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12МЕДИЦИНСКИЕ НАУКИ
THE CURRENT STATE OF THE INCIDENCE OF GASTRIC CANCER IN THE ANDIJAN REGION Mamarasulova D.Z.1, Mamadaliev M.M.2, Babakhanov A.T.3, Ikromov I.I.4, Poziljonov A.B.5, Solijonov O.N.6
1Mamarasulova Dilfuzakhon Zakirzhanovna - DSc, Associate Professor, DEPARTMENT OF ONCOLOGY AND MEDICAL RADIOLOGY, ANDIJAN STATE MEDICAL INSTITUTE;
Mamadaliev Muhammad Mamasadikovich - Deputy Director of
medical work;
Babakhanov Akhror Tillavoldievich - Head of Department, DEPARTMENT OF ABDOMINAL ONCOLOGY ANDIJAN BRANCH REPUBLICAN SCIENTIFIC AND PRACTICAL MEDICAL CENTER OF ONCOLOGY AND RADIOLOGY; 4Ikromov Isroil Islomzhon ugli - Master;
5Poziljonov Alijon Bohodirjon ugli - Master; 6Solijonov Otabek Nishonboy ugli - Master, DEPARTMENT OF ONCOLOGY AND MEDICAL RADIOLOGY ANDIJAN STATE MEDICAL INSTITUTE ANDIJAN, REPUBLIC OF UZBEKISTAN
Abstract: this review article discusses the current state of the incidence of gastric cancer in the Andijan region. In the structure of morbidity and mortality among all malignant neoplasms in most countries, gastric cancer occupies a leading position, second only to lung cancer in some countries. According to the RSPCM and the Andijan branch for 2017, 180 patients with gastric cancer were primarily registered in the Andijan region. In the structure of oncopathology of the republic, gastric cancer (gastric cancer) is 5.6%, ranking 1st among men and 3rd among women. Keywords: cancer, stomach, lungs, morbidity, mortality.
Relevance. Despite significant advances in both theoretical and practical oncology, much remains unclear in the treatment of
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gastric cancer, and therefore the search for possible ways to improve the existing modern methods of treatment for this category of patients remains relevant today [1, 5].
By the end of the twentieth century in many countries of the world there is a pronounced tendency to reduce the incidence of gastric cancer [2, 7], but, nevertheless, this pathology remains one of the most common types of malignant neoplasms in humans, leading to about half a million people annually.
In the structure of morbidity and mortality among all malignant neoplasms in most countries, gastric cancer occupies a leading position [5], second only to lung cancer in some countries. In Russia, gastric cancer ranks second in the structure of all malignant neoplasms and is about 15% [1]. Japan and Russia in the incidence of gastric cancer occupy a leading position in the world. For example, in Japan, the incidence of stomach cancer reaches 75 per 100,000, and in Russia - 26 per 100,000 [], in Uzbekistan [] this figure is 8-10 per 100,000 for 2005.
According to the RSPCM and the Andijan branch for 2017, 180 patients with gastric cancer were primarily registered in the Andijan region. In the structure of oncopathology of the republic, gastric cancer (gastric cancer) is 5.6%, ranking 1st among men and 3rd among women.
Among newly diagnosed patients with gastric cancer (2000), both in the CIS countries and in Uzbekistan, 66.6% have stage III-IV disease [2,3], which determines the treatment tactics and the corresponding prognosis in these patients. According to V.I. Chissov and co-authors, the 5-year survival of patients with stage IV gastric cancer does not exceed 4% [1, 4].
Treatment of patients with common forms of gastric cancer is usually palliative. In order to increase the effectiveness of treatment, these patients are increasingly being given combined treatment [5]. Surgical intervention is palliative and symptomatic in nature and is complemented by chemotherapy and / or radiation therapy in an attempt to reduce the further progression of the tumor process.
Thus, a significant group of patients with RJ can only rely on conservative treatment methods. For the early diagnosis of the
primary tumor, its metastases, and monitoring of radiation and chemotherapy, according to most authors, the definition of tumor markers (protein substances present in biological fluids of the body) is the most acceptable [4].
The tumor marker allows to differentiate a malignant tumor from a benign one on the basis of quantitative differences in the content of the corresponding antigen - a tumor marker in the blood serum, regardless of the location of the tumor focus. A tumor cell is capable of releasing 1 picogram (10-12 g) of a tumor marker into the blood of 1 mg of antigen, which, in terms of concentration, is about 200 ng / ml [6,7]. Testing methods often exceed this concentration in their sensitivity. Thus, an elevated level of markers is detected even at small tumor sizes [1, 7].
However, it has not yet been possible to develop a single strictly tumor-specific serological diagnosticum that can detect only a malignant tumor of a given histological type and detect its localization at the earliest possible stages of formation [3]. To some extent, it is possible to increase the efficiency of diagnostics by using a combination of various tumor markers in the testing process.
There are no specific biochemical markers for the diagnosis of gastric cancer. Cancer embryonic antigen (CEA), a glycoprotein with a high carbohydrate content, is produced in the tissues of the digestive tract of the embryo and fetus. After the birth of the fetus, its synthesis is suppressed and is practically not detected either in the blood or in other biological fluids of an adult healthy person. Cancer-embryonic antigen (CEA) has a pronounced immunogenicity [3, 6] and is found in almost all mucous-producing epithelial tumors, including in gastric cancer [1]. Its increased content is determined in well-differentiated tumors, to a lesser extent - in signato-cellular and rarely - in undifferentiated tumors. With RJ CEA, it is identified on average in 32% of cases, and in patients with a localized tumor it is less frequently expressed (0-29%) than in the presence of multiple metastases (up to 85%). The content of CEA in a tumor tissue does not always correlate with its level in blood serum [2], where it is usually determined for diagnostic purposes.
When using abdominal swabs for quantitative determination of CEA and cytological analysis, it was found that in patients with low antigen content, the 2-year survival rate was 100%, while at a high concentration it was only 21% [5]. In addition, in patients who subsequently died of cancer recurrence, an elevated level of CEA was noted in 91% of cases, whereas malignant cells were found in cytology only in 51% of patients [4, 7]. Therefore, the definition of this marker in washes from the abdominal cavity of patients with gastric cancer can be considered an important prognostic sign of the disease and serve as the basis for the appointment of additional special treatment.
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