Dissertation for the degree of Doctor of Philosophy in specialty 224
"Technologies of Medical Diagnostics and Treatment". – P.L. Shupyk National
Healthcare University of Ukraine, Ministry of Healthcare of Ukraine, Kyiv, 2023.
The dissertation presents a theoretical generalization and a new solution to a
scientific task – increasing the efficiency of radiologic diagnostics of colon tumors
by developing and implementing a complex of sonographic and CT-colonographic
criteria.
An analysis of the results of complex clinical, fibrocolonoscopic,
ultrasonographic, CT-colonographic, and virtual colonoscopic methods of
examination of 224 patients in whom colon tumors were diagnosed during
histological analysis of materials was carried out. The age of the examinees varied
from 31 to 85 years, among them there were 126 (56.2%) men and 98 (43.8%)
women. The comparison group consisted of 35 people aged 29-56 without colon
pathology.
Colon cancer was diagnosed in 150 patients – of them, in 16 patients the
tumor was localized in the cecum, in 13 in the ascending colon, in 14 in the
transverse colon, in 27 in the descending colon, in 31 in the sigmoid colon, in 49
patients in the rectum. Local uneven thickening of the colon wall at stage T2 was
observed in 21 (20.8±4.0%) cases, at stage T3 – in 48 (47.5±5.0%) cases, T4 – in 5
(5.0 ±2.2%) of cases. The false kidney symptom was not observed at the T2 stage,
at the T3 stage it was noted in 4 (4.0±1.9%) cases, T4 – in 23 (22.8±4.2%) cases.
Local irregular wall thickening with high reliability (P<0.001) was observed more
often in stage T3, and false kidney symptom in stage T4.
At stage T2 in 2 (2.0±1.4%) cases the tumor was diagnosed in the cecum, in 3
(3.0±1.7%) – in the ascending colon, in 1 (1.0±1.0% ) – in the transverse colon, in
3 (3.0±1.7%) – in the descending colon, in 12 (11.9±3.2%) – in the sigmoid colon
10
(P<0.05). At stage T3 in 8 (7.9±2.7%) cases the tumor was diagnosed in the
cecum, in 6 (5.9±2.3%) – in the ascending colon, in 9 (8.9±2.8%) – in the
transverse colon, in 13 (12.9±3.3%) – in the descending colon, in 16 (15.8±3.6%) –
in the sigmoid colon. At stage T4 in 6 (5.9±2.3%) cases the tumor was diagnosed
in the cecum, in 4 (4.0±1.9%) – in the ascending colon, in 4 (4.0±1.9% ) – in the
transverse colon, in 11 (10.9±3.1%) – in the descending colon, in 3 (3.0±1.7%) –
in the sigmoid colon. T4 tumor stage in sigmoid colon was observed significantly
less often than T2 (P<0.05) and T3 (P<0.01), and in descending colon, on the
contrary, T2 was observed significantly less often than T3 (P<0.01) and T4
(P<0.05). In addition, stage T4 in the descending colon was observed significantly
(P<0.05) more often than in the sigmoid colon (10.9±3.1% vs. 3.1±1.7%).
A polyp-like form of colon tumor was observed in 9 (8.9±2.8%) cases,
ulcerative-infiltrative – in 75 (74.3±4.3%) and exophytic – in 17 (16.8±3.7% )
cases, respectively. At the T2 stage, the polypoid form of the tumor was registered
in 7 (6.9±2.5%), at the T3 stage – in 2 (2.0±1.4), the ulcer-infiltrative form at the
T2 stage in 14 (13.9 ±3.4%), at stage T3 – in 45 (44.6±4.9%) and at stage T4 – in
16 (15.8±3.6%), exophytic form at stage T3 in 5 (5,0±2.2%), at stage T4 in 12
(11.9±3.2%) cases, respectively.
The ulcerative-infiltrative form of the tumor in the cecum was diagnosed in 13
(12.9±3.3), in the ascending colon – in 8 (7.9±2.7), in the transverse colon – in 11
(10.9± 3.1%), in descending colon – in 15 (14.9±3.5%) and in sigmoid colon – in
28 (27.7±4.5%) cases, exophytic form – in 1 (1.0 ±1.0%), 3 (3.0±1.7%), 2
(2.0±1.4%), 9 (8.9±2.8%) and in 2 (2.0± 1.4%) of cases, and the polyp-like form –
in 2 (2.0±1.4%), in 1 (1.0±1.0%), in 3 (3.0±1.7%) and in 1 (1.0±1.0%) case,
respectively. The ulcerative-infiltrative form of the tumor in all sections of the
colon was recorded significantly more often (P<0.01; P<0.001) than the polypoid
and exophytic forms.
Tumor thickness in the range of less than 6 mm, 6.1-8.0 mm, 8.1-10.0 mm,
more than 10.0 mm, at stage T2, T3 and T4 was studied. The thickness of the
affected segment of the colon wall is within 6.1-8.0 mm at stage T2; from 8.1 to
11
10.0 mm at stage T3; more than 10 mm – at the T4 stage it was marked
significantly (P<0.001) more often than at other stages. The length of the affected
segment of the colon wall is <30.0 mm at stage T2; from 30.0 to 60.0 mm at stage
T3; more than 60.0 mm – at the T4 stage it was marked significantly (P<0.001)
more often than at other stages. The average length of the affected segment at stage
T2 was 23.7±3.2 mm, at stage T3 – 35.4±5.1 mm (P<0.05), at stage T4 – 51.7±6.4
mm (P<0.001).
