| Abstract [eng] |
It is a prospective monocentric biomedical study to evaluate key aspects of the pathogenesis of pancreatic ductal adenocarcinoma (PDAC) and periampullar tumors (including cancer biology, systemic inflammation, nutritional impairments), medical interventions, their interactions, and their impact on patient outcomes. A non-selective group of patients in routine clinical practice was studied. Particular attention was paid to the current unsolved problems in clinical practice - late and inaccurate diagnosis, insufficient diagnosis and treatment of nutritional disorders, lack of individualized precision medicine solutions. Quantitative plasma amino acid study was applied as an experimental method, significant results were obtained: significant differences of 11 amino acid concentrations in PDAC vs. other periampullar tumors, correlation of 3 amino acid concentrations (Asn, Aaba, His) with cancer stages, characteristic patterns of amino acid concentrations in relation to cancer stage, correlation of 3-methyl histidine - a specific skeletal muscle metabolite - with PDAC diagnosis. Significant and statistically significant differences in systemic inflammatory response rates were found: higher systemic inflammatory response rates (IL-6 levels) in PDAC before surgery. Preoperative immunonutrition statistically significantly reduced the incidence of multiple and severe complications in the overall patient sample. Various investigations of nutritional status were used - surveys, anthropometric measurements, instrumental and laboratory tests. Regression equations revealed a significant overall effect of nutritional indicators on the frequency and severity of complications. |
