10-летний катамнез больных раком желудка - дефекты диагностики и диспепсия, как самый ранний «тревожный признак»; результаты программы «радиус» («ранняя диагностика рака желудка при диспепсии»)

Л. Б. Лазебник, Е. И. Бусалаева,Н. Н. Дехнич, И. В. Долгалёв, М. В. Ефимова, А. А. Жилина, С. М. Жучкова, Г. М. Коновалова,М. А. Ливзан, Е. А. Лялюкова, М. В. Мокшина,В. А. Невзорова, Е. В. Онучина, М. М. Петрова, О. Ю. Позднякова, Л. В. Прохорова, И. В. Рогачева, Н. Н. Романова,А. С. Сарсенбаева, О. В. Стефанюк, М. Е. Тен, О. В. Хлынова, Е. Н. Чернышева, Т. Н. Янковая, Н. В. Павлова, Е. Д. Ли, Е. Н. Карева

Экспериментальная и клиническая гастроэнтерология(2021)

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Abstract
In 2019, a retrospective analysis of medical records for 10 previous years (2019-2009) was conducted for 426 patients with confirmed malignant neoplasm (MN) of the stomach registered in 125 outpatient and polyclinic medical and preventive treatment facilities in 12 cities of the Russian Federation. The average age of patients at the time of diagnosis was 61.9 years, the life expectancy after diagnosis being 2.2 years. In 67.4% of patients the diagnosis was made at stages III and IV of the disease. All patients had a history of any upper digestive tract pathology. The record of H. pylori c examination was detected in 16.9% of patients, all of them with positive results. In 64,3% of esophagogastroduodenoscopy (EGDS) protocols there were visible changes in the gastric mucosa. Dynamic EGDS control was performed irregularly. During the whole period of observation, an average of 2.5 biopsies per patient were taken during EGDS. In the clinical diagnosis of “chronic gastritis” morphological examination was performed in 70.0% of patients. Classical “warning signs” were registered on the average 2.4 years before the diagnosis of gastric cancer. Dyspepsia syndrome was registered 4.6 years before cancer verification. The correlation between dyspepsia and the timing of cancer diagnosis was confirmed. Thus, the dyspepsia syndrome can be categorized as “early warning signs”. For the diagnosis of gastric adenocarcinoma, 3D correlation analysis showed a correlation between the number of biopsy samples taken, the number of “warning signs” and the number of years lived after the diagnosis of malignant neoplasms.
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Key words
stomach cancer,dyspepsia,early diagnosis
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