Kolesnik O. Cliniko-morfologycal criterea of progression cancer of rectum.

The object of the investigation is patients suffering from cancer of the rectum. The aim is to increase the effectiveness of treating patients with cancer of the rectum by the individual administration of the pre-operative radial therapy and the adjuvant chemotherapy by means of the supplementary progressing criteria. The methods are clinical, instrumental, roentgenological, histological, immunohistochemical, the quantitave analysis of the automatical regime picture, biostatistics, methods of the neuronet modeling. The result of the investigation there have been carried out methods of the determination of the proliferative activity indices and the expression of induced synthase of nitric oxide in malignant tumours of the rectum by the indirect reaction of immunofluorescence and the system of the picture computer analysis, by methods of the discriminant analysis there has been built the mathematical model prognosing the surviving of the patients with cancer of the rectum; there have been determined riskgroups of patients with the quick progressing of cancer of the rectum; there have been worked out the recommendation on using the pre-operative radial therapy and the adjuvant chemotherapy in patients having cancer of the rectum with clinical and morphological progressing criteria. The novelty: for the first time there has been carried out the quantitative determination of proliferative activity indices and the expression of nitric oxide induced synthase in the carcinoma of the rectum and has been evaluated their connection with patients surviving; there has been proved that prognostically the most important is the tumour localization in the rectum, the stage of disease, the proliferating index and the quantity of the induced form of nitric oxide in the carcinoma of the rectum; for the first time there has been established the connection of proliferation indices and the expression of the induced form of nitric oxide with the effectiveness of the pre-operative radial therapy and the adjuvant chemotherapy. Theresult of the investigation are put into practice in Zaporozhye regional oncological сlinical dispancery, in Melitopol intradistrict oncological dispancery, in the oncological department of Berdyansk city hospital, in the course of oncology of Zaporozhye State Medical University. The branch of usage is medicine (oncology).