epithelial lesions (GEL), which are absent in subtype 1. The subtype 1 is characterized by the presence of gammaglobulines, esp. immunoglobuline G4 and IgG4 positive extrapancreatic lesions. The subtype 2 is typically associated with the inflammatory bowel diseases, esp. ulcerative colitis. But the common characteristic of both subtypes is the fact response to applied steroid treatment. Due to diverse diagnostic criteria in the past, in 2011 the consensus for the diagnosis of autoimmune pancreatitis was announced. It is based on clinical symptoms, biochemical results, the results got by using of imaging methods, histomorphology and positive response to steroid treatment. The matter to be solved is the question of early differential diagnosis between focal autoimmune pancreatitis and adenocarcinoma of pancreatic head. From imaging methods are MRI/CT, MRCP (in Asia ERCP), EUS with targeted biopsy of the gland (under EUS control), are recommended as the methods of choice.

2 Review Differentiating autoimmune pancreatitis from pancreatic cancer. 2014

Díte, P / Uvírová, M / Bojková, M / Novotný, I / Dvorácková, J / Kianicka, B / Nechutová, H / Dovrtelová, L / Floreánová, K / Martínek, A. ·Academic Centre of Gastroenterology Department of Internal Medicine, University Hospital and Faculty of Medicine of the University of Ostrava, Ostrava - pdite.epc@gmail.com. ·Minerva Gastroenterol Dietol · Pubmed #25288201.

ABSTRACT: Differential diagnosis between autoimmune pancreatitis (AIP) and pancreatic cancer can be very difficult. The main clinical symptoms in patients with autoimmune pancreatitis are jaundice, weight loss, abdominal pain and new onset of diabetes mellitus. Unfortunately, the same symptoms could be observed in patients with pancreatic carcinoma too. Imaging methods as computed tomography (CT) scan, magnetic resonance imaging (MRI) and endosonography (EUS); together with serological examination (IgG4 and Ca 19-9) play the important role in differentiation autoimmune pancreatitis from pancreatic cancer. Extrapancreatic findings are distinctive in patients with autoimmune pancreatitis. In some cases the pancreatic biopsy is indicated, mainly in patients with focal or multifocal form of autoimmune pancreatitis. Response to steroids (decreased pancreatic or extrapancreatic lesion or damage) is distinctive to AIP. In clinical practice, CT scan seems to be the most reasonable tool for examining the patients with obstructive jaundice with or without present pancreatic mass. Stratification the patients with possible AIP versus pancreatic cancer is important. In patients with AIP it may avoid pancreatic resection, as well as incorrect steroid treatment in patients with pancreatic carcinoma.

3 Article [A contribution to the differential diagnostics of sclerosing cholangitides]. 2017

Blaho, Martin / Dítě, Petr / Bojková, Martina / Rydlo, Martin / Kupka, Tomáš / Svoboda, Pavel / Klvaňa, Pavel / Martínek, Arnošt. · ·Vnitr Lek · Pubmed #28225291.

ABSTRACT: Sclerosing cholangitides represent a group of chronic biliary obstructive diseases which include primary sclerosing cholangitis (PSC), IgG4 associated sclerosing cholangitis (IgG4-SC) and secondary sclerosing cholangitis (SSC). The manifestations of the diseases are similar, but their asymptomatic course is also frequent. IgG4-SC belongs to the group of IgG4 associated diseases and it is the most frequently related to type 1 autoimmune pancreatitis. Diagnosing of IgG4-SC is based on typical histopathological images, shape changes revealed by diagnostic imaging, serological tests, concurrent impairment of other organs and response to therapy, where IgG4-SC responds well to treatment with corticoids, whereas the only possibility for the remaining units is endoscopic intervention or liver transplantation. Secondary sclerosing cholangitis may develop as a result of many different insults affecting the biliary tree. Among them, the most frequently described include long-lasting biliary obstruction, surgical injury of the biliary tree, and ischemic cholangitis in liver allotransplants or recurrent pancreatitis. We use serological and imaging examination in PSC diagnostics, sometimes we have to resort to liver biopsy. PSC is to a significant degree accompanied by the presence of idiopathic bowel disease, typically ulcerative colitis. As a result, PSC may lead to cirrhosis of the liver and it is a precancerous condition of several malignancies. With regard to variable locations of the biliary tree injuries concerning the aforementioned units, also certain malignancies in subhepatic landscape need to be considered in the differential diagnosis: pancreatic cancer and cholangiogenous carcinoma.Key words: genetic factors - IBD - IgG4 cholangitis - liver transplantation - bile duct cancer - ursodeoxycholic acid - primary sclerosing cholangitis - secondary cholangitis - sclerosing cholangitis.

4 Article Evaluation of Dietary Habits in the Study of Pancreatic Cancer. 2016

Azeem, K / Horáková, D / Tomaskova, H / Procházka, V / Shonová, O / Martínek, A / Kysely, Z / Janout, V / Kollárová, H. · ·Klin Onkol · Pubmed #27296404.

ABSTRACT: BACKGROUND: Pancreatic cancer is serious and rapidly progressing condition. Little is known about the role of diet in etiology of pancreatic cancer. The study focused on the role of selected dietary factors related to pancreatic cancer. MATERIAL AND METHODS: The case-control study was performed in the Czech Republic in 2006- 2009, involving three centers in Olomouc, Ostrava and Ceske Budejovice. It comprised a total of 530 persons, of whom 310 had pancreatic cancer and 220 were controls. Data were obtained directly from each participant in an interview with a trained interviewer and entered into a standardized questionnaire. The data were analyzed using a crude odds ratio (OR) and multivariate logistic regression with an adjusted OR and 95% CI. The statistical analysis was performed with the STATA v. 10 software. RESULTS: A very strong protective effect was found in pickled cabbage (OR 0.32; 95% CI 0.19- 0.55), broccoli (OR 0.37; 95% CI 0.25- 0.53), cooked onion (OR 0.14; 95% CI 0.08- 0.27), tomatoes (OR 0.28; 95% CI 0.13- 0.60), raw carrot (OR 0.33; 95% CI 0.20- 0.56), cooked carrot (OR 0.35; 95% CI 0.19- 0.62). In logistic regression model, statistically significant protective associations were found in consumption of more than three portions of cooked vegetables per week (OR 0.16; 95% CI 0.05- 0.55) and high consumption of citrus fruit (OR 0.46; 95% CI 0.23- 0.90). CONCLUSION: The study found statistically significant protective effect of consumption of more than three portions of cooked vegetables per week and high consumption of citrus fruit.

5 Article [A multifactor epidemiological analysis of risk factors for pancreatic cancer in women]. 2015

Azeem, K / Horáková, D / Tomášková, H / Ševčíková, J / Vlčková, J / Pastucha, D / Procházka, V / Shonová, O / Martínek, A / Janout, V / Žídková, V / Kollárová, H. · ·Epidemiol Mikrobiol Imunol · Pubmed #25872994.

ABSTRACT: STUDY OBJECTIVE: A multifactor analysis of risk factors for pancreas cancer in women. MATERIAL AND METHODS: A case-control study was conducted in three centres in the Czech Republic (Olomouc, Ostrava, and České Budějovice) in 2006-2009. In total, 226 women (129 pancreas cancer cases, 97 controls) were included in the study. Statistical analysis was performed, the crude odds ratio (OR) was calculated, and logistic regression analysis was used at a 5% level of statistical significance. RESULTS: A statistically significant inverse association was found between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69). Pregnancy and number of pregnancies or gynecological surgical procedures did not show any association with pancreatic cancer. No significant difference in the first menstrual period was found between pancreatic cancer patients and controls. CONCLUSIONS: The study results showed inverse association between pancreatic cancer and oral contraceptives (OR 0.21; 95% CI: 0.07-0.69), controlled alcohol consumption (OR 0.26; 95% CI: 0.12-0.55), and anti-inflamatory drug use (OR 0.10; 95% CI: 0.02-0.41).

6 Article Immunoglobulin G4, autoimmune pancreatitis and pancreatic cancer. 2015

Bojková, Martina / Dítě, Petr / Dvořáčková, Jana / Novotný, Ivo / Floreánová, Katarina / Kianička, Bohuslav / Uvírová, Magdalena / Martínek, Arnošt. ·Academic Centre of Gastroenterology, Department of Internal Medicine, University Hospital Ostrava, Ostrava, Czech Republic. ·Dig Dis · Pubmed #25531501.

ABSTRACT: BACKGROUND: Immunoglobulin G4 (IgG4)-related diseases are a group of diseases characterized by enlargement of the affected organs, elevation of serum IgG4, massive infiltration of affected organs with lymphocytes and plasma cells with IgG4 positivity and tissue fibrosis. Type I autoimmune pancreatitis is one form of IgG4-related disease. For IgG4-related diseases, various localizations are described for up to 10% of malignancies. The aim of our study was to examine IgG4 serum levels and pancreatic tissue with respect to the simultaneous presence of autoimmune pancreatitis in patients with pancreatic cancer. METHODS: IgG4 serum levels were examined In 106 patients with histologically confirmed pancreatic cancer. The level of 135 mg/dl was considered as the normal value. Pancreatic tissue was histologically examined with respect to the presence of markers of autoimmune pancreatitis. RESULTS: A higher IgG4 level than the cut-off value of 135 mg/dl was proven in 11 patients with pancreatic cancer. Of these 11 patients, 7 had levels twice the normal limit (65.6%). Autoimmune pancreatitis was diagnosed in these individuals. In the case of 1 patient, it was basically an unexpected finding; another patient was initially diagnosed with autoimmune pancreatitis. Repeated biopsy of the pancreas at the time of diagnosis did not confirm the presence of tumour structures, therefore steroid therapy was started. At a check-up 6 months after starting steroid therapy, the condition of the patient improved subjectively and IgG4 levels decreased. However, endosonographically, malignancy was suspected, which was subsequently confirmed histologically. This patient also demonstrated an IgG4 level twice the normal limit. CONCLUSION: IgG4-related diseases can be accompanied by the simultaneous occurrence of malignancies, which also applies to autoimmune pancreatitis. Chronic pancreatitis is considered a risk factor for pancreatic cancer. It cannot be reliably confirmed whether this also applies to autoimmune pancreatitis. In accordance with other works, however, it is evident that, despite the described high sensitivity and specificity for IgG4 elevation in the case of autoimmune pancreatitis, even levels twice the normal limit are demonstrable in some individuals with pancreatic cancer, without the presence of autoimmune pancreatitis. We believe that patients with IgG4-related disease, including autoimmune pancreatitis, must be systematically monitored with respect to the potential presence of malignancy.

7 Article Is physical activity a protective factor against pancreatic cancer? 2014

Kollarova, H / Azeem, K / Tomaskova, H / Horakova, D / Prochazka, V / Martinek, A / Shonova, O / Sevcikova, J / Sevcikova, V / Janout, V. · ·Bratisl Lek Listy · Pubmed #25246281.

ABSTRACT: OBJECTIVES: The objective of the study was to analyze an association between selected factors and pancreatic cancer, assuming that knowing the etiology would help influence the incidence of this severe type of cancer through primary prevention. In addition to age, gender, BMI and education, the analysis aimed at assessing occupational and leisure-time physical activities with respect to pancreatic cancer. BACKGROUND: In numerous studies, physical activity is reported to be a protective factor against pancreatic cancer. METHODS: A case-control study was carried out in three centers in the Czech Republic in 2006-2009. RESULTS: The study comprised a total of 529 individuals, of which 309 were patients with pancreatic cancer and 220 were controls. Leisure-time physical activity showed a statistically significant inverse association with a crude odds ratio of 0.65 (95% CI 0.45-0.93), even after adjustment for other studied factors (OR =0.63, 95% CI 0.43-0.92). Conversely, for occupational physical activity, a positive association was only suggested. CONCLUSIONS: Leisure-time physical activity is a protective factor against the development of pancreatic cancer. Occupational physical activity was not confirmed as a protective factor against pancreatic cancer (Tab. 4, Fig. 1, Ref. 22).

8 Article [Pain in chronic pancreatitis and pancreatic cancer - treatment options]. 2014

Bojková, Martina / Klvaňa, Pavel / Svoboda, Pavel / Kupka, Tomáš / Martínek, Arnošt / Bojko, Marian / Dítě, Petr. · ·Vnitr Lek · Pubmed #24981695.

ABSTRACT: Treatment of pain is one of the main pillars of treatment of pancreatic diseases. Abdominal pain is a common and often debilitating symptom in patients with chronic pancreatitis and pancreatic cancer. Treatment involves abstinence from tobacco, alcohol and analgetics and adjunctive agents. Surgical and endoscopic treatment requires careful patient selection based on a detailed analysis of ductal anatomy. The limited possibilities of this therapy are patients without dilatation of the main pancreatic duct. Results of randomized trials suggest that the effect of surgical treatment is sustained over time and more efficient than the endoscopic treatment. Less frequently used options include EUS - assisted celiac plexus blockade, thoracoscopic splanchniectomia or total pancreatectomy with islet cell autotransplantation. These methods are rarely used when all other options have failed and only in carefully selected patients.

9 Article Physical activity and risk of pancreatic cancer in a central European multicenter case-control study. 2014

Brenner, Darren R / Wozniak, Magdalena B / Feyt, Clément / Holcatova, Ivana / Janout, Vladimir / Foretova, Lenka / Fabianova, Eleonora / Shonova, Olga / Martinek, Arnost / Ryska, Miroslav / Adamcakova, Zora / Flaska, Erik / Moskal, Aurelie / Brennan, Paul / Scelo, Ghislaine. ·Genetic Epidemiology Group, International Agency for Research on Cancer (IARC), 150 cours Albert Thomas, 69372, Lyon Cedex 08, France. ·Cancer Causes Control · Pubmed #24695987.

ABSTRACT: PURPOSE: Findings from epidemiological studies examining physical activity in relation to pancreatic cancer risk have suggested decreased risks for physical activity; however, the results are inconsistent. METHODS: The association between occupational and leisure-time physical activity and risk of pancreatic cancer was examined among 826 pancreatic cancer cases and 930 age-, sex- and center-matched controls from a large multicenter central European study in Czech Republic and Slovakia recruited between 2004 and 2012. Data on physical activity including type and dose (frequency, intensity, and duration) were examined using multivariable-adjusted logistic regression models. RESULTS: Occupational physical activity was not significantly associated with risk of pancreatic cancer [odds ratio (OR) 0.90, 95 % confidence interval (CI) 0.71-1.15]. A 35 % decrease in risk of pancreatic cancer was observed for regular leisure-time physical activity (OR 0.65, 95 % CI 0.52-0.87). The risk estimates were significant for low and moderate intensity of activity with the strongest protective effect among individuals who exercised during more than 40 weeks per year. The results for cumulated leisure-time physical activity assessed 1 year prior to diagnosis achieved the same level of risk reduction. In addition, stronger risk estimates for leisure-time physical activity were observed among women (men: OR 0.74, 95 % CI 0.54-1.01; women: OR 0.53, 95 % CI 0.37-0.75). The findings for female participants were stronger for intensity and frequency of leisure-time physical activity, in particular for light and moderate activity (OR 0.43, 95 % CI 0.25-0.75; and OR 0.57, 95 % CI 0.37-0.88, respectively). CONCLUSION: These results provide evidence for a decreased risk of pancreatic cancer associated with regular leisure-time physical activity.

10 Article [Pancreatic cancer and lifestyle factors]. 2013

Azeem, K / Sevčíková, J / Tomášková, H / Horáková, D / Procházka, V / Martínek, A / Shonová, O / Janout, V / Kollárová, H. ·Ústav preventivního lékařství, LF UP v Olomouci. ·Klin Onkol · Pubmed #23961856.

ABSTRACT: BACKGROUND: Pancreatic cancer is a serious cancer with unfavorable prognosis. Due to differences in the incidence of pancreatic cancer in different regions, it is clear that factors associated with lifestyle play an important role in the etiology. The aim of this study was to evaluate the impact of selected lifestyle factors in relation to pancreatic cancer. MATERIALS AND METHODS: The study included a total of 529 subjects, including 309 cases and 220 control subjects. Cases of newly diagnosed patients with pancreatic cancer who lived in the region were selected in hospitals in three centers (University Hospital Olomouc, University Hospital Ostrava, Hospital Ceske Budejovice). The control group was obtained in cooperation with selected general practitioners for adults, and it is a population control group. RESULTS: Analyses compared persons who reported consuming alcohol with those who do not consume alcohol. Results showed a statistically significant inverse association, even after adjustment for the other studied factors (OR = 0.57, 95% CI 0.36 to 0.89). When assessing leisure time physical activity, results showed statistically significant inverse association and 35% decrease in the risk (crude OR = 0.65, 95% CI 0.45 to 0.93), and this inverse association was confirmed after adjustment for other studied factors although the result is on the border of statistical significance (adjusted OR = 0.68, 95% CI 0.44 to 1.04). Drinking coffee and tea has only a marginal impact on the occurrence of pancreatic cancer, although the medium and high consumption of black tea was found increased risk by 90 or 44%, respectively. Smoking is considered a causal risk factor for pancreatic cancer, but in this study, a positive association was not found. The study found no statistically significant association between overweight and obesity. CONCLUSION: Physical activity, dietary measures that will lead to weight loss and education to non-smoking can have a significant impact on the primary prevention of cancer.

11 Article Body mass index and body size in early adulthood and risk of pancreatic cancer in a central European multicenter case-control study. 2011

Urayama, Kevin Y / Holcatova, Ivana / Janout, Vladimir / Foretova, Lenka / Fabianova, Eleonora / Adamcakova, Zora / Ryska, Miroslav / Martinek, Arnost / Shonova, Olga / Brennan, Paul / Scélo, Ghislaine. ·International Agency for Research on Cancer, Lyon, France. ·Int J Cancer · Pubmed #21520034.

ABSTRACT: The relationship between two measures of excess body weight, body mass index (BMI) and body size score, and risk of pancreatic cancer was examined among 574 pancreatic cancer cases and 596 frequency-matched controls from the Czech Republic and Slovakia enrolled between 2004 and 2009. Analyses using multivariable logistic regression showed an increased risk of pancreatic cancer associated with elevated quartiles of BMI at ages 20 [fourth quartile: odds ratio (OR) = 1.79, 95% confidence interval (CI): 1.23, 2.61] and 40 (fourth quartile: OR = 1.57, 95% CI: 1.09, 2.27) compared to the lowest quartile. Consistent results were observed for body size score at ages 20 (high versus low: OR = 1.66, 95% CI: 1.08, 2.57) and 40 (medium versus low: OR = 1.36, 95% CI: 1.00, 1.86), but no association was found for BMI and body size score at 2 years before the interview. Stronger risk estimates for BMI were observed in males than females, particularly at age 20, but the analysis of body size yielded similar estimates by sex. When considering excess body weight at both ages 20 and 40 jointly, the highest risk estimates were observed among subjects with elevated levels at both time periods in the analysis of BMI (OR = 1.86, 95% CI: 1.32, 2.62) and body size (OR = 1.53, 95% CI: 1.09, 2.13). These findings, based on two different measures, provide strong support for an increased risk of pancreatic cancer associated with excess body weight, possibly strongest during early adulthood.