Transabdominal ultrasonography in the diagnosis of colon cancer

Koval O.V., Shcherbina O.V.

Summary. Colon cancer is the most common malignant tumor of the gastrointestinal tract. Timely and accurate diagnosis plays an important role in improving the prognosis of colorectal cancer. Objective. To assess the possibilities of transabdominal ultrasonography in the diagnosis of colon cancer. Materials and methods. A retrospective analysis of the results of a complex clinical-instrumental study was conducted in 101 patients in whom colon cancer was diagnosed during histological analysis of the materials. The results. Among them, in 16 (15.8±3.6%) patients, the tumor was localized in the cecum, in 13 (12.9±3.3%) patients — in the ascending colon, in 14 (13.9±3.4%) of patients — in the transverse colon, in 27 (26.7±4.4%) — in the descending colon, and in 31 (30.7±4.6%) patients — in the sigmoid colon. Local thickening of the wall (p <0.001) was observed in 74 (73.3±4.4%), false kidney symptom — in 27 (26.7±4.4%). 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%) cases. The symptom of a false kidney 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. Polypoid 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. The value of the wall thickness in the range of 8.1–10.0 mm at the T2 stage was recorded in 4 (19.0±8.6%) cases (p <0.001), at the T3 stage — in 35 (67.3±6.5%) cases (p <0.001) and at stage T4 — in 9 (32.1±8.8%) cases. Wall thickness >10 mm was not observed at stage T2, at stage T3 it was recorded in 9 (17.3±5.2%), at stage T4 — in 19 (67.9±8.8%) cases (p <0.001). The average thickness of the affected segment at stage T2 was 5.6±0.7 mm, at stage T3 — 8.9±1.5 mm (p <0.05), at stage T4 — 14.3±2.1 mm (p <0.001). Conclusions. Local uneven thickening with loss of differentiation of the wall layers is the main feature of colon cancer. The false kidney symptom is most characteristic of late-stage colon cancer. The ulcerative-infiltrative form occurs significantly more often than other forms of colon cancer. Wall thickness from 8 to 10 mm occurs more often in stage T3 and more than 10 mm — in stage T4. An indirect sign of wall invasion is the presence of an exophytic component of the tumor.

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