Assessment of external risk factors of hepatocellular cancer development and markers of genetic predisposition to its development in the ethnic group of yakut - men


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Abstract

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.

About the authors

N D Yushchuk

A.I. Evdokimov Moscow State University of Medicine and Dentistry

акад. РАН, проф., зав. каф. инфекционных болезней и эпидемиологии, президент ФГБОУ ВО «МГМСУ им. А.И. Евдокимова» Минздрава России, ORCID: 0000-0003-1928-4747 Moscow, Russia

S S Sleptsova

M.K. Ammosov North-Eastern Federal University, Medical Institute

д.м.н., доцент, зав. каф. инфекционных болезней, фтизиатрии и дерматовенерологии медицинского института ФГАОУ ВО «Северо-Восточный федеральный университет им. М.К. Аммосова» Министерства науки и высшего образования России, ORCID: 0000-0002-0103-4750 Yakutsk, Russia

S I Malov

Irkutsk State Medical University; Irkutsk State Medical Academy of Continuing Education

Email: lynx2000@mail.ru
к.м.н., ассистент каф. инфекционных болезней Иркутского государственного медицинского университета; с.н.с. ЦНИЛ Иркутской государственной медицинской академии последипломного образования; ORCID: 0000-0002-3135-4616 Irkutsk, Russia

I F Bilukina

M.K. Ammosov North-Eastern Federal University, Medical Institute

д.м.н., в.н.с. научно-исследовательского центра медицинского института ФГАОУ ВО «Северо-Восточный федеральный университет им. М.К. Аммосова» Министерства науки и высшего образования России, ORCID: 0000-0001-8099-2270 Yakutsk, Russia

S I Semenov

M.K. Ammosov North-Eastern Federal University, Medical Institute

очный аспирант каф. инфекционных болезней, фтизиатрии и дерматовенерологии медицинского института ФГАОУ ВО «Северо-Восточный федеральный университет им. М.К. Аммосова» Министерства науки и высшего образования России, ORCID: 0000-0001-6094-7827 Yakutsk, Russia

L A Stepanenko

Irkutsk State Medical University

к.м.н., с.н.с. научно-исследовательского института биомедицинских технологий ФГБОУ ВО «Иркутский государственный медицинский университет» Минздрава России, ORCID: 0000-0002-5792-7283 Irkutsk, Russia

O B Ogarkov

Irkutsk State Medical Academy of Continuing Education; Scientific Center of Family Health and Human Reproduction

д.м.н, зав. отд. эпидемиологии и микробиологии Научного центра проблем здоровья семьи и репродукции человека; в.н.с. ЦНИЛ Иркутской государственной медицинской академии последипломного образования, ORCID: 0000-0002-3168-1983 Irkutsk, Russia

E D Savilov

Irkutsk State Medical Academy of Continuing Education; Scientific Center of Family Health and Human Reproduction

д.м.н., проф., г.н.с. отд. эпидемиологии и микробиологии Научного центра проблем здоровья семьи и репродукции человека; зав. каф. эпидемиологии и микробиологии, в.н.с. ЦНИЛ Иркутской государственной медицинской академии последипломного образования, ORCID: 0000-0002-9217-6876 Irkutsk, Russia

I V Malov

Irkutsk State Medical University

д.м.н., проф., зав. каф. инфекционных болезней, ректор Иркутского государственного медицинского университета, ORCID: 0000-0002-0122-4618 Irkutsk, Russia

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