ТАКТИКА ВЕДЕНИЯ ПАЦИЕНТОВ С ДИФФУЗНЫМ РАКОМ ЖЕЛУДКА, ОБУСЛОВЛЕННЫМ НАСЛЕДСТВЕННЫМИ МУТАЦИЯМИ

Igor Igorevich Bykov, Marina Vyacheslavovna Nemtsova, Tatiana Vitalevna Khorobrykh


Аннотация


В структуре онкологической заболеваемости во всем мире рак желудка занимает пятое место и является третьей среди наиболее распространенных причин смерти от рака, абсолютное число смертельных случаев в год оценивается в 723 000. Подавляющее большинство случаев рака желудка имеют спорадический характер, но известно, что 1–3% являются проявлением наследственных форм и синдромов. Настоящая статья посвящена новым тенденциям и стратегии в управлении риском развития наследственного диффузного рака желудка. Освещены основы генетического консультирования и современные критерии отбора семей, с целью проведения анализа наследственных мутаций. Рассмотрены вопросы эндоскопического скрининга и динамического наблюдения за состоянием слизистой оболочки желудка. Обсужден возможный подход к выбору тактики хирургического лечения в объеме профилактической гатсрэктомии. Обобщены особенности морфологического исследования при наследственно диффузном раке желудка. Изложены принципы послеоперационного ухода. Рассмотрены перспективы медицинского обеспечения пациентов с наследственным диффузным раком желудка.

Ключевые слова


наследственный рак желудка; диффузный рак желудка; мутации гена CDH1; генетическое консультирование

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Литература


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DOI: https://doi.org/10.12731/wsd-2018-4-88-110

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(c) 2018 Igor Igorevich Bykov, Marina Vyacheslavovna Nemtsova, Tatiana Vitalevna Khorobrykh

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