THE RESULTS OF THE JAPANESE GASTRIC CANCER SOCIETY MORPHOLOGICAL CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION

S. Menbayev, E. Izhanov, D. Kaidarova, T. Goncharova, E. Saparova, T. Belikhina, A. Borombayev, R. Raskaliev, A. Kabdrakhieva, K. Soltangazin, E. Nasibullin
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Abstract

Relevance: Gastric cancer (GC) morbidity is growing in Kazakhstan every year. In 2022, 2 915 new GC cases were detected (15 per 100,000 population), making GC the third most common cancer. The early detection rate of GC does not exceed 10-20%, and advanced forms of GC are over 40%. Mortality increases in the first year after the diagnosis (up to 40%). The best way of solving early detection of gastric cancer is carrying out diagnostics at the stage of pre-tumor stomach diseases. Timely diagnosis and treatment of surgical and borderline diseases of the upper gastrointestinal tract (metaplastic and dysplastic changes in the mucous ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ Онкология и Радиология Казахстана, №4 (70) 2023 17 membrane of the esophagus, stomach, and duodenum and adenocarcinomas and early cancer arising against this background) are a complex medical and social problem. Endoscopic methods for diagnosing esophagus, stomach, and duodenum diseases are the most highly informative nowadays. However, precancerous changes (atrophy, metaplasia, and dysplasia) in conventional endoscopic examination may not have specific features. It is necessary to improve the results of endoscopic diagnosis. The chromoscopy method may be one of the methods used to identify precancerous pathology and GC methods. The study aimed to increase the efficiency of gastric cancer early detection by adapting the morphological classification of the Japanese Gastric Cancer Society (JGCA) for the Kazakh population. Methods: We conducted endoscopic studies of 500 residents of the Republic of Kazakhstan using chromoscopy and morphological studies of the biopsy obtained during endoscopic examination. These patients had digestive system problems but previously did not have a GC diagnosis. We formed the risk groups according to JGCA (editions 13th and 14th). Results: We identified 3(0.6%) morbidity of severe dysplasia according to the results of 500 patients’ biopsy samples morphological study. This morphological structure is classified as a well-differentiated adenocarcinoma. We recommended a surgical treatment for identified patients. Conclusion: The identified cases of obligate pre-cancer with an extremely high probability of degeneration into a malignant neoplasm prove the importance of using JGCA for the early diagnosis of gastric cancer and allow us to recommend the use of chromoscopy in stomach endoscopic examination.
日本胃癌协会形态学分类法对哈萨克斯坦人的适应性研究结果
相关性:哈萨克斯坦的胃癌(GC)发病率逐年上升。2022 年,新发现胃癌病例 2 915 例(每 10 万人中有 15 例),使胃癌成为第三大常见癌症。GC 的早期发现率不超过 10-20%,晚期 GC 的发现率超过 40%。确诊后第一年的死亡率会上升(高达 40%)。 解决胃癌早期发现的最佳方法是在肿瘤前胃病阶段进行诊断。及时诊断和治疗上消化道的外科疾病和边缘疾病(粘膜的变性和发育不良变化黏膜的移行性和增生性变化)的及时诊断和治疗、食管、胃和十二指肠膜以及在此背景下产生的腺癌和早期癌症)是一个复杂的医学和社会问题。 目前,诊断食道、胃和十二指肠疾病的内窥镜方法信息量最大。然而,传统内窥镜检查中的癌前病变(萎缩、变性和发育不良)可能没有特异性。因此有必要改进内窥镜诊断的结果。色镜检查法可能是用于鉴别癌前病变和 GC 方法的方法之一。 本研究旨在通过调整日本胃癌协会(JGCA)的形态学分类,提高哈萨克斯坦人群胃癌早期检测的效率。 研究方法我们对哈萨克斯坦共和国的 500 名居民进行了内窥镜检查,使用了色内窥镜并对内窥镜检查中获得的活检组织进行了形态学研究。这些患者都有消化系统问题,但之前并未确诊为消化道癌症。 我们根据 JGCA(第 13 版和第 14 版)划分了风险组。 结果根据 500 例患者活检样本的形态学研究结果,我们发现了 3 例(0.6%)严重发育不良的病例。 这种形态结构被归类为分化良好的腺癌。我们建议对发现的患者进行手术治疗。 结论已发现的具有极高变性为恶性肿瘤可能性的强制性癌前病变病例证明了使用 JGCA 进行胃癌早期诊断的重要性,并使我们能够建议在胃内窥镜检查中使用色镜。
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