THE RESULTS OF THE JAPANESE GASTRIC CANCER SOCIETY MORPHOLOGICAL CLASSIFICATION ADAPTATION FOR THE KAZAKH POPULATION

Abstract

Relevance: Gastric cancer (GC) morbidity is growing in Kazakhstan every year. In 2022, 2 915 new GC cases were detected (15 per 100,000 population), making GC the third most common cancer. The early detection rate of GC does not exceed 10-20%, and advanced forms of GC are over 40%. Mortality increases in the first year after the diagnosis (up to 40%). The best way of solving early detection of gastric cancer is carrying out diagnostics at the stage of pre-tumor stomach diseases. Timely diagnosis and treatment of surgical and borderline diseases of the upper gastrointestinal tract (metaplastic and dysplastic changes in the mucous ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ Онкология и Радиология Казахстана, №4 (70) 2023 17 membrane of the esophagus, stomach, and duodenum and adenocarcinomas and early cancer arising against this background) are a complex medical and social problem. Endoscopic methods for diagnosing esophagus, stomach, and duodenum diseases are the most highly informative nowadays. However, precancerous changes (atrophy, metaplasia, and dysplasia) in conventional endoscopic examination may not have specific features. It is necessary to improve the results of endoscopic diagnosis. The chromoscopy method may be one of the methods used to identify precancerous pathology and GC methods. The study aimed to increase the efficiency of gastric cancer early detection by adapting the morphological classification of the Japanese Gastric Cancer Society (JGCA) for the Kazakh population. Methods: We conducted endoscopic studies of 500 residents of the Republic of Kazakhstan using chromoscopy and morphological studies of the biopsy obtained during endoscopic examination. These patients had digestive system problems but previously did not have a GC diagnosis. We formed the risk groups according to JGCA (editions 13th and 14th). Results: We identified 3(0.6%) morbidity of severe dysplasia according to the results of 500 patients’ biopsy samples morphological study. This morphological structure is classified as a well-differentiated adenocarcinoma. We recommended a surgical treatment for identified patients. Conclusion: The identified cases of obligate pre-cancer with an extremely high probability of degeneration into a malignant neoplasm prove the importance of using JGCA for the early diagnosis of gastric cancer and allow us to recommend the use of chromoscopy in stomach endoscopic examination.