Introduction: According to the World Health Organization (WHO) data from 2022, 19.9 million people were diagnosed with cancer globally, and 9.7 million people died from the disease. In recent years, the incidence of colorectal cancer (CRC) has been rapidly increasing, ranking 4th among all cancers with 18.4 cases and 8.1 deaths per 100,000 population. In Mongolia, 826 new cases of CRC have been registered over the past six years, with an incidence rate of 8.2 cases and a mortality rate of 5.03 per 100,000 population. It is projected that by 2030, the incidence will reach 13.28 cases and the mortality rate will rise to 8.72 per 100,000 population. We aimed to comprehensively examine the risk factors for colorectal cancer among the population of Mongolia, establish a scientific basis for early detection and prevention, and strengthen preventive measures. Materials and Methods: A case-control study was conducted from 2022 to 2024. The study enrolled a total of 305 subjects, including 98 patients with colorectal cancer, 101 patients with colon polyps, and 106 healthy subjects. The risk. questionnaire consisted of 50 questions divided into 10 sections. All statistical analysis was performed with SPSS version 23.0 software (SPSS Inc., Chicago, IL, USA) and P value <0.05 was considered statistically significant. categorical data was represented as numbers and percentages. Pearson’s chi-squared and Fisher’s exact test were used to compare categorical variables. Multivariate logistic regression was used to identify the risk factor associated with recurrence. The study protocol was approved by Ethics Review Committee of Ministry of Health of Mongolia on 17 March 2023 (approval number: 23/012). Results: The average age of the participants was 57.1±12.8 years. Among all study participants, 37.6% (115) were male and 62.4% (188) were female. Comparison of colorectal cancer incidence by age and gender revealed no statistically significant differences (p=0.021; p=0.422). Regular physical exercise was found to have a protective effect against colorectal cancer (p=0.076; OR 0.341 95% Cl 0.118-.0986). The frequency of fruit consumption, 4 to 6 times per week (p=0.008, OR 0.08, 95% Cl 0.01-0.45), frequency of vegetable consumption 4 to 6 times per week (p<0.00; OR 0.07, 95% Cl 0.02-0.19), no dining out (0.007, OR 0.3, 95% Cl 0.18-0.68), and meat consumption (p=0.001) are decreased risk of colorectal cancer. Conclusion The patient's age and the presence of colon polyps are risk factors for colorectal cancer, while regular physical activity and a diet rich in fruits and vegetables are protective factors that help reduce the risk of developing colorectal cancer.

Introduction: In 2018, the overall colorectal cancer (CRC) incidence rate was 3.6%, according to the National Cancer Center of Mongolia (NCCM), and the incidence of colorectal cancer has increased slightly in recent years. According to cancer stages, late stage cancer has a 5-year survival rate of 51%, while early stage cancer has a 5-year survival rate of 79%. The overall survival rate of colorectal cancer in Mongolia has not been studied in precisely. In Asia, the 5-year survival rate for colorectal cancer was 60%. Therefore, this study investigated the colorectal cancer survival rate and prognostic factors at NCCM. Methods: A total of 108 patients diagnosed with CRC at NCCM’s General Surgery Department from 2013 to 2015 were used in this retrospective cohort study. The Kaplan-Meier method was used to develop the survival graphs, which were then compared using the Log-rank test. Results: The median survival time was 42 months, with a 95% CI (38.55-45.66). A 5-year period, the overall survival rate for CRC was 61.2%. Survival rates at the I, II, III, and IV stages were 100%, 75%, 65.4%, and 13.5%, respectively. There was a significant difference in CRC survival rates across all stages (p=0.0001). There was a statistically significant difference in determining the relationship between adjuvant chemotherapy and survival rate (p=0.0003). Conclusion The outcome of the surgery is determined by the CRC stage. The postoperative survival rate (61.2%) is directly related to tumor stage, peripheral glandular metastasis, distant metastasis, and chemotherapy effects.

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.

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.

Gastric and esophageal cancer is a significant global health issue. The epidemiology of these tumors has significantly increased over the past several years especially in developing and developed countries. Many dietary exposures have been proposed to protect against or increase risk for esophageal and gastrointestinal (GI) cancers, including poor diets, foods, individual nutrients, methods of food preparation, and habits of consumption. Overweight/obese status is associated with an increased risk for many cancer types such as esophageal, gallbladder, kidney, pancreatic and gastric cancer. The association between obesity and cancer is strong. Nowadays there is a recognized decrease in incidence and mortality of distal gastric cancer and an increase in incidence and mortality of proximal esophageal cancer. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. It is very important to understand how diet and nutrition affect to gastric and esophageal cancers. In this review we will discuss the effect of diet in locally advanced gastro-esophageal cancer. Although we tried to conclude all published articles about gastric and esophageal cancers in Mongolia.
In this survey, is considered dietary risks into 5 groups as following;
• Insufficient nutrition education(don’t know food and nutrients significance and food hygiene, don’t know right consumption of food)
• Bad habits (hot tea and meals, salty tea and food, low consumption of fruits and vegetables, sometimes eating breakfast, most of daily energy of food in the night, high amount of sugar, a drink of caffeine, overweight and etc.)
• Food processing technology (such as overcooking, pickling, preserving, frying, excessive salt in tea fried and etc).
• Chemical contaminants in food products (various inorganic fertilizers, heavy metals and etc.)
• Household economic capacity is influencing
Diet can be used as a tool to evoke the positive/desirable biological responses of an organism aiming to maximize health and protection against diseases (chronic/non-communicable diseasesparticularly cancer) by mostly means of prevention.

Gastric cancer is the second leading cause of death worldwide. About half of the incidence of stomach cancer has been reported in East Asian countries. In Mongolia, gastric cancer is the second most common cancer in males and the third most common in females. The age-standardized mortality rate for gastric cancer was 29.3 per 100,000 in 2016, ranking second after liver cancer. Pepsinogen (PG) is a proenzyme of pepsin, by chief and mucous neck cells in the gastric mucosa. On the basis of the source of secretion, PGs are subdivided into 2 types: PG I and II. PG I is only secreted from the fundic glands in the corpus of the stomach, whereas PG II is secreted from the corpus, as well as the pyloric glands in the antrum and proximal duodenum. PG is excreted mainly into the stomach lumen, but approximately 1% diffuses into the blood stream. Atrophic gastritis and intestinal metaplasia are well-known risk factors for gastric neoplasms including dysplasia. To identify these premalignant gastric conditions, histological biopsy or image-enhanced endoscopy is performed. Gastric cancer is usually preceded by a decades-long precancerous process driven by Helicobacter pylori infection and environmental conditions with well-defined successive lesions. In the advanced stages, they are characterized by glandular atrophy and intestinal metaplasia. These changes involve loss of the original glands and result in decrease of the mass of chief cells of the gastric corpus, where PGI is produced. Loss of chief cells leads to lower PGI levels and PGI/PGII ratio in the peripheral blood. Serum PG levels are therefore a key tool to be used in screening programs. Serum PG measurements could provide a simple and noninvasive method for screening gastric neoplasms.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. Immune cell surface receptors, called Toll-like receptors (TLRs) recognize and bind pathogens. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulatory proteins on the IFN-γ/TLR9 synergistic signaling pathway Materials and Methods: This study was held in the Core Laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). In this study, murine endothelial cell (END-D) culture was used. The negative and positive regulator protein expression was detected by Western blotting. Result: Result of immunoblotting assay indicated that CpG DNA enhanced IFN-γ positive regulator protein p38 phosphorylation in the endothelial cells. Treatment by TLR9 ligand CpG DNA and IFN-γ increased p38 activation in 0.5 hour and 1 hour. CpG DNA inhibited IFN-γ negative regulator SOCS1 protein expression in 4 hr and 8 hr. Therefore, TLR9 ligand CpG DNA increased IFN-γ signal transduction in the endothelial cell line. Conclusion TLR9 ligand CpG DNA has decreased IFN-γ negative regulator protein SOCS1 expression. CpG DNA has increased IFN-γ positive regulator protein p38 phosphorylation.

Introduction: When human body encounters external pathogens primary/innate immunity cells are activated by recognizing them and secondary/adaptive immunity is activated consecutively. In our previous study, we revealed that there is a synergistic action between TLR9 and IFN-γ signaling in the endothelial cells. Purpose: To determine the role of negative and positive regulator proteins on the IFN-γ/TLR9 signaling pathway. Methods: In this study, murine endothelial cell (END-D) culture was used. END-D cells pre-treated with TLR9 ligand CpG DNA and then stimulated with IFN-γ. The negative (SHP-2, SOCS1, PIAS1) and positive (p38) regulator protein expression was detected by Western blotting. Results and Conclusion Treatment by TLR9 ligand CpG DNA and IFN-γ increased positive regulator p38 phosphorylation in 0.5 hour. CpG DNA inhibited IFN-γ negative regulator PIAS1 protein expression in 6 hour and SOCS1 and SHP-2 expression could not affect in 4 hour.

BACKGROUND: Toll like receptors (TLRs) are a class of proteins that key role in the innate immune system. TLR7 is expressed on monocytes, macrophages and dendritic cells, T cell, B cell and eosinophiles. TLR7, originally identified as recognizing imidaquinoline, loxibrine, broprimine and ssRNA, ssRNA viruses such as vesicular stomatitis virus, influenza A virus and human immunodefiency virus. It is known that virus ssRNA affects signaling molecule of IFN-y. Objective: To determine gene and protein activation of IFN-y signal transduction by TLR7 ligand in the endothelial cells. MATERIAL: In study we used mouse aortic linear endothelial cell which is cultured (END-D) in 5% heat- inactivated fetal calf serum (FCS), medium (DMEM) containing antibiotic mix(penicillin G, streptomycin, amphotericin B) at 37°C (5% CO2). Endothelial cells treated with synthetic IFN-γ and imiquimodligands, then the NO (nitric oxide) concentration in the supernatant is determined by Griess reagent. Endothelial cells are cultured in 6 well cell culture plate and in each well 2*104cells are expected to be grown for 24 hours of culture. Then, the cells are treated with synthetic IFN-γ and имиквимод ligand for 6 hours and the NO signaling gene activation iNOS mRNA expression which is induced by IFN-γ is determined by RT-qPCR. Endothelial cells are cultured in 12 well cell culture plate and in each well 2*104 cells are expected to be grown for 18 hours of culture. Then, the cells are treated with synthetic IFN-γ and imiquimodligands for 24 hours and the NO signaling protein iNOS expression which is induced by IFN-γ is determined by western blotting. The experiment was conducted as representation mean of at least three test results. The difference between statistical probabilities is determined by the “Students” t test. The p<0.01 value is assumed to be statistically different. RESULTS: TLR7 ligand imiquimodaugmented interferon gamma induced nitric oxide production TLR7 ligand imiquimodincreased interferon gamma induced iNOS mRNA gene expression. TLR7 ilgand imiquimodup-regulated interferon gamma induced iNOS protein expression. CONCLUSIONS: TLR7 ligand imiquimod augments IFN-γ signaling in the endothelial cells. This synergistic effect has revealed in the levels of gene and protein expression.

Introduction: The aim of this research project is to elucidate the crosstalk of innate and adaptive immune reactions against the DNA containing bacteria. : This study held in the Core laboratory, Science Technology Center, Mongolian National University of Medical Sciences (MNUMS). Murine aortal endothelial cells, END-D cultured and the cell viability checked by MTT assay. In addition, the NO production, protein and gene expression studied by Griess Reagent assay, R.T-PCR and immunoblotting, respectively. Results: 0.1µM, 1µM and 10µM of TLR9 ligand exhibited no cytotoxic action against the cells by MTT assay. IFN-ү alone induced NO production in END-D cells. In the other hand, TLR9 ligand at 0.1µM, 1µM and 10µM up-regulated IFN-ү induced NO production in dose dependent manner. RTPCR results exhibit that TLR9 ligand up regulates iNOS mRNA. Immunoblotting analysis showed the enhanced iNOS protein expression and phosphorylation of STAT1 in cells pre-treated with TLR9 ligand. Discussion: We have demonstrated CpG DNA, TLR9 ligand, up-regulates IFN-ү induced NO via enhanced IFN-ү signaling. The result of Western Blotting and RT-PCR support the up-regulation of NO. CpG DNA can be used as agent against virus and bacteria. Further research need to be conducted. Conclusion TLR9 ligand, CpG DNA up-regulates IFN-ү induced NO production in time and dose dependent manner. TLR9 ligand augments the expression of iNOS mRNA and STAT1 phosphorylation in response to IFN-ү.