The telomerase effect. Oncological aspects of gastric stump cancer (methodology and literature review)

Aim . To assessing the prospects for the integral interdisciplinary characteristics of the modern strategy of oncological surgery for gastric stump cancer (GSC), which allow us to formulate the concept of a more physiological surgery. Materials and Methods . The study used gastrobiopsies taken specifically during fibrogastroscopy in the area of the anastomosis in patients who had undergone gastrectomy in the past for pyloroduodenal ulcers using the first and second Billroth methods. Depending on the time elapsed after gastrectomy, observations were divided into 2 groups. Results . In 45 patients with post‐resection gastritis (based on a morphometric, statistical study of the lymphoid tissue of the mucous membrane of the gastric stump), there was established: a significant (p <0.05) increase in the number of interepithelial lymphocytes (from 5.14 to 30.60) of the plasmatization index of the lamina propria of the mucous membrane in comparison with the control group (from 4.9 to 46.70), increasing in time after surgery, which is associated with the progression of atrophic gastritis. This relationship is most clearly observed (p<0.005) over 15 years after gastrectomy, according to Hoffmeister–Finsterer. Conclusions . A study of the components of the natural environment was carried out: sources of drinking water supply: phenol, manganese, copper, formaldehyde and in samples of pasture vegetation: iron, chromium, nickel, cadmium; with the establishment of inflated indicators (MPC). Early diagnosis in the preclinical stage with screening monitoring in the group of patients with resected stomach after 10 years or more remains extremely relevant. The hypothesis put forward by Yu.I. was confirmed to be correct by Fishson–Ryss that antral gastritis after gastric gastritis for peptic ulcer disease tends to antrocardial expansion with the progression of atrophic gastritis, which is a background component for the development of gastric stump cancer.