INTRODUCTION:Uterine leiomyomas are the common smooth muscle tumors of female genital tract. Usually theirdiagnosis poses no problem. On the other hand leiomyosarcomas are highly malignant tumors.Distinction between the two poses no problem if the leiomyosarcoma shows significant dysplasia,however at times it may become a serious problem to differentiate between leiomyoma and well–differentiated leiomyosarcoma. Under such circumstances the mitotic count per 100 high powerfields considered by many as the most important criterion of distinction.MATERIAL AND METHODS:To investigate the role of mitotic activity in the growth of uterine leiomyomas, the mitotic count per100 high-power fields and the relation of this to the patient’s age (30 to 54 years) were examined intissue sections of leiomyomas from 130 surgically removed leiomyomatous uteri.RESULTS:The mean mitotic count in submucosal uterine leiomyoma was significantly higher (42.3%) than thatof the other location such as intermural and subserosal leiomyoma. We found the highest mitoticcount in a leiomyoma at the late reproductive aged women (46.1%) at early secretory phase. But therewas not a statistical correlation between women’s age and mitotic activity of uterine leiomyoma.CONCLUSION:Increased mitotic activity in leiomyomas under the late reproductive aged women suggests that thegrowth of these tumors is affected by progesterone level

Aim was to investigate expression of tumor suppressor P53 gene, proliferating Ki-67 protein inordinary and proliferating uterine leiomyomato establish possible usefulness of these two parametersin distinguishing between ordinary leiomyoma and proliferating leiomyoma. Retrospective study of49uterine leiomyoma (25 ordinary leiomyoma, 24 proliferating leiomyoma) technically acceptable foranalysis from years 2010–2013 department of Obstetrics and Gynecology and department of Pathology,Mongolian National University of Medical Science, Ulaanbaatar, Mongolia.MethodAll tissue specimens were obtained from surgically removed tumors. Tissue was fixed in formalinand cut to thickness of 5 mm from paraffin-embedded blocks. All haematoxylineosin slides and allimunohistochemical slides for each case were reviewed by two experienced pathologist.ImmunohistochemistryParaffin-embedded tumor sections were deparaffinized and stained in automated platformDakoCytomationusing monoclonal mouse anti-human Ki-67 antigen (Dako,Glostrup, Denmark), monoclonal mouse anti-humanP53 protein (Dako, Glostrup, Denmark).Immunohistochemicalanalysis of P53 and Ki67 expression was performed. Every nuclei stained brown,regardless of shade intensivity, was considered positive. The interpretation of immunohistochemicalstaining was expressed as number of positive cells in 100 cell count in most active area of the slide.Non-parametric analysis of variance Kruskal-Walistest was performed.P53 expressionExpression of P53 was negative in 24/24 ordinary uterine leiomyoma, 2/10 mitotic activity leiomyoma,11/15 cellular leiomyoma. Expression of P53 in 1–10% of cells showed 3/10(30%) mitotic activeleiomyoma and 1/15(6.6%) cellular leiomyoma. Expression in 10-70% of cells showed 5/10(50) mitoticactivity leiomyoma, 3/15(20%) cellular leiomyoma. A significant difference in expression of P53 wasseen between ordinary and proliferative (mitotic activity and cellular) uterine leiomyoma (p<0.007, Table1).Ki-67 expressionExpression of Ki67 was negative in 20/20 (100%) ordinary leiomyoma, 4/11(36.3%) mitotic activityleiomyoma and 7/18(38.8%) cellular uterine leiomyoma. 1–10% of cells were positive in 4/11 (36.6%)mitotic activity leiomyoma, and 5/18% cellular leiomyoma. Expression was positive in 10-70%of cellsof 3/11(27.2%) mitotic activity leiomyoma and 6/18(33.3%). Statistically significant differences in Ki67expression was found between ordinary leiomyoma and proliferating leiomyoma (p<0.014, Table 2) andbetween LM and LMS (p=0.000, Table 1).Conclusion:The findings of our study in concordance with other study results are helpful information establishingmore diagnostic criteria and parameters for diagnosis in doubtful cases between two entities.Immunoassaying for Ki-67 and P53 are such parameters. The panel of their expression in specific caseeases diagnosis.

Introduction: Cancer continues to be one of the world’s major health issues, with Mongolia continues to lead Asia in esophageal (100’000: 17.1) and gastric cancer incidence (100’000: 41.0). In the previous decade, 8,137 new cases of gastric cancer were reported in Mongolia. According to TNM staging, eight out of every ten people are diagnosed late, recognizing the need to improve people’s knowledge, attitudes, and practices. Methods: The survey was carried out using a questionnaire. A total of 320 participants between 17- 80 ages from the aimags of Uvs, Khovd, and Zavkhan were chosen at random for the survey, and data was collected through social media. SPSS (v28.0, SPSS Inc., Chicago, IL, USA) software was used for statistical analysis. Results: The survey included 110, 106, and 104 participants from the aimags of Uvs, Zavkhan, and Khovd. A total of 320 participants, with 20.9% (67) and 79.1% (253) being male and female respectively. The average age was 35.56±9.15 years. The participants’ mean knowledges, attitudes and practices scores were 7.54±2.7, 9.6±2.2, and 3.82±1.1 respectively in the first survey. Following the advocacy campaign, the mean knowledge, attitude, and practice scores increased to 9.3±2.7, 10.1±2.2, and 4.00±1.2, respectively. Conclusion The attitudes and practices of the participants were related to their level of knowledge. It is critical to increase health education and advocacy efforts in order to develop the appropriate attitudes and behaviors to reduce cancer-related deaths.

Introduction : In the last years other country scientists told about not only determine infant weights, need to interest correlation between maternal weight, height and infant weight. In our country few research articles posted about anthropometry of obstetrics and gynecology. Our study aim is determine maternal weight, infant weight, placenta weight and assess factors affecting roles on maternal story of “Amgalan” Maternity Hospital in 2014-2015. Goal: The current study aimed at assessing maternal weight, infant weight, placenta weight and evaluating the effect of factors leading to it. Materials and Methods: The data was already collected from “Amgalan” Maternity Hospital using maternal history and record and it was collected measuring general physical characteristics such as body weight and height, infant weight, placenta weight and body circumferences. We used retrospective method and collected statistical data was analyzed using SPSS 21.0 software. Results: Of total 964 study participants aged 18-45. The average age of participants was 29.6 ± 5.8 years old and 49.7% (n=479) was working during pregnancy, 45.7% (n=441) hadn’t works, 4.6% (n=44) was student. The average weight of mothers was 75.4±11.5, weight of infants was 3439.5±456, weight of placenta was 685±129. The following factors affected maternal and infant weights: lower education, working, early and late pregnancy complication. Maternal weight had a low direct correlation with infant weight (r=0.267, p<0.01) and placenta weight (r=0.208, p<0.01). In our study maternal height had a low direct correlation with infant weight(r=0.173, p<0.01) and infant weight had a moderate direct correlation with placenta weight (r=0.376, p<0.01). Conclusions
1. The average maternal weight was 75.4±11.5, infant weight was 3539.5±456, placenta weight was 685±129.
2. The following factors affected maternal and infant weights: lower education, working status, early and late pregnancy complications.
3. Maternal weight had a little direct correlation with infant weight (r=0.267, p<0.01) and placenta weight (r=0.208, p<0.01).

Introduction: Gastric cancer is still one of the most leading causes of mortality in the world. The highest mortality rate of gastric cancer is estimated in Mongolia. South Korea and Japan, where leading the incidence of gastric cancer, mortality rates are observed in 51th and 31nd rank respectively. In Mongolia, gastric cancer is the second leading site, after liver cancer. Goal: We aimed to determine the cause of late diagnosis of gastric cancer and to evaluate supply of upper endoscopy devices and human resource for gastric cancer in the general hospital of provinces and districts. Materials and Methods: In this study, 84 patients suffering from gastric cancer (42 patients in III, IV TNM stage; 42 patients in I, II TNM stage)were investigated in National Cancer Center, Mongolia. A survey questionnaire which included age, gender, education, income, risk factors and clinical questions was detected from all patients. And we conducted study of supply of upper endoscopy devices and human resource for gastric cancer in general hospitals of from 21 provinces and general hospitals of 6 districts by questionnaire. Results: Seventy three(86.9%) patients were over 50 years old and the highest rates of gastric cancer were in group of 61-70 years (40.5%). From the results, the reason to visiting hospital was significantly different between two groups. 55.1% of patients suffering from early-stage gastric cancer were voluntarily diagnosed by upper endoscopy. In contrary, 55.8% of patients suffering from late-stage gastric cancer have visited the hospital due to worsening symptoms or dysphagia and vomiting. Factors such as age, gender, education, employment status and income had no significant effect on late diagnosis of gastric cancer. In totally 24(89%)general hospitals out of 27 had upper endoscopy devices and 22 (81.5%) hospitals had endoscopist. Although 75% of total general hospitals conduct annual cancer screening, 64% of them do not perform the endoscopy in annual screening. Conclusion In our country, late diagnosis of gastric cancer is related to the attitudes of patients for preventing and screening disease. Therefore, it is important to improve the health education of the population and to develop healthy, right attitudes and practices. And the study revealed that general hospitals have insufficient for upper endoscopy devices and human resource.

Introduction: Cancer is a major public health issue both in Asia and in Mongolia. The most prevalent cancer related deaths in Mongolia are registered for the stomach, esophagus and liver. Purpose: We aimed to investigate the incidence of stomach and esophageal cancer in Mongolian population. Materials and Methods: Epidemiologic data were collected from 2009 to 2018 through the oncology cabinet of all hospitals and medical centers from all provinces, soums (the smallest unit of provinces) and major districts of the capital city. The incidence of stomach and esophageal cancer was calculated by appropriate methods and it was presented by ArcGIS Pro 9.2 software. A P-value of less than 0.05 was considered to be statistically significant and based on two side hypotheses. All calculations were performed in the IBM SPSS Statistics software. The study design in concordance with ethical guidelines was approved by the Ethics Committee of Ministry of Health Mongolia. All clinical investigations were conducted according to the principles laid down in the Declaration of Helsinki. Results: The incidence of esophageal cancer in last ten years (2009-2018) was 10.09 in 100000 populations and the highest incidence were registered in Uvs (38.13), Bayan-Ulgii (24.15) and Zavkhan (18.18) provinces, respectively. The incidence of stomach cancer was 20.33 in 100000 populations and the highest incidences were registered in Uvs (53.01), Khovd (46.02) and Darkhan-Uul (40.50) provinces, respectively. Conclusion
1. Incidence rates for esophageal and stomach cancer are high among the Mongolian population. In the last decade, the incidence of esophageal cancer had not decreased significantly, but it’s constant.
In our study, the esophageal cancer incidence was 10.09 per 100’000 people, which includes one of the high incidence rate countries according to the WHO classification. More than 10 aimags incidence rate of esophageal cancer was higher than the National average. Most of them have occurred in the western region of the country. Most of the Western, some of Khangai and Eastern soums have had the highest incidence of esophageal cancer what we have shown on the mapping.
2. The incidence rates of stomach cancer were registered as 20.33 per 100’000 people in the last 10 years at the national level. It has shown that according to the WHO classification, our country is also one of the countries with the highest incidence of stomach cancer. The stomach cancer incidence trend was increased in the last 10 decades. Therefore, some of aimag’s soums has included the highest rate classification. In addition, some soums in the Western, Khangai, and Eastern aimags had have a very high incidence of stomach cancer.
According to results in the above, the nationwide targeted prevention program is needed especially where the highest incidence rates. Also there is a lack of cooperation between national organizations to accurate registration of gastrointestinal cancer and to fight against these harmful cancers.

Introduction: In 2018, a total of 901 new cases of gastric cancer were recorded, of which 64.8% in males and 34.2% in females. The incidence rate of gastric cancer was 28.5 per 100 000 population, which 38.2 for males and 19.2 for females. Goal: We aimed to investigate the associations between some risk factors and gastric cancer among the Mongolian population. Materials and Methods: A case-control study was conducted between November 2017 and September 2019. We selected 120 cases from National cancer center of Mongolia who newly diagnosed gastric cancer. And 120 controls were selected by matching by sex, age and the place of residence. Informed consents were obtained from all subjects. All subjects were personally interviewed with researchers used by a structured questionnaire consisting of 86 questions. The SPSS 21 (version 16.0, SPSS Inc., Chicago, IL, USA) software was used for all analyses. Results: The mean age was 59.2±11.4 (26-85) years. Habits of having dinner after 6.00 pm (OR 1.42, 95%CI 1.11-1.83, p=0.008), having leftover meals (OR 2.22, 95%CI 1.27-3.86, p=0.008), daily consumption of tea with salt (OR 1.97, 95%CI 1.18-3.30, p=0.01), smoking on an empty stomach (OR 2.44, 95%CI 1.11-5.37, p=0.033), weekly consumption of ham and smoked meat (OR 1.5, 95%CI 1.17- 2.13, p=0.02), and consumption of fat grease (OR 2.09, 95%CI .03-4.24, p=0.038) were significantly increased gastric cancer risk. In contrast, habit of eating at regular times (OR 0.43, 95%CI 0.25-0.73, p=0.002), chewing thoroughly (OR 0.39, 95%CI 0.23-0.67, p=0.001), cooking meat thoroughly until it’s tender (OR 0.48, 95%CI 0.25-0.97, p=0.047), daily consumption of vegetables (OR 0.45, 95%CI 0.27-0.76, p=0.003), and daily consumption of fruit juice (OR 0.36, 95%CI 0.15-0.85, p=0.026) were significantly reduced gastric cancer risk. Furthermore, having first-degree relatives diagnosed with gastric cancer had 2-3 fold higher increased risk of gastric cancer (parents OR 2.88, 95%CI 1.07- 7.78, p=0.038, sibling (OR 3.09, 95%CI 1.09-8.81, p=0.036). Also, previous records of the digestive disease increased risk of gastric cancer (OR 3.65, 95%CI 2.10-6.35, p<0.0001). Conclusion Dietary habits, family history of gastric cancer and previous records of digestive disease were associated with risk of gastric cancer. Thus, prevention effort could be focused on the population with a family history of gastric cancer, changing bad dietary habit and screening precancerous disease of gastric cancer.

Background: The incidence of gastric cancer has been declining worldwide in recent years; on the contrary, it has increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed in the late stage. We performed a gastroduodenoscopy for screening and histological evaluation to diagnose gastric cancer. These methods are an effective diagnostic modality for gastric diseases; however, invasive and cause discomfort, making it an undesirable procedure for patients. Aims: To determine serum PGs and H.pylori IgG in atrophic gastritis and gastric cancer patients and evaluate the risk by ABC(D) classification. Materials and Methods: We selected 40 atrophic gastritis and 36 newly diagnosed gastric cancer patients from National Cancer Center of Mongolia, before surgery and other therapies. Besides, we enrolled population-based 38 healthy controls. Subjects of three groups were matched by age (±1) and sex. Written informed consents were obtained from all subjects. The fasting blood samples were collected and tested PGI, PGII, and H.Pylori IgG levels by enzyme-linked immunosorbent assay. Also, PGI to PGII ratio (PGI/II ratio) was calculated. We classified subjects into four groups based on ABC(D) classification. All statistical analyses were performed by SPSS (version 26.0, Chicago, IL, USA) software. Results: Median age of the subjects was 62, 52.6% (n=60) were male. Proportions of family history of gastric cancer and previous history of gastric disease were significantly higher in the gastric cancer group compared with atrophic gastritis and healthy control groups (p<0.05, p<0.05). H.pylori was positive in 67 (58.8%) subjects according to H.pylori IgG assay and there was no difference between study groups. The serum PGI level and was significantly decreased in gastric cancer and atrophic gastritis groups as compared to the healthy control (p<0.05, p<0.05). The PGI/II ratio was significantly lower in the gastric cancer group compared with the healthy control (p<0.01). The optimal cut off value of PGI was ≤35.25 ng/ml (AUC 64.3, 95% CI 51.3-77.2, p<0.05) for gastric cancer and PGI was ≤75.07 ng/ml (AUC 65.2, 95% CI 53.0-77.3, p<0.05) for atrophic gastritis. Also, the optimal cut off value of PGI/II ratio was ≤5.27 (AUC 71.6, 95% CI 69.6-82.8, p<0.01) for gastric cancer and PGI/II ratio was ≤6.25 (AUC 62.7, 95% CI 50.1-75.3, p<0.05) for atrophic gastritis. According to classification of atrophic gastritis patients and healthy control, group D had higher proportion of atrophic gastritis cases than group A, B and C (OR 5.04, 95% CI 1.13-22.50, p<0.05). According to classification of gastric cancer patients and healthy control, groups C had higher proportion of gastric cancer cases than group A, B and D (OR 6.19, 95% CI 1.04-36.78, p<0.05). Conclusion Our findings suggest that PGs level and H.pylori IgG may predict development of gastric cancer and could identifying individuals at high risk of gastric cancer and precancerous lesions who may need endoscopy.

Gastric cancer has been and still considered one of the most common causes of cancer-related mortality and it continues to be a major public health issue. The incidence and mortality of gastric cancer in Mongolia is the highest in the world. For this reason, this paper provides the information about current status of gastric cancer in Mongolia in the first section. Morbidity and mortality of gastric cancer increased steadily during the last decade. In the second section we overview the most important factors that can accelerate the risk of gastric cancer. Evidence from case-control, cohort studies and meta-analysis have suggested that the risk of gastric cancer is related to several factors including genetics, Helicobacter pylori, other factors related to the environment and lifestyle. Risk factors could have different effects on the onset and the evolution of gastric cancer.

Introduction: Cases of gastric cancer have been declining worldwide in recent years. However, gastric cancer incidence increased in the last decade in Mongolia. In Mongolia, over 80% of gastric cancer cases are diagnosed during the late stage. Several studies have revealed that serum pepsinogens (PGs) level reflects, indirectly, histological and functional characteristics of the gastric mucosa. Goal: We aimed to evaluate the risk of gastric cancer and its precancerous condition based on serum PGI, PGI/II biomarkers. Materials and Methods: This case-control study enrolled 114 subjects, including patients with gastric cancer (n=36), atrophic gastritis (n=40) and healthy controls (n=138). The questionnaires were obtained to determine risk factors. Serum PGI, PGII, and H. pylori IgG levels were measured by ELISA (Pepsinogen I ELISA; Pepsinogen II ELISA; H.Pylori IgG ELISA; BIOHIT Plc, Helsinki, Finland). PGI to PGII ratio was calculated. Patients were classified into the ABC(D) group according to Miki K approach. Also, we developed new scoring system based on some risk factors and serum PGI, PGI/II ratio. Logistic regressions were performed to evaluate risk and expressed by odds ratio (OR) and 95% confidence intervals (95%CI). Results: Mean age of the subjects was 60±10.9 years. H.Pylori was positive in 67 subjects. The serum PGI and PGI/II ratio levels were significantly decreased in gastric cancer and atrophic gastritis groups compared to the healthy control. According to classification ABC(D), group D (OR 5.04, 95% CI 1.13-22.50) had higher proportion of atrophic gastritis cases, group C (OR 6.19, 95% CI 1.04-36.78) had higher proportion of gastric cancer cases than others. Additionally, we created a risk prediction scoring system with a score ranging from 0 to 7, based on variables age, family history of gastric cancer, prior disease history, PGI and PGI/II ratio levels. For the atrophic gastritis patients, 17 (42.5%) were classified into medium-risk category (OR 4.49, 95% CI 1.38-14.58) and 17 (42.5%) were classified into high-risk category (OR 7.69, 95% CI 2.16-27.43). Whereas, 11 (30.6%) patients with gastric cancer were classified into medium-risk category (OR 4.35, 95% CI 1.13-16.85), 21 (58.3%) were classified into high-risk category (OR 14.25, 95% CI 3.60-56.43). Conclusion The methods based on serum PGI and PGI/II may identify a high risk population of gastric cancer and atrophic gastritis.