[The role of carbonic anhydrase IX in the progression of malignant tumors - a potential therapeutic target?] / A szénsavanhidráz IX szerepe a malignus daganatok progressziójában ­ lehetséges terápiás célpont?

Insufficient tissue perfusion in malignancies results in hypoxic areas, favoring neoplastic progression. Tumor cells under hypoxia undergo an adaptive program by activating alternative metabolic pathways, which is regulated by hypoxia inducible factor-1 (HIF1) in order to overcome microenvironmental changes. The expression of carbonic anhydrase IX (CAIX) is a prominent protective mechanism against intracellular acidosis occurring in cancer cells suffering from hypoxia. Due to the activity of CAIX, the restored intracellular pH (pHi) supports tumor cell proliferation and migration, while the compensatory extracellular acidosis contributes to immunoprotection and to chemo- and radioresistance. In vitro and animal model experiments showed that the chemotherapeutic efficiency could be significantly improved by the selective inhibition of CAIX, thus, its adjuvant therapeutic potential is under active investigation.

[The treatment of walled-off pancreatic necrosis. Review]. / A demarkált pancreasnecrosis kezelése. Irodalmi áttekintés.

Walled-off pancreatic necrosis is a late complication of severe acute pancreatitis that generally needs some interventions. The aim of this review is to analyse the indications, technical aspects and limits of these therapeutic options. The development of the walled-off pancreatic necrosis needs 4-6 weeks from the onset of the disease. The necrosectomy is recommended after this time. Endoscopic necrosectomy offers good results if the necrosis is in retrogastric or retroduodenal localisations. Open necrosectomy can be performed through the gastrocolic ligament or the mesocolon. It is suggested to complete necrosectomy with open or closed omental bursa drainage or packing. The transgastric necrosectomy does not need external drainage. Surgical procedures can be performed with laparoscopy either. In localized necrosis other minimal invasive approaches can be used. CONCLUSIONS: In addition to the transluminal endoscopic or minimal invasive necrosectomies different types of surgical procedures has an important role in the treatment of walled-off pancreatic necrosis. Orv. Hetil., 2016, 157(47), 1866-1870.