Review on the problem of sanitary-epidemiological welfare of the population in the Siberian

Hepatocellular carcinoma (HCC) is the second leading cause of death in oncological patients. The prognosis of the disease outcome depends directly on its timely detection. Currently, in the majority of countries, the diagnostic algorithm at the preclinical stage of tumor development includes determination of alpha-fetoprotein in combination with instrumental imaging techniques. This approach allows the detection of about 65-80% of liver tumors at an early stage (A according to the BCLC classification), whereas at a very early stage (0 according to the BCLC classification) only 32-50% of cases, the result which cannot be considered satisfactory. In this regard, the search for effective biomarkers of hepatocellular carcinoma is an important challenge that faces the world healthcare. Advances in proteomics and genomics have led to the discovery of numerous promising markers which are now being clinically tested. Molecules of protein nature proposed as hepatocellular carcinoma tumor markers in different periods of time are described in this review. Comparative data on their effectiveness and specificity are also presented. The possibility of isolated or combined use of these biomarkers for risk assessment and early diagnosis of primary liver cancer is considered.

Проведен анализ результатов двусторонней факоэмульсификации с интраокулярной коррекцией афакии у 73 больных в возрасте от 47 до 82 (66,2±7,2) с целью выявления псевдоаккомодационного эффекта системы «моновижн» у больных с двусторонней артифакией в отдаленном периоде наблюдений. В отдаленном периоде наблюдения за пациентами, оперированными с достижением дозированной анизометропии, рефракция ведущего глаза составила (-) 0,08±0,25Д, парного глаза (-) 1,43±0,52Д. Острота зрения обоих глаз с коррекцией у всех пациентов равнялась 0,9-1,0. Бинокулярно, без коррекции вдаль она была равна 0,8-1,0 (0,89±0,11). Причем у 54 из них острота зрения равнялась 1,0, у 19-0,8-0,9 (ввиду наличия у больных индуцированного прямого простого миопического астигматизма в 0,75-1,25Д). Не корригированная острота зрения бинокулярно вблизи (на расстоянии 0,33-0,40 м) составила в среднем 0,68±0,08. Не корригированная острота зрения на среднем расстоянии (0,6-1,0 м) бинокулярно в среднем была на уровне 0,82±0,08. Ключевые слова: артифакия, анизометропия, моновизуальная коррекция афакии.

Aim. To establish the main external and genetically determined risk factors for the development of hepatocellular cancer in the ethnic group of male Yakuts living in the Republic of Sakha (Yakutia) [RS (Y)] in the epidemiologically unfavorable conditions of the incidence of viral hepatitis. Materials and methods. A total of 97 male Yakuts were examined, including 44 people diagnosed with hepatocellular cancer and 53 people diagnosed with chronic viral hepatitis. HCC risk factors were identified by analyzing medical records and questioning patients. In the experimental and control groups, genetic studies of single nucleotide polymorphisms of genes mapped on the X-chromosome and involved in the activation of antiviral immunity along the TLR7 signaling pathway were performed. Results and discussion. In 100% of patients with hepatocellular cancer, infection with hepatitis B, C, D viruses or co - infection with these agents was detected. Every fourth patient with HCC in the RS (Y) was infected with hepatitis D. The course of hepatocellular cancer associated with HDV was characterized by rapid progression of liver cirrhosis, development of portal hypertension, bleeding from varicose veins of the stomach and esophagus (36.4%) and edematous ascitic syndrome (63.6%). In addition to viral agents, additional risk factors for liver cancer were identified, such as alcohol abuse, overweight, diabetes mellitus, and smoking. Among the studied variation sites of genes localized on the X-chromosome and encoding the reaction of innate antiviral immunity, no genetic marker was found with a sufficient degree of confidence determining the likelihood of hepatocellular cancer developing. Conclusions. The high incidence of hepatocellular carcinoma of the male population in the RS (Y) is due to the widespread prevalence of parenteral viral hepatitis, especially viral hepatitis D. Due to the introduction of mass vaccination of the population against hepatitis B in the Russian Federation in the foreseeable future in the RS (Y) we should see a decrease in the proportion of hepatocellular cancer associated with hepatitis B and D viruses, and therefore the focus should be on the treatment and prevention of hepatitis C virus and non - infectious risk factors.

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