Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_151_библиотеки_им_акад_М_И_Перельмана

sixth most commonly diagnosed cancers and the second leading cause of tumor deaths worldwide (McGlynn et al. 2015). The most common histological type of primary liver cancer, which results from chronic liver cirrhosis linked to hepatitis, is hepatocellular carcinoma (HCC) (El-Serag and Rudolph 2007). Because of the lack of symptoms during the early disease stages, HCC usually has a bad prognosis (Sakamoto 2009). The popular HCC causes are liver cirrhosis and infection with hepatitis B virus (HBV) and hepatitis C virus, respectively. In particular, HBV in Asia is clearly a significant risk factor for HCC. Due to HCV infection, alcohol intake, and high rates of obesity linked to non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), and eventual development of chronic liver disease with cirrhosis, Western countries have shown rising incidence rates in the past decades (Ozakyol 2017; Younossi et al. 2018). Curative treatment approaches such as surgical resection or orthotopic liver transplant ation are applicable only in a narrow subset of patients with retained liver function at early HCC stages. Therefore, the overall prognosis for HCC patients remains unsatisfactory, with a 5-year survival of 6.9%, an incidence-to-mortality ratio of 0.95, and a median overall survival of just 11 months (Greten et al. 2005). Although considerable efforts have been made over the past few decades to discover novel biomarkers for early tumor detection in clinical practice, recent approaches to HCC diagnosis, including serum α-fetoprotein and liver imaging measurements, lack adequate accuracy and sensitivity (Ressom et al. 2012). Finally, esophageal cancer (EC) is considered one of the most common cancers and ranked as the sixth leading cause of tumor mortality in 2018, causing about 572,000 new cases and 508,000 deaths worldwide (Bray et al. 2018). Esopha­gus squamous cell cancer accounts for nearly 90% of all esophageal cancers occurring worldwide. Proximal to the squamocolumnar junction, esophageal squa­mous cell carcinoma (SCC) occurs, showing a multifactorial pathogenesis. Inflam­mation and other mutagenic/carcinogenic factors contribute to in situ dysplasia and subsequent malignant transformation. The main risk factors are alcohol, tobacco, caustic strictures, tylosis, thoracic radiation, and achalasia (Watanabe 2015). East Asia and Central Asia are the regions with the highest global incidence of esophageal SCC, followed by areas along the Great Rift Valley in Africa and Uruguay in South America (Arnold et al. 2015). Esophageal cancer is diagnosed accidentally through routine endoscopy or by monitoring identified Barrett’s esophagus at an early stage (15% of EC). However, most esophageal cancers are detected when they are locally advanced and are due to initial symptoms that are not unique, such as heartburn or abdominal bloating (Meves et al. 2015; Rubenstein and Shaheen 2015). The gold standard for diagnosis is upper endoscopy with biopsy and histopathological (Zhang et al. 2016a, b). In addition to the fecal detection of occult blood, currently, serum tumor–associated markers such as carcinoembryonic antigen (CEA) and carbohy­drate antigen 19–9 (CA19–9) are used for the clinical monitoring of gastrointestinal neoplasia, but these tests are not advantageous as diagnostic screening, show ing low specificity and low sensitivity (Burton and Ma 2019). Nevertheless, as we have previously explained, the efficacy of the different therapeutic approaches for anti­gastrointestinal (GI) cancers is strictly linked to early diagnosis. Several models for different malignancies have been developed to determine the causal risk based on