[25-year trends of incidence and mortality from liver cancer and viral hepatitis in Novosibirsk].

The article presents data of Cancer Registry in Novosibirsk for the period 1988-2012 concerning primary liver cancer. Over the period studied the incidence and mortality have declined significantly (2,5 and 2,1 times, respectively). Both figures fall in line for men and women being generally twice as high in men. The long-term trends of main etiologic risk factor for liver cancer (prevalence of hepatitis viruses B and C in the population) are shown. The issues of screening and prevention are discussed.

Pancreatic cancer (data of the Registry in Novosibirsk, risk factors, prevention options).

Dynamics of morbidity and mortality from pancreatic cancer in the population of Novosibirsk according to the Population-based Cancer Registry and the Registry of total mortality for 25 years (1988-2012) were analyzed. The morbidity and mortality for the studied period decreased slightly. Incidence rates in middle-aged males are higher than in females but this difference is leveled after 75 years. Possible risk factors for pancreatic cancer as well as issues of screening and prevention are discussed.

PREVALENCE AND PECULIARITY OF CORPUS ATROPHIC GASTRITIS IN POPULATION WITH HIGH LEVEL OF HELICOBACTER PYLORI INFECTION.

BACKGROUND: Corpus atrophic gastritis (CAG) maybe the outcome of Helicobocterpylori (U pylon) - infection or autoimmune damage of the parietal system, affecting the risk of gastric cancer and requiring different approaches in the treatment and observation. AIM: To study the prevalence and peculiarity of CAG in population with, high prevalence of H.pylori infection. MATERIALS AND METHODS: Prevalence of CAG was studied in the representative group of Novosibirsk citizens (246 subjects aged 45-69,117 males and 129 females) using serology for noninvasive testing of gastritis phenotype Gastro-Panel. Pepsinogen I (Pgl) level < 30 pg/I and/or Pgl/Pgil ratio c 3.0 were interpreted as sever atrophy. In addition, a clinical group with serologically proven corpus atrophy was studied: 39 females and 8 males aged 38-79. Upper endoscopy and morpholojical examination was performed in 38 patients. As a pilot project, in 19 patients with suspicion on autoimmune gastritis (AIG) (low Pgl + high Gastrin-17) parietal cells antibodies (PCA) and vitamin B12 level were determined. CONCLUSION: In Novosibirsk population prevalence of both H.pylori infection and CAG (10.2%) is high. AIG is often associated with H.pylori infection (in 47.4% of cases); however, its role demands a further evaluation. Autoimmune phenotype of gastritis which was found using noninvasive diagnostic was confIrmed with the presence of PCA. In all cases ofAIG atrophy was confirmed morphologically with the presence of intestinal metaplasia in 52.6% and ~ysplasia in 10.5% of cases.

FEATURES OF GILBERT'S SYNDROME IN PATIENTS WITH DIFFERENT GENOTYPES UGT1AI.

The aim; to evaluate the clinical manifestations and data of instrumental methods in patients with Gilbert's syndrome and different genotype UGT1A1. MATERIALS AND METHODS: Clinical manifestations and results of instrumental methods were studies in 104 patients with Gilbert's syndrome (UGIlAl gene mutation rs8175347), including 75 with the homozygous variant (genotype 7TA*7TA) and 29 - with heterozygous variant (genotypes 6TA*7TA or 6TA*STA). RESULTS: The most frequent clinical manifestation was asthenovegetative syndrome. The promoter of the appearance/intensification ofjaundice were physical activity, stress and viral infections. Homozygotes exhibit an earlier manifestation of the disease, higher rates of bilirubin (sometimes not only due to deconjugating), a greater variety of stigmas undifferentiated dysplasia of connective tissue, more frequent detection of biliary sludge or gallstones. The clinical observation of a family case of Gilbert's syndrome where the mother is a homozygote, and the son - heterozygotes on UGT1A1 mutation is presented, which shows the above differences associated with genotype. CONCLUSION: Patients with asthenic constitution and the stigma dysplasia of connective tissue have to be examined by the presence of mutations rs8175347 gene UGT1A1. The carrier not only homozygous but with the heterozygous variant mutations may require changes in the interpretation of symptoms, lifestyle, medication, etc.

PREVALENCE AND RISK FACTORS OF GERD IN ADOLESCENTS IN NOVOSIBIRSK: TEN-YEAR TRENDS.

The aim of the study was the study of ten-year trends (1999-2009) of GERD symptoms and risk factors in schoolchildren in Novosibirsk from 14 to 17 years. MATERIALS AND METHODS: The comparison of the results of the screenings performed at 1999 and 2009 was analyzed. Anthropometry, the survey to identify the symptoms of GERD and eating habits, smoking and alcohol consumption, determination of lgG and CagA antibodies to Helicobacterpylori were included at the program of screenings. RESULTS: No significant dynamics of GER symptoms in adolescents, except weekly heartburn among boys. Among the factors associated with dyspepsia and GER, there have been some mixed changes: the frequency of smoking significantly reduced, but the proportion adolescents with excess body weight have increased. Violations of the regime and diet, and Helicobocrerpylori-infection has not changed significantly. CONCLUSION: The frequency of GERD in adolescents remains high but does not reach the prevalence of GERD in adults.

[EPIDEMIOLOGICAL STUDIES IN GASTROENTEROLOGY: LONG-TERM SIBERIAN EXPERIENCE OF HELICOBACTER PYLORI AND RELATED DISEASES].

The paper presents the long-term experience of Siberian epidemiological studies in the field of gastroenterology (cross-sectional and prospective). High prevalence of Helicobacterpylori infection (75-85%) in the adult population of Siberia, and the association with dyspeptic symptoms in different age groups are shown. The dynamics of infection in children and adolescents, the high detection rates of CagA-positive strains, the prevalence of the different phenotypes of gastritis and the predictive value of gastric atrophy biomarkers in relation to gastric cancer were studied. The importance of epidemiological studies for the formation of groups at risk for a number of diseases and the development of prevention programs is demonstrated.

[NONINVASIVE DIAGNOSTICS OF THE PHENOTYPE OF GASTRITIS: ANALISIS OF THE FIRST THOUSAND OF CASES].

The analysis of noninvasive diagnostics of a phenotype of gastritis among 1050 people aged from 18 till 80 years which consistently addressed to policlinic is presented in the article. The instrument of diagnostics was a <>, including a complex of biomarkers - so-called <> (pepsinogen I, pepsinogen II, gastrin-17 and IgG- antibodies to Helicobacter Pylori). High frequency of different variants of atrophic gastritis (25%) with a gastric cancer risk and conditions with a risk of erosive and ulcer damages of the stomach mucous (26 %) was shown. Clinical and economical expediency of noninvasive screening of a phenotype of gastritis is postulated.

[MODERN METHODS OF PHYSICAL-CHEMICAL RESEARCH IN GASTROENTEROLOGY PRACTICE: THE EXPERIENCE OF INTERACTION].

UNLABELLED: The aim of this work was to assess the potential of some physical and chemical methods for studying erythrocytes and blood serum in gastroenterological practice by the example of colorectal cancer (CC). MATERIALS AND METHODS: A total of 26 persons with various stages of colorectal cancer and 16 healthy (control group) were examined. Parameters of erythrocytes and blood serum were investigated by light microscopy, dielectrophoresis in a non-uniform alternating electric field (DEF in NUAEF), terahertz spectroscopy, ellipsometry, Raman-spectroscopy. RESULTS: Polymorphism of erythrocytes, rigidity, viscosity, indexes of aggregation and destruction were significantly higher in patients with CC and polarizability, amplitude of erythrocyte deformation in NUAEF being lower than those in the controls. The study of erythrocytes by terahertz spectroscopy revealed the low levels of amplitude transmittance over the whole frequency range in CC patients compared to the controls. The increasing of refractive index, degree of heterogeneity of thin films obtained from the serum in CC patients were observed in considering the ellipsometric parameters. We found a significant increasing of the concentration of antigens to CD24 at the early stage of the disease. The areas of some peaks in Raman spectra were significantly lower in patients with CC compared to the healthy ones, it is possible due to a carotin deficiency. Most of the studied parameters were correlated with the stage of the disease. A set of optical methods for studying blood serum compared with those of histology and radiological methods of diagnosis showed their high sensitivity and specificity, positive and negative predictive value (80 % and above). CONCLUSION: The obtained results of the pilot study demonstrate the prospects of using physical and chemical methods of research of erythrocytes and blood serum for early diagnosis, stage of disease and monitoring the effectiveness of treatment of CC.

[VISCOELASTISITY AND ELECTRICAL PARAMETERS OF ERYTHROCYTES IN GILBERT SYNDROME].

Results of viscoelastic and electrical properties of erythrocytes study in patients with genetically confirmed Gilbert's syndrome (n = 81) are presented. Dielectrophoresis of erythrocytes in a nonuniform an alterning electric field was performed in81 patients with Gilbert's syndrome and in 20 persons of the comparison group without of the pathology identified by thelaboratory and instrumental examination. The significant differences in viscoelasticity properties of erythrocytes in Gilbert'ssyndrome were obtained. The amplitude of the deformation, the speed of movement to the electrodes and the polarizability on electric field's of all frequencies were significantly lower, but generalized rigidity index, viscosity, index of aggregationand degradation on electric field's of all frequencies were higher than in the comparison group. A number of electricalparameters (conductivity, the capacity of the cells and the relative polarizability) were also higher than in the comparisongroup. Some differences in the parameters of erythrocytes were obtained from homozygous and heterozygous carriers of A(TA), TAA of gene UGT1A1 promotor.

[Symptoms of gastroesophageal reflux disease and associated factors in adolescents: population survey].

OBJECTIVES: Gastroesophageal reflux (GER) is frequent among the general population affecting 10-20% of adults. However, there is a notable lack of epidemiological data describing prevalence of GER in children. The aims of the present study were to assess the prevalence of GER symptoms (GERS) in adolescents and to evaluate factors associated with GERS including markers of H. pylori infection. METHODS: All school students in grades 9-11 in four randomly selected secondary schools in Novosibirsk participated (449 adolescents, 189 boys, 260 girls aged 14-17). They completed the Bowel Disease Questionnaire, life-style questionnaire, and sera were tested for antibodies against Helicobacter pylori infection. RESULTS: Overall, 60% of adolescents experienced GERS (heartburn and/or acid regurgitation) over the previous year. GER symptoms on a monthly basis were reported by 22% of students, weekly GERS were reported by 9% of adolescents with the same frequency in both genders. GERS were related to family history of dyspepsia or GER, mother's lower educational attainment, overweight, unhealthy eating patterns, alcohol consumption, smoking, and H. pylori infection, as well as concomitant dyspepsia and irritable bowel syndrome. The majority of associations were more prominent in girls. Visiting a physician, endoscopic study, and school absenteeism were reported in the last year more frequently by adolescents with GERS vs those without GERS. CONCLUSIONS: Gastroesophageal reflux symptoms are frequent among the adolescent population and result in frequent use of health care resources. Some precipitated factors found in this study are modifiable and may be corrected in adolescent population.

[Use of immunoenzyme assay to detect the level of pepsinogen in blood].

Determining the level of blood pepsinogens has important clinical significance in the formation of risk groups for gastric cancer and erosive/ulcerative lesions of the gastric mucosa. A comparison of imported and domestic kits for testing the level of pepsinogens was performed. Russian diagnostic kits in comparison with foreign ones proved to show similar sensitivity and specificity.

[Risk of gastric cancer dependent on serological markers of atrophic gastritis: cohort study].

In a prospective study the risk of subsequent gastric cancer (GC) was assessed in persons aged 45-69 over 5 years after the initial testing with a set of serological tests (pepsinogen I, pepsinogen II, gastrin-17, antibodies to Helicobacter pylori). The presence of gastric atrophy markers was a significant predictor of GC in the forthcoming years. Non-invasive techniques may be used in the formation of high-risk groups, followed by GC active surveillance.

[Mode of dieting as a risk factor for dyspeptic symptoms: a two-year prospective study].

A random representative sample of adolescents has been questioned about gastrointestinal symptoms and mode of dieting habits. Four hundred fifty schoolchildren participated primarily and over two years. Irregular meals, hasty meals, long period between meals were associated with symptoms of dyspepsia and gastroesophageal reflux. Moreover, symptoms developed over 2 years were related to newly reported changes in dieting habits.

[Quality of life at dyspepsia and irritable bowel syndrome: population-based studies].

The aims of the study were to examine the prevalence of dyspepsia and irritable bowel syndrome (IBS) in the unselected population and to assess the quality of life (QOL) in these syndromes and their combination. The study involved 1,040 people, representing a random sample of adults aged 45-70 years (492 men, 548 women). To identify gastrointestinal symptoms using validated questionnaire, dyspepsia and IBS were diagnosed by Rome I criteria. QOL was assessed using a questionnaire SF-36. Dyspepsia was reported by 37.5% (30.1% men and 44.2% women, p < 0.001). The prevalence of IBS was 18.8% (12.0% men and 25,0% in women, p < 0.001). The combination of dyspepsia and IBS was noted in 12.0% (6.5% in men and 17.0% in women). Both dyspepsia and IBS cause significant decrease in QOL on most scales of the questionnaire SF-36 compared with those without these disorders. Their combination reduced QOL even more in comparison with isolated dyspepsia or IBS. Finally, high prevalence of dyspepsia and IBS was stated among the population, both conditions more frequently observed in women. QOL is significantly reduced in subjects with dyspepsia and IBS, especially if these syndromes combine.

[The level of serum cytokines in children infected with various strains of Helicobacter pylori].

Serum contents of 7 cytokines (IL-1, IL-1beta, IL-6, IL-8, TNF-alpha, INF-gamma, INF-alpha) were examined in 87 children aged 14-17 years according to presence of antibodies against Helicobacter pylori and cytotoxic CagA protein. There was a lack of difference in cytokine levels between infected and non-infected children. Thus H. pylori infection in children in contrast to adults does not cause changes in systemic cytokine secretion.

[Rationale for using essential phospholipids in chronic diseases of the liver: the dynamics of electric and viscoelastic parameters of erythrocytes].

Under supervision there were 38 men (age from 36 till 57 years) with diffuse hepatic diseases (DHD) in stadia of hepatitis, 27--in dynamics of treatment of essential phospholipids. Is experimentally established: structure-functional erythrocyte characteristics by methods of dielectrophoresis, thin-layer chromatography correlate with lipid and phospholipid composition of red cell membranes. The low level of phospholipids in erythrocyte membranes and direction of changes in their fractional composition in the DHD is the basis for the use of essential phospholipids. Against the background of therapy noted a significant increase in amplitude of deformation, polarizability, capacity, speed of movement of red blood cells to the electrodes and lower levels of generalized indicators of viscosity, rigidity, electrical conductivity, index of aggregation and destruction.

[Gastrointestinal symptoms in adult population of Novosibirsk city: prevalence and risk factors].

AIM: To study prevalence of dyspepsia symptoms, gastroesophageal reflux (GER) and irritable bowel syndrome (ICS) in city population and to detect relevant risk factors. MATERIAL AND METHODS: Gastrointestinal symptoms were investigated with a validated questionnaire Bowel Disease Questionnaire and dyspepsia, GER, ICS syndromes were identified in a representative sample of adult Novosibirsk population (1040 patients, 492 males and 548 females aged 45-69 years). Risk factors were studied by social-demographic and antropometric parameters, smoking, drinking and administration of nonsteroidal anti-inflammatory drugs (NSAD). Depression was assessed by CESD questionnaire. Helicobacter pylori infection and the level of pepsinogen I were studied with enzyme immunoassay Biohit GastroPanel (Biohit, Finland). RESULTS: Incidence of dyspepsia was 38%, GER--30%, ICS--19%. One of the illnesses was found in 56% cases, combination of the conditions--in 24%. Females had dyspepsia and ICS much more frequently. Social-demographic parameters (age, marital status, education, labor activity), alcohol consumption, intake of NSAD, Helicobacter pylori infection had no significant effect on the incidence of gastrointestinal symptoms. GER occurred more frequently in smoking males. Overweight was characteristic both for GER males and females. Severe depression was associated with the risk of dyspepsia and ICS both in females and males. Hyperpepsinogenemia increased the rate of GER detection in males and dyspepsia in females. CONCLUSION: Dyspepsia, GER and ICS were seen in 50% adult population and often combine, but the risk factors differ. Some of the latter can be modified and prevented.

[Prevalence of atrophic gastritis in different populations in Siberia on medical evidence of the serological survey].

Prevalence of atrophic gastritis in various population of Siberia with serological tests was studied. Representative samples of Novosibirsk adult population and also urban and rural population of Yakutia were examined. 348 persons at the age more than 45 years (180 males and 168 females) were studied. Concentration of pepsinogen I, gastrin 17 and antibodies to Helicobacter pilori in blood serum was estimated with immune-enzyme analysis ("Biohit GastroPanel", "Biohit", Finland). In addition, domestic test-systems were used for detection cytotoxic (expressing CagA-protein) strains H. pylori. Level of markers (pepsinogen, gastrin, antibodies to Helicobacter pilori and antibodies to CagA H. pilori) in observing populations had no difference between males and females, and also did not depend on age. Occurrence of atrophy in body of stomach in Novosibirsk population, urban and rural population of Yakutia was 10.1, 16.7 and 25.6% respectively, and in antral part--10.7, 25.6 and 8.9% respectively. Total atrophy was registered in 1% in all groups. Helicobacter infection was detected in 78-88% of population. Domestic immune-enzyme test-systems were comparable with data of histological examination and demonstrated greater sensitivity at H. pylori detection vs. foreign. High prevalence of atrophic gastritis in various groups of Siberia population was noticed, which must be was bounded with great level of H. pylori infection in population.

[Symptoms of gastroesophageal reflux and quality of life: population study].

AIM: To study prevalence of symptoms of gastroesophageal reflux (GER) in a free living population and to evaluate quality of life (QOL) in this disease. MATERIAL AND METHODS: The gastroenterological symptoms and QOL were studied in a representative sample of adult population of 495 males and 548 females aged 45-70 years using a validated questionnaire, SF-36 questionnaire. RESULTS: GER symptoms were seen in 17.0% responders, with the same frequency in men and women, in responders of different age. QOL was worse in responders with GER by 2 scales of SF-36 questionnaire: in males--"general well-being" and "viability", in females--"general well-being" and "physical functioning". In persons who had visited a doctor QOL was lower by all 8 scales than in those who had GER symptoms but had not visited a doctor. GER prevalence in Russia is similar to that in the West Europe and USA. QOL in GER patients is not low but worse in those who seek medical advice.