The malignant neoplasms (MN) are one of basic reasons of disability and death rate of the person.
Tumors of a large intestine have considerable specific weight in structure of oncological pathology. The colorectal cancer (CRR) for many years is an urgent problem of modern medicine. It is connected as with growth of cancer cases colon and a rectum, and with difficulties of treatment [4].
Today CRR takes the third place in the world on frequency among all malignant tumors. Annually around the world CRR get sick about 1 million and more than 500 000 people die out [15]. CRR most often occurs at persons in an age group 50 years, regardless of a floor, race and ethnic group are more senior [10]. From them 90% – it the population is aged more senior than 55 years, more than in 80% of cases of CRR comes to light at patients 60 years [14] and noticeable increase in incidence aged after 70-75 years are more senior [5].
According to forecasts, in the next two decades as a result of growth and aging of the population, the absolute number of cases of identification of new growths of a large intestine will increase considerably both in developed, and in developing countries [15].
In the Russian Federation (RF) the standardized indicators of incidence of CRR increased by 100 000 men's and female population with 30,35 to 31,77, and with 21,54 to 22,88 in 2010 and 2015 respectively. On death rate at men of CRR is in the third place after malignant new growths of a lung and stomach, at women on the second place after a breast cancer [3,9].
In Republic of Sakha (Yakutia) these indicators are lower, but also increased - with 22,13 to 27,92 (at men) and with 17,45 to 21,15 (at women) [3,9]. In Republic of Sakha (Yakutia) prevalence of CRR has the territorial and social features. It is noted high rates of incidence of men and women in the Southern zone of the republic and the large cities since mostly the population not radical and is engaged at harmful industries of the mining industry. The return picture is noted at inhabitants of the Central area where the aboriginal population prevails and the agricultural industry is developed [2].
The important part in studying of carcinogenesis is assigned to risk factors.
In the relation of risk of development of CRR features of food in the conditions of Far North – excessive consumption of animal protein and fats, insufficient intake of micronutrients with antioxidant properties, and also food fibers are important that increases risk of pretumoral and tumoral diseases of a thick gut therefore the question of development of scientifically based methods of dietary prevention is extremely urgent [6].
You shouldn't forget a northern stress (a syndrome of polar tension) about a concept. At residents of Far North increase of indicators of psychoemotional pressure, endocrine frustration, decrease in resistance of cellular and subcellular structures to negative impact of processes of oxidation, violation in system of enzymes and immunity, disorder of metabolism, delay of regenerator and recovery processes are noted that accelerates progressing of diseases, including oncological [8].
Studying of morphology and morphogenesis of tumors extremely important both in theoretical, and in the practical relation. Knowledge of a morphogenesis of MN has the high importance for a comprehension of their pathogenesis [7].
From the histological point of view of MN of a large intestine represent heterogeneous cell population which can be differentiated in various directions. In this regard it was developed and now in oncomorphological practice the International histological classification of tumors of an intestine is standard [12].
At microscopical studying of biopsies and operational material the most common form of CRR is the adenocarcinoma of different degree of a differentiation, meets in 75-80% of observations. On the 2nd place on the frequency of occurrence there is a mucous adenocarcinoma (up to 10-12%). Further go signet-ring cell (to 3-4%) and squamous cell cancer (to 2%). Benign and malignant tumors of the mesenchymal nature meet in a large intestine approximately in 0,5-3% of all neoplasms. Most often they are localized in a straight line and a caecum, other departments are affected less often [1].
The pathomorphologic characteristic of CRR in Republic of Sakha (Yakutia) is limited only to data for 1991-2005 in which only the percentage ratio of the most met neoplasms becomes perceptible – adenocarcinomas of different degree of a differentiation made 86,6±1,4%, of them the intermediate-grade adenocarcinoma of 44,8±2,1% further low-grade (26,7±1,8%) and high-grade (10,2±1,3) % of an adenocarcinoma [2].Early diagnostics of CRR at early stages can't be considered satisfactory as detectability of tumors at initial stages very low. At the time of statement of the oncologic diagnosis at every third patient generalization of tumoral process becomes perceptible [3]. In the 1990s were taped and the characteristic of genes in which defects caused development of oncologic process in a large intestine is given [11,13]. Opening of the last decades in molecular genetics allow to resolve issues of an etiology, early diagnostics of prophylaxis and cancer therapy of a large intestine (a biotherapy which allows to destroy precisely only tumor cells (target therapy)).
Uses of this knowledge allow to study an etiology and a pathogenesis of a carcinogenesis, and also to optimize treatment of patients with this pathology.
In the conditions of Far North aren't found by us in available domestic and foreign literature of data on features of morphology, a morphogenesis and molecular and genetic heterogeneity of MN of a colorectal zone.
Cancer of colon and a rectum has high value in structure of a case rate of MN of the population of the Republic of Sakha (Yakutia), with a high tendency to further height and conservation of age, ethnic and territorial features.
Thus, despite a large number of the publications devoted to screening, treatment of CRR and related complications, the question of studying of the morphological characteristic of tumors taking into account features of external and internal factors of a carcinogenesis remains not distinguished and demanding further scientific research.
References:
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