vestimИзвестия Национальной академии наук Беларуси. Серия медицинских наукProceedings of the National Academy of Sciences of Belarus, Medical series1814-60232524-2350The Republican Unitary Enterprise Publishing House "Belaruskaya Navuka"10.29235/1814-6023-2019-16-4-391-403vestim-526Research ArticleКЛИНИЧЕСКАЯ И ЭКСПЕРИМЕНТАЛЬНАЯ МЕДИЦИНАCLINICAL AND EXPERIMENTAL MEDICINEЭндоскопическая и гистологическая оценка слизистой оболочки желудка у родственников лиц, страдающих раком желудкаEndoscopic and histological evaluation of the mucous membrane of the stomach in relatives of people suffering from cancer of the stomachКарпенкоО. В.KarpenkaV. V.

Карпенко Ольга Васильевна – ассистент. 

пр. Дзержинского, 83, 220116, г. Минск

Volha V. Karpenka – Assistant. 

83, Dzerzhynski Ave., 220116, Minsk

 

Olga-doc@tut.byГоргунЮ. В.GorgunJu. V.

Горгун Юлия Викторовна – доктор медицинских наук, профессор. 

г. Ораниенбург

Julia V. Gorgun – D. Sc. (Med.), Professor.

Oranienburg

julia.gorgun@mail.ruМитьковскаяН. П.MitkovskayaN. P.

Митьковская Наталья Павловна – доктор медицинских наук, профессор, заведующий кафедрой. 

пр. Дзержинского, 83, 220116, г. Минск

Natalia P. Mitkovskaya – D. Sc. (Med.), Professor, Head of the Department. 

83, Dzerzhynski Ave., 220116, Minsk

mitkovskaya1@mail.ruКраськоО. В.KraskoV. V.

Красько Ольга Владимировна – кандидат технических наук, доцент, ведущий научный сотрудник. 

ул. Сурганова, 6, 220012, г. Минск

Volha V. Krasko – Ph. D. (Eng.), Assistant Professor, Leading researcher.

6, Surganov Str., 220012, Minsk

krasko@newman.bas-net.byБелорусский государственный медицинский университетBelarusian State Medical UniversityОберхавель КлиникенOberhavel Kliniken GMBHОбъединенный институт проблем информатики НАН БеларусиUnited Institute of Informatics Problems of the National Academy of Sciences of Belarus201904122019164391403Copyright © Карпенко О.В., Горгун Ю.В., Митьковская Н.П., Красько О.В., 20192019Карпенко О.В., Горгун Ю.В., Митьковская Н.П., Красько О.В.Karpenka V.V., Gorgun J.V., Mitkovskaya N.P., Krasko V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://vestimed.belnauka.by/jour/article/view/526

Проведена оценка состояния слизистой оболочки желудка у родственников лиц, страдающих раком желудка (РЛРЖ). В исследование были включены 108 РЛРЖ (основная группа) и 102 пациента без семейного анамнеза рака желудка, проходивших обследование по поводу диспепсии. Все участники исследования проходили клинический осмотр, анкетирование и подвергались эзофагогастродуоденоскопии с биопсией для оценки состояния слизистой оболочки желудка в соответствии с модифицированной Сиднейской системой, системами OLGA и OLGIM, а также для определения наличия инфекции Helicobacter pylori (H. pylori). Установлено, что распространенность инфекции H. pylori в основной группе составила 58,3 % (95 % ДИ 48,8–67,7), в контрольной – 56,0 % (95 % ДИ 46,1–65,6). У РЛРЖ достоверно чаще, чем в контроле, обнаруживалась атрофия любой локализации (46,3 % (95 % ДИ 39,4–53,2) против 26,5 % (95 % ДИ 20,4–32,6) соответственно, p = 0,002), антральный атрофический гастрит (41,6 % (95 % ДИ 34,8–48,4) против 26,5 % (95 % ДИ 20,4–32,6) соответственно, p = 0,020), а также изолированная атрофия в теле желудка (4,6 % (95 % ДИ 1,7–7,4) против 0 % ( p = 0,03). У РЛРЖ атрофия развивалась в более молодом возрасте (48,0 года (95 % ДИ 44,0–52,0) против 53,0 года в контрольной группе (95 % ДИ 48,3–57,8), p < 0,001). По частоте выявления метаплазии и дисплазии значимых различий между пациентами групп не обнаружено. По результатам многофакторного анализа установлены следующие факторы риска развития атрофии: возраст старше 60 лет (отношение шансов (ОШ) 53,0; 95 % ДИ 12,2–390,1; p < 0,001), возраст старше 40 лет (ОШ 4,0; 95 % ДИ 2,0–8,2; p < 0,001), наследственность, отягощенная по раку желудка (ОШ 2,7; 95 % ДИ 1,4–5,7; p = 0,006) и употребление крепких алкогольных напитков (ОШ 5,5; 95 % ДИ 1,6–21,6; p = 0,009). Согласно полученным данным, у РЛРЖ повышена частота развития атрофии слизистой оболочки желудка, причем атрофический гастрит развивается достоверно раньше, чем у лиц без отягощенного наследственного анамнеза. Кроме наследственного фактора риск развития атрофии ассоциирован с возрастом и употреблением алкоголя.

The condition of gastric mucosa was assessed in relatives of patients with gastric cancer (RPGC). The study included 108 RPGC (main group) and 102 patients with no family history of gastric cancer who were screened for dyspepsia. All study participants were subjected to clinical examination, questioning and esophagogastroduodenoscopy (EGDS) with a biopsy, in which the gastric mucosa state was assessed according to the modified Sydney system, the OLGA and OLGIM systems, and the definition of Helicobacter pylori (H. pylori) infection. It was established that the prevalence of H. pylori infection in the main group was 58.3 % (95 % CI 48.8–67.7), in the control group – 56.0 % (95 % CI 46.1–65.6). At RPGC, atrophy of any localization (46.3 % (95 % CI 39.4–53.2) versus 26.5 % (95 % CI 20.4–32.6), respectively, was found more often than in the control group, respectively, p = 0.002), antral atrophic gastritis (41.6 % (95 % CI 34.8–48.4) versus 26.5 % (95 % CI 20.4–32.6), respectively, p = 0.020), and isolated atrophy in the stomach body (4.6 % (95 % CI 1.7–7.4) versus 0 % ( p = 0.03). In RPGC, atrophy developed at a younger age (48.0 years (95 % CI 44.0–52.0) versus 53.0 years in the control group (95 % CI 48.3–57.8) p = 0.000). There were no significant differences between the groups in the incidence of metaplasia and dysplasia. The following risk factors for development of atrophy were identified in the factor analysis: age over 6f0 years (odd ratio (OR) 53.0; 95 % CI 12.2–390.1; p < 0.001), age over 40 years (OR 4.0; 95 % CI 2.0–8.2; p < 0.001), heredity burdened by gastric cancer (OR 2.7; 95 % CI 1.4–5.7; p = 0.006) and the use of strong alcoholic beverages (OR 5.5; 95 % CI 1.6–21.6; p = 0.009). The frequency of the atrophy development of the gastric mucosa is increased in RPGC, and atrophic gastritis develops at a younger age in comparison with individuals without a burdened hereditary history. In addition to the hereditary factor, the risk of atrophy is associated with age and alcohol use.

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The authors declare that there are no conflicts of interest present.