Lozynska L. Evaluation of neoplastic transformation risk for the assignment of an adequate surgical tactics in patients with Crohn’s disease.

In dissertation thesis the evaluation of neoplastic transformation risk using exact molecular genetic markers for the assignment of an adequate and personified surgical approach in patients with Crohn’s disease (CD) is presented. A total of 39.2 % of patients with CD requiring surgery were carriers of the 1007fs mutation of NOD2 gene. The frequency of mutation carriers in the patients with penetrating behavior (B3) of the disease was significantly (p=0.02) higher than in the patients without mutation. Overall 65.8 % of patients with CD required intestinal surgical interventions. The most common operations were right-sided hemicolectomies and total colectomy. After a total colectomy 12.2 % of the patients underwent ileostomy and women prevailed among these patients. The most frequent operation performed in the patients with CD-associated CRC was left-sided hemicolectomy.Seven increased risk factors for the development of CRC in males and 5 risk factors for females with CD were identified as significant. In males these risk factors associated with increased CRC rate were: a family history of CRС (p=0.014); pseudopolyps (p=0.034); an average age of CD diagnosis was 49.0 ± 4.4 years (p=0.03); hemoglobin levels < 80 g/l (p=0.027); left side localization of the disease (p=0.021); concomitant pathology – kidney diseases (p=0.04).