Summary. Background: Patients with esophageal squamous cell carcinoma (SCC) have a poor prognosis mostly due to the late diagnosis. A morphological method is still the main diagnostic method for SCC. The aim of the study was to find out which histological criteria, namely Western or Japanese criteria, for early stage SCC are used by pathologists in Ukraine as compared with their Japanese colleagues. Methods: 14 Ukrainian and 6 Japanese pathologists have participated in this study. Virtual slides for research were provided by National Cancer Research Center (Tokyo, Japan) in 2018. Each of the pathologists has used these slides and presented the conclusion via the Internet. Results: Essential diagnostic discrepancies were revealed: a number of biopsy specimens was diagnosed by Japanese pathologists as “noninvasive carcinoma”, while Ukrainian pathologists classified the specimens as high-grade or low-grade dysplasia, indefinite for neoplasia, or reactive/regenerative lesions. Conclusion: The adoption of a unified concept of criteria for non-invasive (intraepithelial) carcinoma underlies early endoscopic/surgical treatment, which significantly increases the survival rate of patients with SCC. A solid common approach to the diagnosis between Western and Japanese pathologists, as well as endoscopists, is necessary to ensure timely treatment and increase survival rate of patients with SCC.

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Gastroesophageal reflux disease (GERD) remains an urgent problem in clinical medicine. The search for ways of effective treatment leads to the need to set new accents in the multifactorial pathogenesis of the disease. According to current trends, special attention is paid to the epithelial barrier of the esophagus. The article presents considerations of the structure of the mucosal epithelial layer, the features of transport routes and intercellular interactions of the esophageal epithelium. Special attention is paid to the phenomenon of the Dilated Intercellular Spaces (DIS) and the syndrome of increased epithelial permeability (SІEP) at GERD. An interpretation of these concepts is given, their role in the implementation of inflammatory processes and the formation of clinical manifestations of the disease, such as heartburn and pain, is revealed. The data on the possible mechanisms of the formation of the DIS and SІEP phenomenon, methods of their diagnosis and aspects that are discussed in the scientific world are presented. The possibilities of cytoprotective therapy using alginate preparations have been shown. Among the alginates, available on the pharmaceutical market of Ukraine, the pharmacological line Gaviscon® (LLC Reckitt Benckiser Ukraine, Great Britain) is presented. The results of experimental studies with the use of the latest technologies, and data from randomized clinical trials confirming the alginates’ clinical efficacy, have been outlined. The phenomenon of DIS of the esophageal epithelium and SІEP for aggression factors is one of the leading links in GERD pathogenesis, in particular, its non‑erosive form, and to some extent determines the features of the clinical manifestations of the disease. Treatment of GERD with the use of alginates is logically justified, successfully used in clinical practice, and continues to be actively studied. The use of Gaviscon® products is expedient due to their unique mechanism of action to increase the resistance of the esophagus.

Background. Esophageal cancer remains a major medical challenge since it belongs to the most aggressive malignant neoplasms, usually diagnosed at a late stage of the disease. Purpose – Studying the general patterns of time course of esophageal cancer epidemiological status in terms of morbidity and mortality among the adult population of Ukraine within the period from 2014 to 2019. Materials and Methods. General and standardized morbidity and mortality rates resulting from esophageal cancer from 2014 to 2019 throughout Ukraine and in terms of administrative territories per 100 thousand adult population have been researched along with calculating the growth rate. The study was carried out based on the data of National Cancer Registry of Ukraine. Statistical processing of the obtained data was performed by means of generally accepted statistical methods. Results and discussion. The all-Ukrainian incidence of esophageal cancer averaged 4.5 per 100 thousand population. Zhytomyr, Sumy and Chernihiv regions can be considered as the regions with the highest incidence of esophageal cancer. The lowest number of esophageal cancer cases was found in Chernivtsi and Odesa regions of Ukraine. Esophageal cancer mortality rates ranged slightly from 3.3 to 3.6 per 100 thousand population, but it reduced by 8.3% within six years. Monitoring changes of esophageal cancer mortality rate over time, in 2014 and 2019 in Ivano-Frankivsk, Mykolaiv and Rivne regions and in Kyiv it increased by more than 20%. A 30% reduction in mortality was observed in Kirovohrad, Odesa, Kharkiv and Zhytomyr regions. In 2019, Odessa and Kirovograd could be considered the regions with a low mortality rate showing 2.1 per 100 thousand population. In 2018, 88% of esophageal cancer cases were diagnosed in men and only 12% in women. The vast majority of cancer patients were aged 50 to 80 years. Mortality from esophageal cancer was significantly higher in men (91.2%) compared to women. Conclusions. The consistency of morbidity and mortality levels of esophageal cancer among the population of Ukraine during 2014-2019 has been established with insignificant regional disparities.