Medicina v Kuzbasse (Jun 2021)
ANALYSIS OF ERRORS IN DIFFERENTIAL DIAGNOSTICS OF DYSPLASIA AND STOMACH CANCER
Abstract
IV stage stomach cancer is detected in 38.9 % of cases; additional use of RNA-based markers seems to be a promising way to improve the accuracy of esophagogastroduodenoscopy with biopsy. Objective of the study – analysis of errors in differential diagnostics of ulcers with dysplasia and stomach cancer using the endoscopic and histological methods, and a classification based on miRNA profiling. Materials and methods. We carried out a retrospective analysis of the results of endoscopic and morphological studies of 89 observations of patients with stomach ulcers with dysplasia and performed a molecular genetic study of samples of archival histological material of these patients in the form of paraffin blocks. The prospective study consisted in repeated endoscopic examinations after 3, 6, 9, 12, 24 months, and we also observed patients using the electronic database BARS Medical Information System. Results. The average time before the detection of the malignant nature of the ulcerative lesion was 11 months. There were detected 8 cases (8.9 %) of stomach cancer, 4 cases out of which (4.5 %) were untimely detected infiltrative ulcerative cancer. In two cases out of four the lesions were attributed to the cancer group according to the classification based on siRNA profiling. 7 out of 8 ulcerative lesions in the description of the endoscopic examination are described as giant, that is, more than 3.0 cm. Conclusions. When a miRNA profile corresponding to stomach cancer is identified, it is necessary to lead the patient more aggressively, after removing the threat of recurrent bleeding, repeat esophagogastroduodenoscopy with multifocal biopsy.
