GASTRIC CANCER. CURRENT STATE OF MORBIDITY, DIAGNOSIS AND TREATMENT
About the author:
Chornobai A., Chornobai M., Myаsoedov S., Sorokin B.
Type of article:
According to calculations, every year on the globe with more than 1 million people with stomach cancer. In the vast majority of countries, the incidence of gastric cancer in men is 2 times higher than that of women. The level of disease varies widely enough, the maximum level of gastric cancer is noted in men in Japan (114,7 per 100 thousand), and the minimum –in white women in the United States (3,1). Helicobacter pylori is recognized as leading in the etiology of stomach cancer. In infected patients, this pathology arises 3.8 times more compared with uninfected patients. Endoscopic examination is one of the most informative methods for diagnosing gastric cancer. Endoscopic examination determines the boundary, the nature and form of tumor growth, the spread of infiltration to the esophagus, the presence of complications. The most promising, in terms of complex diagnosis of intramural and lymphogenic prevalence of the tumor process is the use of endoscopic ultrasound examination. The overall reliability of a spiral CT due to the implementation of a two-phase study on the background of oral and intravenous contrast 74%. In determining the metastases to the lymph nodes, the sensitivity, specificity and overall precision of SCT were 84%, 41% and 67% respectively. Today laparoscopic examination is a compulsory method in preoperative stomach cancer progression and should be performed routinely by all patients. The treatment of stomach cancer today includes the sequencing of the use of combined and complex methods for this pathology. The main single radical method of treating gastric cancer is surgical. However, the radicals of most operations are conditional, which is reflected in the poor results of treatment. Thus, within 5 years after radical operations, 20-50% of patients with localized (T1-2N0) and 40-90% of locally advanced tumors (T3-4N1-2) die from the progression of the disease. Randomized studies comparing the results of chemotherapy (FAMTX, FEMTX, ELF) and symptomatic therapy convincingly demonstrated that drug therapy increases the longevity of patients with a metastatic process from 3-5 months to 10-12 months.The introduction of new cytostatics: docetaxel, irinotecan, xeloda, oxaliplatin and the creation of new chemo-therapy regimens increased the survival rate of patients with metastable gastric Cancer by 1.7 times. Immune and target therapy gastric cancer as treatment methods are today on advanced positions in the treatment of malignant neoplasms. There is now a further study of the expression of genes and receptors in the gastric Cancer. These data make it possible to apply monoclonal antibodies to Rh monoclonal antibodies: hercyptin, tremelimumba (fully humanized CTLA-4 monoclonal antigen), nivolumab – (an antibody that blocks the interaction between Pd-1 and the corresponding Pd-L1 ligand), pemribrolimusab (monoclonal IgG4 antibody, which blocks the interaction of PD-1 with its PD-L1 and PD-L2 ligands. Recently, studies have been conducted on the safety and activity of pemribrolimusab in patients with gastric cancer. (40%) patients were PD-L1 positive. 41% of patients have a tumor reduction.
gastric cancer, morbidity, endoscopy, ultrasound examination, spiral computed tomography, surgical treatment, radiotherapy, chemotherapy, targeted therapy
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Publication of the article:
«Bulletin of problems biology and medicine» Issue 1 Part 1 (142), 2018 year, 62-67 pages, index UDK 116.33-006.6085.277.3