CORRELATION BETWEEN SPECIFIC CANCER MARKERS CA 19-9, REA AND THE TYPE OF HISTOLOGICAL DIFFERENTIATION OF TUMORS OF THE BILIOPANCREATODUODENAL ZONE

In the structure of neoplasms of the organs of the biliopancreatoduodenal zone, cancer of the periampular zone occupies a predominant place, where, in turn, about 90 % are neoplasms of the head of the pancreas. Systematic pathological examination and reporting of pancreatic resection samples after therapy are important for both postoperative management and prognosis for patients with pancreatic duct adenocarcinoma. However, the pathological evaluation of pancreatic samples resected after neoadjuvant therapy is a complex and difficult task for pathologists. The aim of the study is to determine the frequency of occurrence of the pathohistological type of tumors of the biliopacneatoduodenal zone, the correlation between the type of tumor differentiation and the level of cancer markers (REA and CA19-9). The study was conducted on the basis of the I.K. Akhunbayev Clinic at the National Hospital of the Ministry of Health of the Kyrgyz Republic and the Department of Pathohistology of the National Center of Oncology and Hematology, Bishkek. From 2009 to 2023, 85 gastropancreatoduodenal resections were performed for malignant neoplasms of the biliopancreatoduodenal zone. The surgical material was studied macro- and microscopically. For histological examination, pieces were cut from the most altered sections of the surgical material. After histological examination, the morphological diagnosis among the patients was divided as follows: pancreatic adenocarcinoma was diagnosed in 54 patients (63.5 %), adenocarcinoma duodenum – 5 patients (5.9 %), adenocarcinoma of the Fater papilla – 12 patients (14.1 %), cholangiocarcinoma of the OGP – 7 patients (8.2 %), neuroendocrine tumor of the pancreas – 4 patients (4.7 %), solid pseudo-papillary tumor of the pancreas (Franz tumor) – 2 patients (2.4 %), retroperitoneal lymphosarcoma – 1 patient (1.2 %). We verified the correlation between the histopype of the tumor, its differentiation and the level of cancer markers (REA, CA19-9). With a confidence of P ˂ 0.05 (P = 0.036), we note a relationship between the level of REA and the degree of differentiation of the tumor, namely, the lower the differentiation, the higher the level of REA. With a confidence of P ˂ 0.05 (P = 0.045), we note a relationship between the level of CA 19-9 and the degree of differentiation of the tumor, namely, the lower the differentiation, the higher the level of CA 19-9. According to the pathohistological study, pancreatic adenocarcinoma occurs in the overwhelming number of patients undergoing gastropancreatoduodenal resection, namely in 63.5 % of cases. After correlating the histological type of tumor and its differentiation, we noted that the level of cancer markers correlates with tumor differentiation, namely, the higher the level of REA, CA 19-9, the lower the tumor differentiation (P0.05).