1.Performance of risk-based scoring systems in Colorectal cancer screening
Temuulen Ts ; Sarantuya G ; ; Oyuntsetseg Kh ; Sugar B ; Zesemdorj O ; Tsevelnorov Kh ; ; Gantuya B ; ; Sainzaya B ; Munkh-Erdene Ts ; Saruuljavkhlan B ; ; Byambajav Ts ;
Mongolian Journal of Health Sciences 2026;95(5):50-56
Background:
According to the 2024 national health statistics of Mongolia, colorectal cancer accounts for 5.1% of all newly diagnosed cancers, with 74.1% detected at an advanced stage. Although population-based screening programs have recently been implemented, no studies have established a risk factor–based scoring system with an optimal cut-off value or evaluated its clinical utility in resource-limited settings in Mongolia.
Aim:
To develop a modified APCS (mAPCS) scoring system and evaluate its clinical applicability for colorectal cancer screening.
Materials and Methods:
A hospital-based prospective cross-sectional study was conducted between December 2024 and February 2026 at the outpatient clinics of the Mongolian National University of Medical Sciences and the Mongolia–Japan Hospital. A total of 447 eligible participants were enrolled. Anthropometric measurements (height and weight) were obtained, and six categories of questionnaires (demographic data, APCS risk score, behavioral factors, medical history, and medication use) were administered. Eleven participants declined colonoscopy; therefore, 436 participants underwent colonoscopic examination, with histopathological evaluation performed when indicated.
Results:
A total of 436 participants were included, of whom 282 (64.7%) were female, with a mean age of 54.8±11.5 years. Colorectal adenomas (advanced and non-advanced) and colorectal cancer were detected in 199 (45.6%) participants. Among them, 43 (21.6%) had advanced colorectal neoplasia. Multivariable regression analysis identified age ≥55 years (OR 4.8), BMI ≥28 kg/m² (OR 3.6), and a family history of colorectal cancer (OR 3.1) as independent risk factors for advanced neoplasia. The optimal cut-off value for the mAPCS score was 4, with an overall diagnostic accuracy of 41.7% (sensitivity 97.7%, specificity 35.6%).
Conclusions
1. Age ≥55 years, BMI ≥28 kg/m², and a family history of colorectal cancer were identified as independent risk factors for advanced colorectal neoplasia. At a cut-off value of ≥4, the mAPCS scoring system demonstrated high sensitivity (97.7%), low specificity (35.6%), high negative predictive value (99.2%), and low positive predictive value (14.2%). 2. Therefore, the mAPCS scoring system may serve as a useful tool for risk stratification and efficient allocation of limited resources in colorectal cancer screening.
2.Results of using fecal calprotectin in the diagnosis of inflammatory bowel disease
Maral B ; Byambajav Ts ; ; Bira N ; ; Sugar B ; Zesemdorj O ; Khishgee D ; Gantuya B ; ; Tsevelnorov Kh ; ; Sainzaya B ; Munkh-Erdene Ts ; Saruuljavkhlan B ; ; Tuul B ; Pagamdulam L ; Sarantuya G ;
Mongolian Journal of Health Sciences 2026;95(5):77-81
Background:
Inflammatory bowel disease (IBD) is a chronic immune-related condition caused by interactions between genetics, immune dysfunction, gut microbiota changes, and environmental factors, often presenting as persistent or recurring diarrhea. Clinically, it commonly presents with chronic diarrhea and other gastrointestinal symptoms. The global prevalence of IBD is increasing, currently affecting approximately 0.5% of the population, with projections suggesting a rise to nearly 1% by 2030. Fecal calprotectin is a neutrophil-derived S100 calcium-binding protein that is elevated in intestinal mucosal inflammation and serves as a reliable noninvasive biomarker of inflammatory activity. Due to its high stability and close association with intestinal inflammatory activity, fecal calprotectin has been established as a dependable, non-invasive marker for identifying intestinal inflammation. In clinical practice, it is extensively used to distinguish IBD from functional gastrointestinal disorders, especially irritable bowel syndrome, among patients presenting with chronic diarrhea. However, its diagnostic utility in Mongolia remains underexplored, and this study aims to determine its sensitivity and specificity in inflammatory bowel disease and compare its diagnostic performance with other inflammatory markers.
Aim:
To determine the sensitivity and specificity of fecal calprotectin in inflammatory bowel disease and to compare it with other inflammatory markers.
Materials and Methods:
A total of 109 participants aged 18-87 years with chronic diarrhea, who attended the gastroenterology outpatient clinics of the Mongolia–Japan Hospital and Intermed Hospital between December 2024 and December 2025 and provided informed consent, were enrolled in this study. Data were collected using structured questionnaires, and laboratory investigations included complete blood count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and measurement of fecal calprotectin levels from stool samples. Based on fecal calprotectin results, selected participants underwent colonoscopic examination as clinically indicated.
Results:
Among the 109 participants included in the study, 17.4% were diagnosed with inflammatory bowel disease (IBD), with a mean age of 47.41±15.52 years. Fecal calprotectin levels were significantly higher in the IBD group compared to the control group (p<0.001). Fecal calprotectin demonstrated a weak positive correlation with C-reactive protein (CRP) and leukocyte count (p=0.042, p=0.06), while no significant correlation was observed with erythrocyte sedimentation rate (ESR). At a cutoff value of 250 µg/g, fecal calprotectin showed a sensitivity of 94.4%, specificity of 69.2%, positive predictive value (PPV) of 37.8%, and negative predictive value (NPV) of 98.4%. Receiver operating characteristic (ROC) curve analysis identified an optimal cutoff value of approximately 400 µg/g (AUC=0.919, Youden index=0.724), at which the sensitivity remained 94.4% and specificity increased to 78.0%. In contrast, CRP and ESR demonstrated comparatively lower diagnostic performance, with AUC values of 0.640 and 0.644, respectively.
Conclusion
This study demonstrates that fecal calprotectin has superior diagnostic performance compared to conventional inflammatory markers in differentiating inflammatory bowel disease (IBD). An optimal cutoff value of approximately 400 µg/g yielded the highest sensitivity and specificity. Therefore, fecal calprotectin may serve as a valuable tool in clinical practice for both screening and diagnostic confirmation.
3.Genetic variants within the genus echinococcus identified by restriction fragments length polymorphism
Narankhajid M ; Gurbadam A ; Giimaa N ; Purevdorj I ; Munkhtogoo S ; Ouyn-Erdene B ; Tsendjav A ; Ganzorig B ; Sugar S
Mongolian Medical Sciences 2010;153(3):19-23
Background:Echinococcosis is from animals to humans and cause cestode zoonoses. Genetic variations within of echonoccocus and their genotypes may cause a disease as well as can indicate transmission dynamics to human and pets. At present, there are no available data for the typing of echinococcosis isolated in MongoliaMaterials and Methods:A total of 50 human hydatid samples from collected from State Centre on Maternal and Child Health, Oncology Centre of Mongolia. All samples were examined by PCR using cox1. The PCR products with a molecular size of 578 bp were amplified from human hydatid samples. Also we used RFLP method.Results:Genotype and strains of E. multilocularis and Е. granulosus were identified by RFLP. PCR products were digested using Ssp I, Hind III, Bgl II endonucleases. PCR products were digested by Ssp I endonuclease we found E. multilocularis. PCR products were digested by Bgl II endonuclease. Two major bands were seen in human hydatid sample. The bands have molecular weight of 420 and 158 bp respectively. It was infected by E. granulosus G6. Digestion with Hind III revealed two major bands within samples from human hydatids. These bands have molecular weight of 168, 410 bp respectively. These samples were infected by E. granulosus G1. Most of E. granulosus materials obtained from human patients by surgery confirmed the presence of sheep strain G1 (Bowles and McManus, 1993 a & c). In 24 cases of human hydatid echinococcosis in Mongolia sheep strain was found to be infective to humans.Conclusions:1. Echinococcosis caused by E. granulosus, E. multilocularis in human.2. G1, G6 genotypes of E. granulosus found in human hydatids.
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