1.Study of EGFR Gene Mutation Detection in Non-Small Cell Lung Cancer
Mergen D ; ; Tamir B ; Dolgorsuren P ; Ganzorig B ; Undarmaa T ; Enkhjargal B ; Adilsaikhan M
Mongolian Journal of Health Sciences 2025;90(6):105-111
Background:
Lung cancer remains the leading cause of cancer-related mortality worldwide, accounting for approximately
1.8 million deaths annually and representing 18% of all cancer deaths¹. According to the GLOBOCAN 2024 report, 2.4
million new cases were registered globally, ranking second after breast cancer². Non-small cell lung cancer (NSCLC) constitutes
85% of lung cancer cases, with adenocarcinoma being the most common subtype³. The objective of this study is
to map the prevalence of HER2 activation and mutations in EGFR, EML4-ALK, ROS1, BRAF, and KRAS genes among
lung cancer patients in Mongolia, and to evaluate their correlations with clinical and morphological parameters (age, sex,
smoking status, stage, and morphology).
Aim:
To determine the distribution pattern of HER2 activation and EGFR, EML-ALK, ROS1, BRAF, KRAS gene mutations
among patients with lung cancer in Mongolia, and to evaluate their associations with clinical and morphological
characteristics.
Materials and Methods:
A retrospective study was conducted using archived materials from lung cancer patients at the
Clinical Pathology, Molecular Genetics, and Pathology Laboratories of the National Cancer Center of Mongolia, covering
the period from 2019 to June 2025.
DNA Extraction from Tumor Tissue: Formalin-fixed paraffin-embedded (FFPE) tissue blocks from patients diagnosed
with lung cancer, stored in the pathology department archives, were selected for the study. Sections of 5–10 μm thickness
were cut, mounted on glass slides, stained with hematoxylin and eosin (H&E), and reviewed by a pathologist. Areas containing
≥20–30% tumor cells were identified and macro-dissected for analysis.
Real-Time PCR Assay for Detection of EGFR/BRAF/KRAS/EML4-ALK/ROS1 Mutations: EGFR mutation detection
was performed using the PANAMutyper™ EGFR Mutation Detection Kit (Panagene, Daejeon, South Korea) according
to the manufacturer’s instructions. PCR reactions were carried out on a compatible instrument (Roche LightCycler 480,
Germany) as recommended by the manufacturer. Statistical analysis was performed using Prisma-10 software.
Results:
A total of 282 lung cancer cases were included in the study. EGFR mutations were detected in 44% of cases and
were absent in 56%. No significant age-related differences were observed (p=0.2636); however, EGFR mutations were
significantly more frequent in females (36.6% vs. 19.6%, p=0.0019). No statistically significant differences were found
across disease stage, T, N, or M classifications (p>0.05). No association was identified between smoking status and EGFR
mutations (p=0.4178). Morphologically, EGFR mutations were significantly more prevalent in adenocarcinoma (54.83%)
compared to squamous cell carcinoma (SCC) (31.8%; p=0.002).
Of the 282 cases, adenocarcinoma accounted for 155 (54.9%) and SCC for 116 (41.1%). Overall, EGFR mutations were
positive in 43.97% of cases, with a higher prevalence in adenocarcinoma (24.82%) than in SCC (13.1%). By exon:
- Exon 18 mutations were detected in 6% of cases, predominantly in adenocarcinoma (6%, 4.25%).
- Exon 19 mutations occurred in 8.15% and are associated with sensitivity to targeted therapy.
- Exon 20 mutations were found in 3.19%, with the T790M resistance variant in 1.77%.
- Exon 21 mutations were observed in 9.57%, more common in adenocarcinoma (9.57%) than in SCC (3.19%).
Survival analysis stratified by stage at diagnosis showed significantly longer median survival in early-stage patients (18.6
months). Kaplan-Meier curve comparison, log-rank test, and hazard ratio calculations confirmed statistically significant
differences (p < 0.05), indicating that disease stage is a key prognostic factor.
Conclusion
The study findings reveal a high prevalence of EGFR mutations among Mongolian patients with lung adenocarcinoma,
underscoring the need for widespread implementation of targeted therapy (EGFR-TKIs). In contrast, mutation
rates were lower in SCC and other morphological subtypes, highlighting the importance of investigating alternative
molecular markers in these subgroups.
2.Prevalence of Micronutrient Deficiencies Among Mongolian Pregnant Women
Oyundelger D ; Bolormaa N ; Munkhjargal L ; Munkhtamir M ; Davaasuren M ; Amarsanaa B ; Delgermaa D ; Ganzorig T ; Munkhtsetseg P ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):24-31
Background:
Vulnerable populations at risk of micronutrient deficiencies include children and women,
especially pregnant women, lactating mothers, infants and young children. According to
WHO guidelines, a population with a micronutrient (vitamin and mineral) deficiency of more
than 20% is considered a public health problem.
Although Mongolia has made significant progress in improving the nutritional status of the
population, especially children and women, the 2024 VI survey found that micronutrient
deficiencies are high among pregnant women.
The MMS (Multi-ingredient Micronutrient Supplement) distributed to pregnant women by
soum and household health centers contains all the essential vitamins and minerals for
pregnant women, but coverage has remained inadequate for more than 10 years.
Goal:
To establish the prevalence of micronutrients deficiency in pregnant women
Materials and Methods:
Totally 2796 pregnant women included in cross-sectional study from urban and rural
area. Survey procedures consisted of interview, anthropometric measurements, clinical
examinations, and the collection of biological (blood and urine) samples for pregnant
women. Micronutrient deficiencies were assessed by tests for hemoglobin, serum, ferritin,
soluble transferrin receptor (sTfR), 25-hydroxyvitamin D {25(ОН)D}, spot urine samples for
determination of urinary iodine concentration.
Statistical processing :
The data from the survey questionnaires were entered into a database created in the
“EpiData 3.1” software environment. The data created and verified in the EpiData software
environment were converted to the “SPSS–25” program, and statistical analysis was also performed using the SPSS-25 program. The results table was prepared using Microsoft
Word 2021 and Microsoft Excel 2021 programs.
Research ethics:
The research methodology was discussed at the meeting of the Medical Ethics Review
Committee under the Ministry of Health on 2023.03.27 (23/017), and permission to conduct
the study was obtained
Result :
The prevalence of anemia, as measured by hemoglobin, was 22.3% and the iron deficiency
anemia (IDA), as measured by adjusted serum ferritin or soluble transferrin receptor (sTfR)
was (39.8%/9.0%). Prevalence of iron deficiency as measured by serum ferritin was also
highest in Western 41.9% and lowest in Khangai region 40.2% (P<0.01). The prevalence of
vitamin D deficiency among pregnant women was high at 92.5%, and 7.5% of all pregnant
women had adequate vitamin D status. The median concentration of 76.4µg/l indicates
inadequate iodine status in pregnant women, as the desired range for adequate iodine
nutrition in pregnancy 150-249 µg/l.
Conclusions
1. 22.3 percent of pregnant women are anemic, and the prevalence of anemia has not
decreased from 2017 levels and remains common.
2. The prevalence of iron deficiency (as measured by ferritin levels) was 39.8 μg/L and the
soluble transferrin receptor level was 9.0 μg/L, which is higher than previous studies.
3. The prevalence of vitamin D deficiency among pregnant women remains common, with
76.6% having severe or moderate deficiency, and 15.9% having mild deficiency.
3.The prevalence of overweight and obesity among men aged 15-49 in Mongolia
Tuvshinbayar B ; Ganzorig T ; Oyundelger D ; Delgermaa D ; Bayasgalan J
Mongolian Medical Sciences 2025;214(4):32-37
Background:
Men’s health is a vulnerable associated with higher risk behaviors and is less considered
to their health compared to women. According to NSO, of the total population, 49.3 percent
were males and 50.7 percent were females in Mongolia. There is a difference in average
life expectancy between man and woman, and males live in average eight years (9.2) fewer
compared to females.
Objective:
To determine nutrition status among men aged 15-49 in Mongolia
Materials and Methods:
The target population was divided into 5 strata based on Mongolia’s socio-economic regions
and Ulaanbaatar City. 1950 men aged 15-49 were randomly selected. The confidence
interval was set at 95%, with a precision of ±5% or less for all indicators. The sample size
was sufficient to obtain representative data on the nutrition status of men at the national level
and to calculated using WHO recommendation for adults.
Ethics consideration:
The survey methodology was discussed at the Scientific committee
of National Center for Public Health, on February 6, 2023. Ethics approval was obtained
from Medical Ethics Review Committee under the Ministry of Health on March 27, 2023. All
participants were participated voluntarily and written informed consent were obtained from
participants.
Results:
The prevalence of overweight and obesity among men was 57.4%, with 17.0% classified as
obese. Overweight and obesity rates were highest in men aged 30-39 years (62.2%) and 40
49 years (64.5%) among other age groups.
Conclusion
In Mongolia, the prevalence of overweight and obesity among men aged 15–49
increased by 9.4 percentage point to reach 57.4%, since 2017 and 17.0% of men aged
15-49 years are now classified as obese, with biggest increase in age group 20-29. The
prevalence of obesity was higher among men in the above-average and affluent groups
(20.0% and 20.6%) compared to men aged 15-49 living in the average and below-average
income groups (10.8% and 13.1%).
Conclusion: In Mongolia, one in two men age between 15-49 years were overweight and obese. The
prevalence of overweight and obesity has increase age between 30-49 years compared with
other groups.
4.Food supplements
Bayasgalan J ; Erdenetsogt E ; Ganzorig T ; Ariunzaya Sh
Mongolian Medical Sciences 2025;214(4):75-84
At present, when the prevention from diseases became a priority in health system, developed
countries pay their attention to Food Supplements. The food supplements are products
containing biologically active substances of natural origin with a complex composition used
with food or for food fortification.
The daily dose of food supplements should not be higher than the content of the substances
in one curative dose of a drug. The food supplements can be divided into five groups -
nutraceuticals, parapharmaceuticals, probiotics, enterosorbents and cosmeceuticals. The
dose and frequency of use of food supplements with food is based on the specifics if a
person depending on factors such as age, weight, gender and physiology.
The modem nutrition guidelines require adequate intake not only of protein, fat, carbohydrates
and other nutrients but also of food supplements.
5. NON-DIAGNOSTIC RATE COMPARISON BETWEEN THE DIFFERENT FNA TECHNIQUE IN FOUR GROUPS
Otgonbayar S ; Ganzorig B ; Ulzii-Orshikh N ; Bayarmagnai M ; Tudevdorj S ; Munkhbold T ; Buyanjargal SH ; Ishdorj TS
Journal of Surgery 2016;20(2):13-17
mmon clinical scenario [1]. The prevalenceof thyroid nodules is ~18-40% in Chineseadults [2]; however, only 5-10 percent of allthyroid nodules are malignant. Although withthe development of the ultrasound technique,several ultrasonographic characteristics havebeen associated with thyroid malignancy[3], individual ultrasound features arenot accurate predictors of thyroid cancer.Thyroid fine-needle aspiration [FNA] hasbeen recommended by various organizationsfor the more precise preoperative diagnosisof thyroid nodules [4]. Non-diagnostic rateof FNA comparison and estimate betweenthe other studiesMaterials and Мethods: We performedover 100 FNA using one pass of the 21-Gneedle attached to a 10 ml syringe withoutlocal anesthesia in 2015. All the FNAswere performed without the guidance ofultrasound. Recent study 100 cases of themwere not selected for a specific method.Results: In total there were 100 patientsrecruited in the study with a mean ageof 45.94±13.13 years and 83.0% femalepatients.The Non-diagnostic rate was comparedbetween groups with different needlesizes and methods. In the 22 G group,non-aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. In the non-aspirationgroup, a lower ND rate was revealed in the25-G needle group compared to the 22-Gneedle group [34.97 vs. 44.21%, P=0.032;].Notably, the ND rate in the 25 G group wassignificantly lower than in the all 22 G group[34.97 vs. 58.13%, P<0.001;]. In the 21 Ggroups, aspiration showed a decreased NDrate as compared to aspiration [44.21 vs.76.76%, P<0.001;]. 21G aspiration groupshowed decrease twofold ND rate ascompared 22G aspiration group [31.63 vs.76.76%, P<0.001;]Conclusion: There have been studiesusing various needle types [regular needle,needle with a stylet or spinal needle [5]and different needle sizes from [21 G to27 G] with or without aspiration duringthe procedure. Numerous factors influencethe diagnostic rate in thyroid FNA, amongwhich the nodule component is an extremelyimportant factor [6]. In general, the morecystic the percentage of each nodule, thehigher the rate of non-diagnostic, with the lowest ND rate in the solid nodule using a25-G needle at 26.77% and the highest inthe cystic nodule using 22 G aspiration at85.19%. A similar trend was found in eachgroup with lowest rate of ND in the 25 Gnon-aspiration group and highest in the 22G aspiration group.
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