References

gastro-j

Российский журнал гастроэнтерологии, гепатологии, колопроктологии

Russian Journal of Gastroenterology, Hepatology, Coloproctology

1382-43762658-6673

«Gastro» LLC

10.22416/1382-4376-2017-27-2-4-12

gastro-j-129

Research Article

ЛЕКЦИИ И ОБЗОРЫ

LECTURES AND REVIEWS

Аденокарцинома пищевода: факторы риска и современные стратегии скрининга

Esophageal adenocarcinoma: risk factors and modern screening strategy

Маев

И. В.

Mayev

I. V.

noemail@neicon.ru

Андреев

Д. Н.

Andreyev

D. N.

dna-mit8@mail.ru

Кучерявый

Ю. А.

Kucheryavy

Yu. A.

noemail@neicon.ru

Щегланова

М. П.

Scheglanova

M. P.

noemail@neicon.ru

ФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова»РоссияState educational government-financed institution of higher professional education «Yevdokimov Moscow State University of Medicine and Dentistry»Russian Federation

2017

12082018

272412

2018

Маев И.В., Андреев Д.Н., Кучерявый Ю.А., Щегланова М.П.

Mayev I.V., Andreyev D.N., Kucheryavy Y.A., Scheglanova M.P.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.gastro-j.ru/jour/article/view/129

Цель обзора. Отразить современные представления об эпидемиологической структуре и факторах риска аденокарциномы пищевода (АКП), проанализировать современные стратегии скрининга. Основные положения. АКП характеризуется стремительным ростом заболеваемости в развитых странах, а также высоким уровнем смертности. Как правило, АКП диагностируется достаточно поздно, на 3-4-й стадиях, что в значительной мере объясняет высокую смертность, так как возможности лечения на данных стадиях весьма ограничены. Основным доказанным фактором риска АКП является гастроэзофагеальная рефлюксная болезнь (ГЭРБ). АКП развивается обычно только как осложнение при пищеводе Баррета (ПБ), который служит следствием хронической ГЭРБ. Значимыми факторами риска АКП считаются мужской пол, европеоидная раса, ожирение и метаболический синдром, табакокурение, а также ряд генетических маркёров. Главной целью скрининговых программ АКП является ранняя диагностика заболевания, позволяющая обеспечить улучшение показателей выживаемости пациентов. Заключение. АКП развивается только у пациентов, страдающих ГЭРБ, с наибольшим риском у мужчин-европеоидов, курильщиков, лиц с избыточной массой тела и неконтролируемой симптоматикой. Своевременная диагностика ГЭРБ, ее эффективная терапия и динамическое наблюдение за больными с ПБ может предупредить развитие АКП.

Aim of review. To present the modern concepts on epidemiological pattern and risk factors of esophageal adenocarcinoma (EAC) and analyze the modern screening approach. Summary. In developed countries EAC is characterized by rapid increase of mobidity, as well as by high mortality level. As a rule, EAC is diagnosed at the late stage: diagnosis is often made at the 3rd or 4th stage of the tumor that is a major contributing factor for high mortality as treatment options at these stages are significantly limited. The basic established risk factor for EAC is the gastroesophageal reflux disease (GERD). EAC develops usually as a complication of the Barret's esophagus (BE) being a consequence of the long-standing GERD. Male gender, Caucasian race, obesity and metabolic syndrome, tobacco smoking, and series of genetic markers are considered to be significant EAC risk factors. A main goal of EAC screening programs is the early diagnosis that allows to improve patient survival. Conclusion. Only GERD patients develop EAC, with the highest risk in males, Caucasians, smokers, overweight patients and those with uncontrolled symptoms. Timely diagnosis of GERD, its effective treatment and follow-up of BE cases can prevent EAC development.

аденокарцинома пищеводагастроэзофагеальная рефлюксная болезньпищевод Барретаскрининг

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The authors declare that there are no conflicts of interest present.