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the Urgency of a problem and some risk factors

In structure of a case rate and a mortality of the population of the majority of the countries of the world the share of malignant neoplasms of organs of digestion makes more than 50 % [2].

In Russia 126,5 thousand new cases of a cancer of a gastroenteric tract (GASTROINTESTINAL TRACT) are annually registered, that makes about 30 % in structure of an oncologic case rate [2].

The carcinoma of the stomach is the form of malignant neoplasms second for frequency. Annually in the world 876,3 thousand new cases and 646,6 thousand morses from this disease [2,3,75] is registered. Its share makes 10 % of all malignant tumours [96,167,190].

In Russia with 1992 for 2002 the distinct tendency to reduction of indicators of a case rate by a carcinoma of the stomach (with 43,1 to 31,7 on 100 thousand at men and with 18,2 to 13,5 at women) [2,3,75,160] is observed.

The highest indicators of a mortality from a carcinoma of the stomach have been registered in China, Japan, Korea, Mongolia, Russia, Belarus, Kazakhstan [2,3,75,160,193].

In countries of Western Europe and the USA frequency of a carcinoma of the stomach much more low (9 on 100000), that reflects the tendency to reduction of its prevalence in the majority of economically developed countries [132,137].

Annually in the world are registered more than 944,7 thousand sick of a cancer colonic both a rectum and 492,4 thousand morses from it. In 2002 in Russia have taped 49,5 thousand new cases, and its share in the general structure onkozabolevaemosti has reached 10,3 % at men and 11,6 % at women. [3]

Case rate a cancer colonic and a rectum above in economically developed countries in comparison with the developing. The maximum indicators in Australia, the North America, Israel and Europe (32-60 on 100 thousand), relative high — in Kazakhstan, Kyrgyzstan, moderated — in the South America, the case rate in Africa and Asia, except for Japan in which it is equivalent European [3,27] is low.

In 2002 in Russia from a colorectal cancer has died 35,4 thousand persons. In structure of a mortality from malignant neoplasms the cancer of a colonic intestine occupies the third rangovoe a place from persons of both sexes, making at men of 5 %, at women of 8,5 %. Dynamics of a mortality from a colorectal cancer for 1992-2002 in Russia is rather stable (9 on 100000 and 6-7 accordingly at the man's and female population). [3,27]

In Russia the cancer of a colonic intestine is taped in 1,2 times more often, than a rectum cancer. [3]

The case rate malignant neoplasms of a blind and colonic intestine among men makes 11,6, and among women 9,2 persons on 100 thousand adult population. The case rate a rectum cancer has made (accordingly) among мужчині 1,0, and among women — 7,1 on 100 thousand [27]

Thus, the problem of diagnostics and treatment of a carcinoma of the stomach and a colon has social value. Early diagnostics of malignant tumours all over the world is for today one of the major problems of medicine as a whole and should take the central place in the field of social and economic priorities.

The case rate a carcinoma of the stomach among men almost twice exceeds a case rate among women and makes 32,8 on 100000 population [75]. At all forms of malignant neoplasms of organs of digestion, except for intestine tumours, men [2,3] is more often die.

Among all ill with a carcinoma of the stomach the share of patients aged is more senior 60 years has made 67,5 % at men and 76,9 % at women [2]. For women of advanced age ascending of number sick of a colorectal cancer with 63,2 to 68,9 % [2] is characteristic. Indicators at men in the senior age groups in 1,5-2 times exceed indicators at women.

In Russia among first five reasons of morses from malignant neoplasms at persons is more senior 60 years, after a lung and mammary gland cancer, the most frequent forms are a carcinoma of the stomach and an intestine [2,21,27,75].

The colon cancer extremely seldom meets at persons till 30 years. Most often PTK it is taped at persons is more senior 50 years, with gradual depression of level of a case rate in groups of the population after 75 years. But, despite accurate enough augmentation of frequency PTK in the senior age groups, even more often this disease is diagnosed at young age, especially by its linear and hereditary forms [6,27].

Appreciable differences in case rate level between separate groups of the population and regions is of interest for revealing of prospective risk factors of a cancer [72].

The carcinoma of the stomach meets the raised frequency at some diseases of a stomach which should be surveyed as background; a chronic atrophic gastritis, a chronic stomach ulcer and a stump of a stomach after a distal resection, stomach adenomatous polyps, an intestinal metaplasia and a hyperplastic gastropathy [98,146,154,168,194]. It is considered, that the atrophy mucous stomach bodies leads to a hypochlorhydria promoting formation of carcinogens, and an atrophic gastritis and a metaplasia, being hyperproliferative conditions, promote the perverted neogenesis and process of a mutagenesis with an outcome in a carcinoma [96,118].

Special value for development of a carcinoma of the stomach was got by the factor of presence Helicobacter pylori, provoking development of pathological processes in GASTROINTESTINAL TRACT. [135,141,149,155,179] In 1994 International agency on cancer studying has included Helicobacter pylori in the list of carcinogens of the first order. Prevalence HP in population of the developed countries makes 80-90 %. The share of cases of the carcinoma of the stomach, bound to presence of this bacterium, is estimated in 42 %. [92,121,122,129] this correlation is stronger is shown at the long period of a becoming infected in zones of the raised risk [71], in the senior age group [71,92,105].

The mechanism of influence Helicobacter pylori — assotsiirovannogo a carcinogenesis is bound to ability of a microorganism to cause expressed infiltrativnyj a gastritis with a proliferation of intersticial cells. The long period of an inflammation causes processes of an atrophy and a cellular metaplasia which should be surveyed as precancerous changes for development of a carcinoma of the stomach of intestinal type [36,92,105,129].

More often the carcinoma of the stomach is presented by adenocarcinomas which make 95 % of all malignant tumours of a stomach [37,45].

At a colorectal cancer colorectal polyps and inflammatory diseases of a colon (an ulcerative colitis) are considered as precancerous diseases. Though at all and not each polyp, especially in the size less than 1 sm, are transformed to a cancer, but such probability exists at appreciable number of these neoplasms [27]. Adenomas develop at 510 % of persons is more senior 40 years, but at the overwhelming majority proceed asymptomatically [103,127]. Frequency of development of adenomas with the years and in 50-59 years reaches 35 % [136]. The persons who are ill with an ulcerative colitis more ZOlet, have 60 % probability of development of a cancer of a thick intestine [13,147,161,163,191]. Illness a colon Crone also is accompanied by high risk of occurrence of a cancer of a thick intestine, but it is less, than at an ulcerative colitis [119,182]. At the same time to differentiate malignant transformation at this disease it is much more difficult (27). More often, colon neoplasms have adenocarcinoma structures (95,9 %) [6,27,140].

In Russia the cancer of a thick intestine in the big industrial cities was observed more often, than in a countryside [27]. Malignant tumours of a gastroenteric tract also concern those forms of a tumour at which social differences are shown: the colon cancer is more characteristic for the persons concerning a high social class, and the cancer of an esophagus and a stomach meets in less well-to-do of the population [41] is more often.

Also it is necessary to carry malignant tumours of other organs to risk factors. So, at the women having a cancer of a mammary gland, organs of genesial system the risk to be ill with a colon cancer is considerably enlarged. Besides, the patients who have transferred operation concerning a cancer of a thick intestine, have an occurrence high probability metahronnoj tumours both in a colon, and in other organs. [24,27,152]

One of the diseases, to development of a colorectal cancer the diabetes [13,24] is contributing. Naturally, there is a thought on great value of individual predisposition to the malignant neoplasms, caused by those or other biological characteristics of an organism, including genetic features, or sredovymi factors - bad habits, food conditions, background nonmalignant diseases.

The role of the genetic factor has been suspected of development of a carcinoma of the stomach because at persons with group of blood A (II) case rate above on 20 %, than at persons with group O (I) and B (III). [20,23,59,97] In tajvanskom research of patients with a carcinoma of the stomach were compared to control group [150]. Among patients the second group of blood met a carcinoma of the stomach more often (OJA 1,61, r

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A source: Beleninova Irina Arturovna. USE of MORPHOLOGICAL And BIOCHEMICAL CRITERIA of BLOOD FOR FORMATION of GROUPS of the RAISED RISK AT the CARCINOMA OF THE STOMACH And TOLSTOY of the INTESTINE. The dissertation on competition of a scientific degree of a Cand.Biol.Sci. Barnaul - 2005. 2005

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