GASTROENTEROLOG GASTROENTEROLOG Y, Y, LABORATORY LABORATORY DIAGNOSTI DIAGNOSTI CS CS - - CASES CASES MUDr.Petr Kocna CSc. http://www.lf1.cuni.cz/~kocna/pkweb1.htm MUDr.Petr Kocna CSc. MUDr.Petr Kocna CSc. http://www.lf1. http://www.lf1. cuni cuni . . cz cz /~ /~ kocna kocna /pkweb1. /pkweb1. htm htm Seminar Seminar Medical Faculty Medical Faculty - - Pra Pra gue gue , , November November 20 20 12 12 Institute of Medical Biochemistry and Laboratory Diagnostics 1st Faculty of Medicine, Charles University General Faculty Hospital, Prague Institute of Medical Biochemistry and Laboratory Diagnostics Institute of Medical Biochemistry and Laboratory Diagnostics 1 1 st Faculty of Medicine, Charles University st Faculty of Medicine, Charles University General Faculty Hospital, Prague General Faculty Hospital, Prague
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Seminar Medical Faculty - Prague, November 2012SeminarSeminar Medical FacultyMedical Faculty -- PraPraguegue, , NovemberNovember 20201212
Institute of Medical Biochemistry and Laboratory Diagnostics1st Faculty of Medicine, Charles University
General Faculty Hospital, Prague
Institute of Medical Biochemistry and Laboratory DiagnosticsInstitute of Medical Biochemistry and Laboratory Diagnostics11st Faculty of Medicine, Charles Universityst Faculty of Medicine, Charles University
General Faculty Hospital, PragueGeneral Faculty Hospital, Prague
CCOLOREOLORECCTTAAL L CANCER SCREENINGCANCER SCREENING
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
CCOLOREOLORECCTTAAL L CANCER SCREENINGCANCER SCREENING
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
44
GASTRITIS - CARCINOMA SEQUENCESGASTRITGASTRITIS IS -- CCARCINOMARCINOMA SEQUENCESA SEQUENCES
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
55
Male - J.N. - IT specialist - born 1978in childhood common childhood diseases,
none of injury, none of hospitalization, parents in healthy,severe disease in the family - who do not know.Now does not have any subjective complainrts.
MaleMale -- J.N. J.N. -- ITIT specialisspecialistt -- born born 19719788in childhood common childhood diseasesin childhood common childhood diseases,,
none of injury, none of hospitalizationnone of injury, none of hospitalization,, parents in healthyparents in healthy,,severe disease in the family severe disease in the family -- who do not knowwho do not know..Now does not have any subjective complainrts.Now does not have any subjective complainrts.
CASE: 12-01CASECASE:: 1212--0101
Comes to LG laboratories with requirement for Hp test - UBTComes to LG laboratories with requirement for Hp test Comes to LG laboratories with requirement for Hp test -- UBTUBT
On the internet he found - Hp is cancerogen of the 1.classOn theOn the internetinternet he foundhe found -- HpHp isis ccancerogenancerogen of the of the 11..classclass
On the internet he found - LG laboratory, non-invasive Hp testOn theOn the internetinternet he foundhe found -- LGLG laboratolaboratory, nonry, non--invainvassivivee Hp Hp testtest
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
66
13C-UBT performed on the individual wish (self-paying)Value of 13C DOB – 14.1 ‰, Hp - positive
( Normal values up to DOB 5 ‰ )
1313CC--UBTUBT performed on the individual wish (selfperformed on the individual wish (self--paying)paying)Value of Value of 1313C DOB C DOB –– 14.1 ‰, 14.1 ‰, HpHp -- popossitivitivee
( ( NormNormaall values up to values up to DOB DOB 55 ‰ )‰ )
Comes to GE ambulance with requirement foreradication therapy, which the alone cannot pay
Comes toComes to GE ambulance GE ambulance with requirement forwith requirement foreradieradication cation tthheraperapyy,, which the alone cannot paywhich the alone cannot pay
On the internet he found - suitable eradication therapyOn theOn the internetinternet he foundhe found -- suitablesuitable eeradiradiccaation therapytion therapy
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
European Helicobacter Pylori Study GroupCurrent Concepts in the Management of
European Helicobacter PyloriEuropean Helicobacter Pylori StudyStudy GroupGroupCurrent Concepts in theCurrent Concepts in the Management ofManagement of
WHO TO TREAT - STRONGLY RECOMMENDED INDICATIONSWHO TO TREAT WHO TO TREAT -- STRONGLY RECOMMENDED INDICATIONSSTRONGLY RECOMMENDED INDICATIONS
DU/GU (active or not, including complicated PUD) 1
MALToma 2
Atrophic gastritis 2
Post-gastric cancer resection 3
Patients - first degree relatives of gastric cancer patients 3
Patients wishes (after full consultation with their physician) 4
DUDU//GUGU ((active oractive or not,not, including complicatedincluding complicated PUD)PUD) 11
MALTomaMALToma 22
AtrophicAtrophic gastritisgastritis 22
PostPost--gastric cancer resectiongastric cancer resection 33
PatientsPatients -- first degree relatives of gastric cancer patientsfirst degree relatives of gastric cancer patients 33
Patients wishesPatients wishes ((after full consultation with their physicianafter full consultation with their physician)) 44
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
HCl HCl
88
HOW TO PREDICT RESULT of Hp INFECTIONHOW TO PREDICT RESULT of Hp INFECTIONHOW TO PREDICT RESULT of Hp INFECTION
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
99
Suspected - Gastritis - Hp infection - Gastric-cancer Suspected Suspected -- Gastritis Gastritis -- HpHp infecinfection tion -- GastricGastric--cancer cancer
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
negative Hp,normal PGI/PGII
normal G-17b
negative Hp,normal PGI/PGII
normal G-17b
positive Hp,normal PGI/PGII
normal G-17b
positive Hp,normal PGI/PGII
normal G-17b
Hp +/-,low PGI/PGIIhigh G-17b
Hp +/-,low PGI/PGIIhigh G-17b
positive Hp,low PGI/PGII
low G-17b
positive Hp,low PGI/PGII
low G-17b
No risk of a stomach disease
No risk of No risk of a a sstomachtomach diseasedisease
Increased risk ofgastric or duodenal
ulcer
IncreasedIncreased risk ofrisk ofgastric or duodenalgastric or duodenal
ulcerulcer
Increased risk ofgastric cancer
IncreasedIncreased risk ofrisk ofgastric cancergastric cancer
detection HpPGI/PGII, G-17b
detection HpPGI/PGII, G-17b
H. pylori gastritisH.H. pyloripylori gastritisgastritis Atrophic gastritis Atrophic gastritiAtrophic gastritis s
Rationale in diagnosis and screening of atrophic gastritis with stomach-specific plasma biomarkers. Agréus L, Kuipers EJ, Kupcinskas L, Malfertheiner P, et al.
Scand J Gastroenterol. 2012; 47(2):136-147
Rationale in diagnosis and screeningRationale in diagnosis and screening ofof atrophicatrophic gastritisgastritis with stomachwith stomach--specific specific plasmaplasma biomarkersbiomarkers.. AgréusAgréus L,L, KuipersKuipers EJ,EJ, KupcinskasKupcinskas L,L, MalfertheinerMalfertheiner P,P, et alet al..
Hp INFECTION DIAGNOSTICHp INFECHp INFECTION TION DIAGNOSTIDIAGNOSTICC
non-invasive test, gold standard, specificity and sensitivity 95% - 13C UBT, breath test with 13C-urea
non-invasive test, if 13C-UBT not available, Hp antigen in stool
rapid urease test (CLO test) - if the gastroscopy clinically indicated, required bioptic samples from at least three different gastro-duodenal positions
IgA-IgG antibodies determination in serum does not have primary diagnostic importance, as positivity to Hp-antibodiesin subjects > 60 years could be 85%
non-invasive test, gold standard, specificity and sensitivity 95% - 13C UBT, breath test with 13C-urea
non-invasive test, if 13C-UBT not available, Hp antigen in stool
rapid urease test (CLO test) - if the gastroscopy clinically indicated, required bioptic samples from at least three different gastro-duodenal positions
IgA-IgG antibodies determination in serum does not have primary diagnostic importance, as positivity to Hp-antibodiesin subjects > 60 years could be 85%
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
CCOLOREOLORECCTTAAL L CANCER SCREENINGCANCER SCREENING
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
1122
Woman - L.J. - born 1972in childhood anemic, asthenic, often in sanatoria,
mother and sister followed for thyreopathyastheny, height 171 cm, weight 52 kg
menarche at 15 years, married,at the time of diagnosis (2005) after 1 spont. abortion 1994
WomanWoman -- L.J. L.J. -- born born 19721972in childhoodin childhood anemicanemic, , asthenicasthenic, , often in sanatoria,often in sanatoria,
mother and sister followed for mother and sister followed for thyreopatthyreopathyhyasthenasthenyy, , heightheight 171171 cm, cm, weightweight 5252 kgkg
menarchmenarchee atat 15 15 yearsyears, , married,married,at the time of diagnosisat the time of diagnosis (2005) (2005) afterafter 1 spont. 1 spont. abortionabortion 19941994
CASE: 12-02CASECASE:: 1212--0202
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
1313
2005 admitted to gastroenterology clinic
with requiremed of colonoscopy for hypochrome anemia
Colonoscopy - normal findings
Histology of bioptical samples - normal findings
2005 2005 admitted to admitted to gastroenterologgastroenterology cy clinilinicc
with requiremed of colonoscopy for with requiremed of colonoscopy for hypochypochhromromee anemianemiaa
CColoolononossccopopyy -- normnormaal l findingsfindings
Histology of bioptical samplesHistology of bioptical samples -- normnormaal l findingsfindings
CASE: 12-02CASECASE:: 1212--0202
Routine laboratory test indicatedRoutine laboratory test indicatedRoutine laboratory test indicated
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
1515
coeliac screening markers - 11/4/05:
IgA anti-transglutaminase 132 U/ml
IgA anti-gliadin 30 U/ml
IgG anti-gliadin 132 U/ml
IgA anti-endomysium - positive
ccooeliaeliac screening markers c screening markers -- 11/4/05:11/4/05:
IgA antiIgA anti--transglutamintransglutaminasease 132 U/ml132 U/ml
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
1818
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
C. Briani et al. / Autoimmunity Reviews 7 (2008) 644–650C.C. Briani et alBriani et al. /. / Autoimmunity ReviewsAutoimmunity Reviews 7 (2008) 6447 (2008) 644––650650
Definitive diagnosis of CDDefinitive diagnosis of CD
Gluten free dietGluten free diet
HLA HLA typitypingng,,bbiopsiopsy rey re--evaluationevaluation
New ESPGHAN guidelines for the diagnosis of Coeliac Disease inChildren and Adolescents - Steffen Husby, Odense University Hospital, Denmark
New ESPGHAN guidelines for the diagnosis ofNew ESPGHAN guidelines for the diagnosis of CoeliacCoeliac Disease inDisease inChildren and Adolescents Children and Adolescents -- SteffenSteffen HusbyHusby,, OdenseOdense University Hospital, DenmarkUniversity Hospital, Denmark
Definitive diagnosis of CDDefinitive diagnosis of CD
Normal dietNormal dietFurther serology testingFurther serology testing
IgA EmAIgA EmA
EmA positiveEmAEmA positivepositive
1199
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Old and new serological tests for celiac disease screening.Volta U., Fabbri A., Parisi C. et al. Expert Rev. Gastroenterol. Hepatol. 2010, 4(1)
Old and new serological testsOld and new serological tests forfor celiac disease screeningceliac disease screening..Volta U.,Volta U., FabbriFabbri A., Parisi C.A., Parisi C. et alet al. Expert. Expert RevRev.. GastroenterolGastroenterol.. HepatolHepatol. 2010, 4(1). 2010, 4(1)
INCREASE OF IgA atTG SPECIFICITYINCREASEINCREASE OFOF IgA atTGIgA atTG SPECIFICITYSPECIFICITY INCREASE OF IgA atTG SPECIFICITYCOELIAC DETECTION WITH IgA DEFFICIENCYCOELIAC DETECTION IN CHILDRENS < 2 YR
INCREASE INCREASE OFOF IgA atTGIgA atTG SPECIFICITYSPECIFICITYCOELIAC DETECTION WITHCOELIAC DETECTION WITH IgAIgA DEFDEFFICIENCYFICIENCYCOELIAC DETECTIONCOELIAC DETECTION IN CHILDRENSIN CHILDRENS < 2 YR< 2 YR
COELIAC DETECTION WITH IgA DEFFICIENCYCOELIAC DETECTION WITHCOELIAC DETECTION WITH IgAIgA DEFDEFFICIENCYFICIENCY
COELIAC DETECTION IN CHILDRENS < 2 YRCOELIAC DETECTIONCOELIAC DETECTION IN CHILDRENSIN CHILDRENS < 2 YR< 2 YR
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
INTESTINAL BIOPSY IN THE COELIAC DISEASE DIAGNOSTICSINTESTINAL BIOPSY IN THE COELIAC DISEASE DIAGNOSTICSINTESTINAL BIOPSY IN THE COELIAC DISEASE DIAGNOSTICS
Clinical practice - Coeliac disease - Eur J Pediatr. - online March 2012C. M. Frank Kneepkens & B. Mary E. von Blomberg
ClinicalClinical practicepractice -- Coeliac diseaseCoeliac disease -- EurEur J Pediatr. J Pediatr. -- online Marchonline March 20122012C. M. FrankC. M. Frank KneepkensKneepkens & B. Mary E.& B. Mary E. von Blombergvon Blomberg
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
NormNormaall duodenalduodenalmusocamusoca
Mosaic pattern of duodenal mucosaMoMossaiaic pattern of c pattern of duodenal mucosaduodenal mucosa
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Alvine Pharmaceuticals Reports Positive Results With ALV003 In Phase 1 Trial of
Therapy In Development For Celiac DiseaseOctober 30, 2008
Alvine Pharmaceuticals Reports Positive Alvine Pharmaceuticals Reports Positive Results With ALV003 In Phase 1 Trial of Results With ALV003 In Phase 1 Trial of
Therapy In Development For Celiac DiseaseTherapy In Development For Celiac DiseaseOctoberOctober 30, 200830, 2008
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
0
10
20
30
40
50
1 3 5 7 9 11 13 15 17 19 21 23 25 27 290
10
20
30
40
50
1 3 5 7 9 11 13 15 17 19 21 23 25 27 29
day amount - mg gliadin/50kg weightday amount day amount -- mgmg gliadingliadin//50kg 50kg weightweight
Therapy errorFood with high gliadin level
Therapy errorTherapy errorFood with highFood with high gliadingliadin levellevel
250 g gluten free foodhigh - 9,9 mg gliadin
250 g 250 g gluten free foodgluten free foodhigh high -- 9,9 mg9,9 mg gliadingliadin
Hodnocení bezpečnosti potravin pro bezlepkovou dietu, Gabrovská D. VÚPP-Praha, 2009 - projekt 1B53002
Hodnocení bezpečnosti potravin pro bezlepkovou dietu, Hodnocení bezpečnosti potravin pro bezlepkovou dietu, Gabrovská D.Gabrovská D. VÚPPVÚPP--Praha, 200Praha, 20099 -- pprojektrojekt 1B530021B53002
GLUTEN FREE DIET - DAY QUANTITYGLUTEN FREE DIET GLUTEN FREE DIET -- DAY QUANTITYDAY QUANTITY
since 11/2005 complete gluten-free diet2008 gave birth to a healthy daughter, who has not coeliac,
follows the diet - is on remision
sincesince 11/2005 11/2005 completecomplete glutengluten--freefree dietdiet2008 2008 gave birth to agave birth to a healthy daughterhealthy daughter, , who has not coeliac,who has not coeliac,
follows the diet follows the diet -- is on remisionis on remision
coeliac specific antibodies - 24/4/06:
IgA anti-transglutaminase 2 U/ml
IgA anti-gliadin 7 U/ml
IgG anti-gliadin 29 U/ml
IgA anti-endomysium - negative
coeliac specific antibodies coeliac specific antibodies -- 24/4/06:24/4/06:
IgA antiIgA anti--transglutamintransglutaminasease 2 U/ml2 U/ml
IgA antiIgA anti--gliadin 7 U/mlgliadin 7 U/ml
IgG antiIgG anti--gliadin 29 U/mlgliadin 29 U/ml
IgA antiIgA anti--endomysium endomysium -- negativnegativee
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
tumor necrosis factor, TNFα 74,7 (normal up to 44 %)
interleukin, IL2 - 47,9 (normal up to 28 %)
immunologicalimmunological marmarkkerers s -- 24/7/12:24/7/12:
interfeinterferrron gammaron gamma,, IFNIFNγγ 57,757,7 (norma(normall up tolup tol 31 %)31 %)
tumor necrosis factor,tumor necrosis factor, TNFTNFα α 74,774,7 (norma(normall up toup to 44 %)44 %)
interleukin, interleukin, ILIL22 -- 47,947,9 (norma(normall up toup to 28 %)28 %)
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
H2 a 13C - BREATH TESTSHH22 aa 1313CC -- BREATH TESTSBREATH TESTS
3333
SMALL BOWEL ABSORPTION - FUNCTION TESTSSMALL BOWEL ABSORPTION - FUNCTION TESTS
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Hydrogen analyserHydrogen analyserLacto FANLacto FAN
1313--CC analyseranalyserHeliHeli FANFAN
Regression of lactose malabsorption in coeliac patients after receiving a gluten-free diet.
Scand J Gastroenterol. 2008;43(2):174-177
Regression of lactose malabsorption in coeliac patients Regression of lactose malabsorption in coeliac patients after receiving a glutenafter receiving a gluten--free diet.free diet.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
HISTOCHEMICAL DETECTIONOF LACTASE ACTIVITY IN THEENTEROCYTE BRUSH BORDERIMMUNOHISTOCHEMICAL TEST
CCOLOREOLORECCTTAAL L CANCER SCREENINGCANCER SCREENING
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
3366
Male - A.A. - born 1938history of gallbladder problems - (cholecystolithiasis)
hypertension treatment on Ca blockers, obesityDietary error - goulash, beer
Abdominal pain around the navel broadening in the back, vomitingS-amylase 20,2, C-reactive protein 1.day 5 g/l, calcium 1,85 mmol/l
Abdominal ultrasound - cholecystolithiasa
MMaleale -- AA..AA. . -- bornborn 19381938history of history of gallbladder problemsgallbladder problems -- (cholecystolithias(cholecystolithiasisis))
hypertension treatment on Ca blockers, obesityhypertension treatment on Ca blockers, obesityDietary error Dietary error -- goulash, beergoulash, beer
Abdominal pain around the navel broadening in the back, vomitingAbdominal pain around the navel broadening in the back, vomitingSS--amylase amylase 20,220,2, C, C--reactive protein 1.day 5 g/l, calcium 1,85 mmol/lreactive protein 1.day 5 g/l, calcium 1,85 mmol/l
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
3377
5.day - CT abdomenSevere acute necrotizing pancreatitis (more than 60%)
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
1-2 day dehydratation 7 day metabolic alkalosis11--2 day dehydratation 7 day metabolic2 day dehydratation 7 day metabolic alalkkalalosisosis
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
3399
CASE: 12-03CASECASE:: 1212--0303
Transfer to metabolic unit of 2nd. medical clinicTransferTransfer toto metabolicmetabolic unit of 2nd. medical cunit of 2nd. medical clinilinicc
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
45.den abdominal CT native and contrast - enhanced biphasic.In comparison with the presence of 8.9.08 slightly accentuated necrotic deposit in pancreatic body, about 39 x 30 mm, minor
hypodense districts in cauda of the pancreas which is the border width, with unsharp bounded. Pancreatic head not enlarged,
without any deposits. Dc. pankreaticus unextended. Peripancreatical fluid better highlightet, particular cranially
from the pancreas - 100 x 110 mm and anterior to the pancreas 110 x 60 mm, fluid collection up to the front of the left renal fascia.
Cholecystolithiasis. Fluidothrax right posterior 71 x 25 mm.
45.den abdominal CT native and contrast45.den abdominal CT native and contrast -- enhanced biphasic.enhanced biphasic.In comparison with the presence of 8.9.08 slightly accentuated In comparison with the presence of 8.9.08 slightly accentuated necrotic depositnecrotic deposit in pancreatic body, about 39 x 30in pancreatic body, about 39 x 30 mm, minor mm, minor
hypodensehypodense districts in cauda of the pancreas which is the border districts in cauda of the pancreas which is the border widthwidth, , with unsharpwith unsharp bounded. Pancreatic head not enlarged, bounded. Pancreatic head not enlarged,
without any deposits. Dc. pankreaticus unextended. without any deposits. Dc. pankreaticus unextended. Peripancreatical fluid better highlightet,Peripancreatical fluid better highlightet, particular cranially particular cranially
from the pancreas from the pancreas -- 100 x 110 mm and anterior to the pancreas 100 x 110 mm and anterior to the pancreas 110 x 60 mm,110 x 60 mm, fluid collection up to the front of the left renal fascia. fluid collection up to the front of the left renal fascia.
Cholecystolithiasis.Cholecystolithiasis. Fluidothrax right posterior 71 Fluidothrax right posterior 71 x 25 x 25 mmmm..
4040
45.day transfer to metabolic unit of 2nd. medical clinicintroduced naso-jejunal probe, pulled the drain, gradually increased
enteral nutrition to 2200 ml per day (2200 kcal, 85 g protein)Drugs: proton pump inhibitors (omeprazole 2x20 mg),
substituted pancreatic enzymes (Creon 25000j 3 x 1 cps),liquid free, probiotics. Conducted training for home
enteral nutrition and released to home care
45.45.dday transferay transfer toto metabolicmetabolic unit of 2nd. medical cunit of 2nd. medical cliniliniccintroduced nasointroduced naso--jejunal probejejunal probe,, pulled the pulled the drdraiainn, , gradually increased gradually increased
enteralenteral nutrition to 2200 ml per day (2200 kcal, 85 g protein)nutrition to 2200 ml per day (2200 kcal, 85 g protein)Drugs: proton pump inhibitors (omeprazole 2x20 mg),Drugs: proton pump inhibitors (omeprazole 2x20 mg),
substituted pancreatic enzymes (Creon 25000j 3 x 1 substituted pancreatic enzymes (Creon 25000j 3 x 1 cpscps)),,liquid liquid freefree,, probiotics. Conducted training for homeprobiotics. Conducted training for home
enteral nutrition and released to home careenteral nutrition and released to home care
The ICU 52 days, 55 days in the hospital, then home enteralnutrition 93 days, gradual transfer to oral intake.
The ICU 52 days, 55 days in the hospital, then home enteralThe ICU 52 days, 55 days in the hospital, then home enteralnutrition 93 days, gradual transfer to oral intakenutrition 93 days, gradual transfer to oral intake..
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
CASE: 12-03CASECASE:: 1212--0303
4411
Cholecystectomy performed after 5 months.Continued pancreatic enzyme application,
Creon 25000 - 3 x 1 cps, total 1,5 year with good effect.
CCholecysteholecystecctotomy performed after 5 months.my performed after 5 months.Continued Continued panpanccreatic enzymreatic enzyme application,e application,
CCreon 25000reon 25000 -- 3 x 1 3 x 1 cpscps, , total total 1,5 1,5 year with good eyear with good effffeect. ct.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
90.day - CT and contrast - enhanced abdominal natively.Conclusion: Compared with the measurement of 19.9.08
increased pancreatic pseudocyst extending peripherally to the mediastinum. Splenic vein thrombosis with colleterals at large
curvature of the stomach. Necrosis of the pancreatic body, relatively less is its head and tail. Small deposit in the liver,
90.d90.dayay -- CT and contrastCT and contrast -- enhanced abdominal natively.enhanced abdominal natively.Conclusion: Compared with the measurement of 19.9.08 Conclusion: Compared with the measurement of 19.9.08
increased pancreatic pseudocyst extending peripherally to the increased pancreatic pseudocyst extending peripherally to the mediastinum.mediastinum. Splenic vein thrombosis with colleterals at large Splenic vein thrombosis with colleterals at large
curvature of the stomach.curvature of the stomach. Necrosis of the pancreatic body, Necrosis of the pancreatic body, relatively less is its head and tail.relatively less is its head and tail. Small deposit in the liverSmall deposit in the liver,,
Pancreatic enzyme substitution discontinued,at this time gall diet without pancreatic substitution.
PPananccreaticreatic enzymeenzyme substitusubstitution tion discontinueddiscontinued,,at this time gall diet without pancreatic substitutionat this time gall diet without pancreatic substitution..
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Diagnosis of mild chronic pancreatitis (Cambridge classification)Sai JK, Suyama M, Kubokawa Y, Watanabe S.
World J Gastroenterol 2008 February 28; 14(8): 1218 - 1221Researchers Test the Value of ERPC for the Detection of Early Chronic Pancreatitis
Frei R. - Gastroent.Endoscop.News 2007, 58, 02
DiagnosisDiagnosis ofof mild chronic pancreatitismild chronic pancreatitis (Cambridge (Cambridge classificationclassification))SaiSai JK,JK, SuyamaSuyama M,M, KubokawaKubokawa Y,Y, WatanabeWatanabe S. S.
WorldWorld JJ GastroenterolGastroenterol 20082008 FebruaryFebruary 28; 14(8): 1218 28; 14(8): 1218 -- 12211221ResearchersResearchers TestTest the Valuethe Value of ERPC forof ERPC for the Detectionthe Detection ofof Early Chronic PancreatitisEarly Chronic Pancreatitis
FreiFrei R. R. -- GastroentGastroent..EndoscopEndoscop..NewsNews 2007, 58, 022007, 58, 02
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Diagnostic imaging for mild chronic pancreatitisDiagnostic imaging for mild chronic pancreatitisEndoscopic ultrasound (EUS)Endoscopic ultrasound (EUS)
Quantitative MRCP assessment of pancreatic exocrine reserve and itscorrelation with faecal elastase-1 in patients with chronic pancreatitis
Manfredi R. el al. Radiol med. - DOI 10.1007/s11547-011-0774-6
Quantitative MRCP assessment of pancreatic exocrine reserve and Quantitative MRCP assessment of pancreatic exocrine reserve and itsitscorrelation with faecal elastasecorrelation with faecal elastase--1 in patients with chronic pancreatitis1 in patients with chronic pancreatitis
Manfredi R. el al. Radiol med. Manfredi R. el al. Radiol med. -- DOI 10.1007/s11547DOI 10.1007/s11547--011011--07740774--66
MRCP - SECRETION VOLUMEMATHEMATICAL PROCEDUREPANCREATIC FUNCTION TEST
MRCP MRCP -- SESECCRERETION VOLUMETION VOLUMEMATHEMATICAL PROCEDUREMATHEMATICAL PROCEDUREPANPANCCREATIC FUNCREATIC FUNCTION TESTTION TEST
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
EXOCRINE PANCRAETIC FUNCTION TESTSEXOEXOCCRINRINEE PANPANCCRAETRAETIC FUNCTION TESTSIC FUNCTION TESTS
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
EXOCRINE PANCRAETIC FUNCTION TESTSEXOEXOCCRINRINEE PANPANCCRAETRAETIC FUNCTION TESTSIC FUNCTION TESTSBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
13C- MTG BREATH TEST 1313CC-- MTG BREATH TEST MTG BREATH TEST
4477
peroraladminitration
peroralperoraladminitrationadminitration
enzymichydrolytic
GIT function
enzymicenzymichydrolytichydrolytic
GIT GIT funcfunctiontion
13C 1313C C
absorptionabsorpabsorptiontion
13C 1313C C
eliminationeliminaeliminationtion
measurementof 13C/12C ratiomeasurementmeasurementof of 1313C/C/1212CC ratioratio
cummulativeCO2 output
ccuummmulmulativeativeCOCO22 outputoutput
cPDRcPDRcPDR
13CO21313COCO22
CO2 excretionCOCO22 excretionexcretion
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
4488 Kahl S., Best Pract.Res.Clin.Gastro. 2004KahlKahl SS., ., Best PractBest Pract..ResRes..ClinClin..GastroGastro. . 20020044
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Amarri S. et al.: Archives of Disease in Childhood 1997; 76: 349–351
13Carbon13Carbon mixed triglyceride breathmixed triglyceride breath testtestand pancreaticand pancreatic enzymeenzyme supplementation in cystic fibrosissupplementation in cystic fibrosis
AmarriAmarri S.S. et alet al.:.: ArchivesArchives ofof Disease in ChildhoodDisease in Childhood 1997; 76: 3491997; 76: 349––351351
CF without enzyme therapy2400 IU lipase/kg/food4800 IU lipase/kg/food
CFCF without enzyme therapywithout enzyme therapy2400 IU lipase2400 IU lipase//kgkg//foodfood448800 IU lipase00 IU lipase//kgkg//foodfood
cPDR 13CcPDRcPDR 1313CC
4499
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
13C-MTG - BREATH TEST WITH MIXED TRIGLYCERIDE13C-MTG - BREATH TEST WITH MIXED TRIGLYCERIDE
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
13C-MTG - BREATH TEST & FECAL ELASTASE13C-MTG - BREATH TEST & FECAL ELASTASE
13C-MTG - BREATH TEST & FECAL ELASTASE13C-MTG - BREATH TEST & FECAL ELASTASEBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
5522
13C-breath test provides a comprehensive assessment of MTG digestive process - digestion of lipids
Values of cPDR 13C-MTG test are cummulative data, which includes as well the pancreatic function, as substitution therapy
Cut-off value of cPDR 13C-MTG test, lower limit of normalsestablished by mathematical approximation is 30%
To assess exocrine pancreatic function testing is an appropriatecombination of 13C -MTG breath test and determination of faecal elastase 1, affecting various aspects
Economical benefit of exocrine pancreatic function tests is in possibility to exclude pancreatic substitution therapy in more than three-fourths patients with suspected pancreatic insufficiency.
13C-breath test provides a comprehensive assessment of MTG digestive process - digestion of lipids
Values of cPDR 13C-MTG test are cummulative data, which includes as well the pancreatic function, as substitution therapy
Cut-off value of cPDR 13C-MTG test, lower limit of normalsestablished by mathematical approximation is 30%
To assess exocrine pancreatic function testing is an appropriatecombination of 13C -MTG breath test and determination of faecal elastase 1, affecting various aspects
Economical benefit of exocrine pancreatic function tests is in possibility to exclude pancreatic substitution therapy in more than three-fourths patients with suspected pancreatic insufficiency.
EXOCRINNE PANCREATIC FUNCTION TESTSEXOCRINNE PANCREATIC FUNCTION TESTS
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
CCOLOREOLORECCTTAAL L CANCER SCREENINGCANCER SCREENING
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
5544
Colorectal carcinoma is the most common tumor of the GE tractIn the Czech Republic (2008) was diagnosed 8236 subjects with CRC,
on CRC died 4313 patients, more than 50% of the mortality is due to the high proportion of patients diagnosed in advanced stages III and IV
Screening over 50 years - the target population in the Czech Republic includes 3,782,524 subjects
FOBT/TOKS screening test was carried out in 2010 only in 370,905 persons, ie. 9.8%
FOBT/TOKS + indicated colonoscopyin 2009 found only 618 CRC of 8236 diagnosed CRC, which is only 7.5%
Colorectal carcinoma is the most common tumor of the GE tractColorectal carcinoma is the most common tumor of the GE tractIn the Czech Republic (2008) was diagnosed 8236 subjects with CRIn the Czech Republic (2008) was diagnosed 8236 subjects with CRC, C,
on CRC died 4313 patients, on CRC died 4313 patients, more than 50%more than 50% of the mortality is of the mortality is due to the high proportion of patients diagnosed in due to the high proportion of patients diagnosed in advanced advanced stages III and IVstages III and IV
Screening over 50 years Screening over 50 years -- the target population in the Czech Republic the target population in the Czech Republic includes includes 3,782,524 3,782,524 subjectssubjects
FOBT/TOKS FOBT/TOKS screening test was screening test was carried outcarried out in 2010 only in 2010 only in in 370,905 370,905 persons, iepersons, ie. . 9.8% 9.8%
FOBT/TOKS + indicated FOBT/TOKS + indicated colonoscopycolonoscopyin 2009in 2009 found only 618 found only 618 CRCCRC of of 82368236 diagnosed diagnosed CRCCRC, , which is only 7.5% which is only 7.5%
Recommendations for the Ministry of Health Commission proposes a solution which enables
1. increase the number of subjects with FOBT/TOKS2. increase the detection of early CRC with more accurate test TOKS
regional cooperation with general practitionersand offer quantitative FIT for FOBT/TOKS
Recommendations for the Ministry of Health Commission Recommendations for the Ministry of Health Commission proposes a solution which enablesproposes a solution which enables
1. 1. increase the numbeincrease the number of subjectsr of subjects with FOBT/with FOBT/TOKSTOKS2. 2. increase the detection of early increase the detection of early CCRC RC with more accurate testwith more accurate test TOKSTOKS
regional cooperation with general practitionersregional cooperation with general practitionersand offer quantitative and offer quantitative FIT for FOBT/TOKSFIT for FOBT/TOKS
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
gg--FOBT FOBT WITH SENSITIVITY < WITH SENSITIVITY < 30% 30% USED TILL 31.12. 2012USED TILL 31.12. 2012
Commitee of CRC screening at Ministry of health CR, July 2012Commitee of CRC screening at Ministry of health CR, July 2012Commitee of CRC screening at Ministry of health CR, July 2012
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
2 TIMES HIGNER SENSITIVITY OF 2 TIMES HIGNER SENSITIVITY OF ii--FOBTFOBTss TO GUAJAC gTO GUAJAC g--FOBTsFOBTs
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
AA Quantitative Immunochemical Fecal Occult BloodQuantitative Immunochemical Fecal Occult Blood Test forTest for Colorectal NeoplasiaColorectal Neoplasia
ng Hb/mlng Hbng Hb/ml/ml SYMPTOMATIC SUBJECTS FOR COLONOSCOPYSYMPTOMATIC SUBJECTS FOR CSYMPTOMATIC SUBJECTS FOR COLONOSOLONOSCCOPOPYY
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
gg--FOBTFOBT ii--FOBTFOBTINVIATIONINVIATION 10 30110 301 10 32210 322PARTICIPATIONPARTICIPATION 4 8364 836 6 1576 157POSITIVE FOB TESTPOSITIVE FOB TEST 117117 339339EXAMINATIONEXAMINATION 103103 280280POLYPS AND CANCERPOLYPS AND CANCER 8080 218218ADV.ADENOMAS AND CANCERADV.ADENOMAS AND CANCER 5757 145145COLORECTAL CANCERCOLORECTAL CANCER 1111 2424
DUTCH SCREENING STUDY 2008DUTCHDUTCH SCREENINGSCREENING STUDY 2008STUDY 2008
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BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Value defined by manufacturer (Eiken): 100 ng/mlValue defined by manufacturerValue defined by manufacturer (Eiken): (Eiken): 100 ng/ml100 ng/ml
OPTIMIZATION OF CUT-OFF VALUE FOR qFITOPTIMIZATION OF CUTOPTIMIZATION OF CUT--OFF VALUE FOR qFITOFF VALUE FOR qFIT
Improvements in colorectal cancer screening programmes – quantitative immunochemical faecal occult blood testing .
Kovářová J.T., Zavoral M., Zima T., Žák A., Kocna P. et al. Biomed Pap 2012, 156:143
Improvements in colorectal cancer screening programmes Improvements in colorectal cancer screening programmes –– quantitative quantitative immunochemical faecal occult blood testing . immunochemical faecal occult blood testing .
Kovářová J.T., Zavoral M., Zima T., Žák A., Kocna P. et al. BiomKovářová J.T., Zavoral M., Zima T., Žák A., Kocna P. et al. Biomed Pap 2012, 156:143ed Pap 2012, 156:143
Cutoff value determines the performance of a semi-quantitative immunochemical faecal occult blood test in a colorectal cancer screening programme.
van Rossum LG, van Rijn AF et al. Br J Cancer. 2009;101:1274
Cutoff value determines the performance of a semiCutoff value determines the performance of a semi--quantitative quantitative immunochemical faecal occult blood test in a colorectal cancer simmunochemical faecal occult blood test in a colorectal cancer screening programme.creening programme.
van Rossum LG, van Rijn AF et al. Br J Cancer. 2009;101:1274van Rossum LG, van Rijn AF et al. Br J Cancer. 2009;101:1274
Pilot study in the Czech Republic: 75 ng/mlPilot studPilot study in they in the CzechCzech RRepublic: epublic: 75 ng/ml75 ng/ml
Dutch study - GE specialization: 75 ng/mlDutchDutch studstudyy -- GE specializationGE specialization: : 75 ng/ml75 ng/ml
Dutch study - economical: 50 ng/mlDutchDutch studstudyy -- eecconomiconomicalal: : 50 ng/ml50 ng/mlCost-effectiveness analysis of a quantitative immunochemical test
for colorectal cancer screening.Wilschut JA, Hol L, Dekker E et al. Gastroenterology. 2011;141:1648
CostCost--effectiveness analysis of a quantitative immunochemical test effectiveness analysis of a quantitative immunochemical test for colorectal cancer screening.for colorectal cancer screening.
Wilschut JA, Hol L, Dekker E et al. Gastroenterology. 2011;141:1Wilschut JA, Hol L, Dekker E et al. Gastroenterology. 2011;141:1648648
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Higher Fecal Immunochemical Test Cutoff LevelsTerhaar sive Droste JS et al. Cancer Epidemiol Biomarkers Prev. 2011; 20(2)
Higher Fecal Immunochemical Test Cutoff LevelsHigher Fecal Immunochemical Test Cutoff LevelsTerhaarTerhaar sive Drostesive Droste JS et al. Cancer JS et al. Cancer EpidemiolEpidemiol Biomarkers Biomarkers PrevPrev. 2011; 20(2) . 2011; 20(2)
75
80
85
90
95
50 75 100 125 150 20075
80
85
90
95
50 75 100 125 150 200
sensitivitysensitivitysensitivity
specificityspecificityspecificity
ngng/ml/ml
Optimization of qFIT cut-off, for indication to colonoscopy: Indicate as much as possible, all pathology - with 15% healthy subjects ?
NOT indicate healthy subjects, but decrease sensitivity about 15% ?
Optimization of qFIT cutOptimization of qFIT cut--off, for indication to off, for indication to colonoscopycolonoscopy: : Indicate as much as possible, all pathology Indicate as much as possible, all pathology -- with with 15% healthy subjects15% healthy subjects ??
NOT indicate healthy subjects, but NOT indicate healthy subjects, but decrease sensitivity about 15%decrease sensitivity about 15% ??
BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.
Proteomics of colorectal cancer: overview of discovery studies and identification ofcommonly identified cancer-associated proteins and candidate CRC serum markers.
MOLECULAR BIOLOGYDNA CHIPs FOR COLORECTAL CANCER SCREENING
MOLEMOLECCULULAARR BIOLOGBIOLOGYYDNA DNA CHIPCHIPss FOR CFOR COLOREOLORECCTTAALL CCAANCER SCREENINGNCER SCREENING
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PreGen-Plus - DETECTION23 MOLECULAR MARKERS OF CR-CA
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BIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGY Kocna P.BIOCHEMICBIOCHEMICAL DIAGNOSTICS IN GASTROENTEROLOGYAL DIAGNOSTICS IN GASTROENTEROLOGY KocnaKocna P.P.