Doctor axborotnomasi № 2—2016
3
Introduction:
In spite of such widespread conducting primary preventive measures, the
number of patients diagnosed with colon cancer (CC) is increasing annually. In particular, in the
United States 102.480 patients diagnosed with primary CC was recorded for 2013. In Samarkand
region it was registered 46 cases initially diagnosed with colon cancer in 2012, including 24 male
and 22 female patients. In the structure of morbidity colon cancer is in the ninth place in the Sa-
markand region and the eighth in the Republic of Uzbekistan. Long
-
term results of treatment of
the patients in the early stages CC satisfactory. When tumors are bordered with only mucous
shield of the intestine, 5
-
year survival rate of the patients consist 90
-
100%. In stage II, the figure
drops to 70%. The small number of patients with CC reach 5
-
year survival rate after diagnosis of
the primary set CC in stage III
-
IV. According to morphological classification CC has the follow-
ing forms: adenocarcinoma, mucinous adenocarcinoma, medullary adenocarcinoma, undifferenti-
ated and unclassified carcinoma. The most common among them is adenocarcinoma. As the
growth of the tumor are divided into: exophytic, endophytic and mixed forms. Age is also a major
УДК: 616
-
006.6.348:575.14
CLINICAL AND MORPHOLOGICAL ANALYSIS OF COLON CANCER ACCORDING
SAMARKAND ONCOLOGY DISPENSARY.
© 2016
A. Asatullayev, F. Raufov
Samarkand State medical institute, Department of medical oncology
Keywords:
colon cancer (cc), morbidity, tumors, 5
-
year survival, adenocarcinoma, mucinous adenocarcinoma, medullary adeno-
carcinoma, undifferentiated and unclassified carcinoma, exophytic, endophytic, mixed forms, chemotherapy, histological structure,
samarkand regional oncology dispensary.
Таянч сўзлар:
йўғон ичак саратони, ўсма, 5 йиллик яшаш кўрсаткичи, аденокарцинома, муциноз аденокарцинома,
медулляр аденокарцинома, дифференциялашмаган, эндофит, экзофит, аралаш тури, гистологик тури, самарқанд вилоят
онкология диспансери.
Ключевые слова:
рак ободочной кишки (рок), 5
-
летняя выживаемость, опухоль, аденокарцинома, муцинозный рак, не-
дифференцированный, эндофитный, экзофитный, смешанный форма, гистологическая структура, самаркандский област-
ной онкологический диспансер.
Each year are diagnosed worldwide about 600 000 new cases of colon cancer. In Uzbekistan, colon cancer is registered with a fre-
quency of 3.7 per 100 thousand population. The aim of our study was to identify the incidence of clinical and morphological forms
CC according to Samarkand Regional Oncology Dispensary (SROD). The analysis of the medical records of 103 patients diagnosed
with CC received treatment at SROD from 2010 to 2012. The most frequent localization CC are sigmoid and cecum. From histo-
logical forms in CC mainly determine adenocarcinoma. Investigation the degree of malignancy (grading) has showed that the most
frequently occurring type is moderately differentiated (G2). In most cases patients diagnosed with CC came to hospital with ad-
vanced stages of the disease.
САМАРҚАНД ВИЛОЯТ ОНКОЛОГИЯ ДИСПАНСЕРИ МАЪЛУМОТЛАРИГА КЎРА ЙЎҒОН ИЧАК
САРАТОНИНИНГ КЛИНИК
-
МОРФОЛОГИК ТАҲЛИЛИ
А.Ф. Асатуллаев, Ф.М. Рауфов
Жаҳон миқёсида ҳар йили 600 000 га яқин инсонларда йўғон ичак саратони ташҳиси қўйилади. Ўзбекистонда ушбу
касаллик кўрсатгичи 100 минг аҳоли сонига 3.7 га тўғри келади. Самарқанд онкология диспансерида 2010
-
2012 давомида
йўғон ичак саратони ташҳиси билан даволанган 103 беморнинг касаллик тарихи ва амбулатор карталаридан йўғон ичак
саратонининг кўп учрайдиган клиник ва морфологик турлари ўрганилди. Жойлашган жойига қараб йўғон ичакнинг энг
кўп учрайдиган жойлашуви сигмоидал ва кўр ичак соҳаси бўлди. Ўрта дифференциаллашган ўсманинг тури (
G2)
беморларнинг яримидан кўпида кузатилди. Аденокарцинома ўсманинг энг кўп учрайдиган гистологик турилиги
аниқланди. Беморларнинг катта қисми йўғон ичак саратонининг кечки 3
-
4 босқичларида мурожаат қилишган.
КЛИНИКО
-
МОРФОЛОГИЧЕСКИЙ АНАЛИЗ РАКА ОБОДОЧНОЙ КИШКИ ПО ДАННЫМ
САМАРКАНДСКОГО ОБЛАСТНОГО ОНКОЛОГИЧЕСКОГО ДИСПАНСЕРА
А.Ф. Асатуллаев, Ф.М. Рауфов
Ежегодно в мире диагностируется около 600 000 новых случаев рака ободочной кишки. В Узбекистане рак ободочной
кишки (РОК) регистрируется с частотой 3,7 на 100 тыс. населения. Целью нашего исследования было выявить частоту
встречаемости клинико
-
морфологических форм РОК по данным Самаркандского Областного Онкологического
диспансера (СООД). Проведен анализ медицинской документации 103 пациентов с диагнозом РОК, получившие лечение в
СООД с 2010 по 2012 годы. Самая частая локализация РОК является сигмовидная и слепая кишка. Из гистологических
форм при РОК в основном определяют аденокарциному. При определении степени злокачественности (градации)
обнаружено что, самый часто встречающийся вариант умеренно
-
дифференцированный. Пациенты с диагнозом РОК
поступают с запущенными стадиями в большинстве случаев заболевания.
ОРИГИНАЛЬНЫЕ СТАТЬИ.
Doctor axborotnomasi № 2—2016
4
factor in the development of the CC. The reason for identifying late stages due to the fact that CC
is not visual tumors and to identify this pathology is difficult to achieve. Furthermore, CC is not
oncological diseases for which screening methods is carried out annually. Most patients randomly
diagnosed with primary colon cancer during examination of patients for other diseases, which
makes this topic more important comparing to other cancers.
In the treatment of colon cancer refer special methods like surgical techniques and chemo-
therapy, but in the outcome of this disease play a major role histological structure and location of
the tumor. In addition, the outlook is deteriorating in the case of treatment of patients with ad-
vanced stages of colon cancer.
Purpose of the study:
Identify the incidence of clinical and morphological forms CC according to the Samarkand
Regional Oncology Center.
Materials and methods:
The analysis of the medical records of 103 patients diagnosed with CC received treatment
Pic.1. Proportion of CC by gender.
Pic.2. The rate of CC by age.
our dispensary from 2010 to 2012. And 53 (51.5%) of those patients representatives of the female
and 50 (48.5%) male (Pic.1).
According to our information by age CC rate increases several times. The peak incidence of
CC reach a peak in the age group 50
-
60 years (43 patients (44.3%)). At the age of 40
-
50 years (21
patients
-
21.6%) (Pic.2).
According to the regional prevalence in Samarkand region CC often occurs in Samarkand
city, Samarkand rural areas, Pastdargom, and in other areas of the Samarkand region CC frequency
Pic.3. Epidemiology.
Doctor axborotnomasi № 2—2016
5
of occurrence was only some cases. In the above
areas the average percentage of patients is
24.7% (Pic.3).
According to the study it was found that
the localization of colon tumors were located as
follows (Pic.4): caecum
-
24 (24.7%), ascending
colon
-
13 (13.4%), hepatic angle
-
3 (3.9%), the
transverse colon
-
3 ( 3.9%), splenic angle
-
3
(3.9%), descending colon
-
3 (3.9%), and most
often localized in sigmoid colon
-
53 (54.6%). A
common form of colon cancer was observed in
only one case that was (1.03%).
In growth form
exophytic
tumor growth
was observed in 55 (56.6%) patients. In the next
place is mesophytic or mixed form of tumor
growth in 25 (25.75%). The most rarely occur-
ring form
-
endophytic 23 (23.7%). In particular,
all forms of growth occurs between 10% to 20%
in the right half of the colon. In 10% of cases,
endophytic, 12% mesophytic and 20% exophyt-
ic form. When in the left half of the colon most
often occur form exophytic growth is 40%, and
only 14% of cases mesophytic form. In our
study we did not find endophytic growth of the
tumor in the left half of the colon.
Histological study of CC rarely encoun-
tered such aggressive variants of cancer as squa-
mous and solid form
-
2 cases (2.06%), whereas
the other forms (Pic.5): adenocarcinoma
-
57
(58.7%) and squamous type 6 (6.2% ).
Pic.4.
Pic.5
Pic.6
When studying grade found that when more frequent CC moderately differentiated forms CC
(Pic.6): grade 1
-
in 28 cases (28.84%), grade 2
-
43 (44.3%), grade 3
-
31 (31.93%). Undifferenti-
ated forms of CC found only in 1 case (1.03%).
When studying the disease staging, it was found that 57 patients (58.7%) was set III stage of
CC. In 19 patients (19.2%) the II stage of the disease and 27 patients (27.81%) with IV stage of the
Pic.7
Doctor axborotnomasi № 2—2016
6
disease (Pic.7).
From our analysis of observed clinical course of the following forms of colon cancer: toxic
-
anemic form in 10 patients (18.5%), intestinal obstruction
-
8 (8.2%).
From accompanying diseases: chronic calculous cholecystitis was diagnosed with CC in 32
cases (33%), and in 7 (7.2%) patients with hypertension were found. Kidney disease with CC in 4
(4.1%) cases: chronic pyelonephritis
-
3 (3.1%) and polycystic kidney disease
-
1 (1.03%). Diseas-
es like simplicity, pneumonia, endometritis, ovarian cyst was found only in few cases.
Conclusions:
1. The most frequent localization of CC is sigmoid and caecum.
2. From the histological forms at CC mainly determine adenocarcinoma.
3. When determining the degree of malignancy (grading) found that the most frequently occurring
type moderately differentiated.
4. In most cases, patients with a diagnosis of CC comes with advanced stages of the disease.
5. The peak incidence with CC diagnosed are in 50
-
60 aged patients.
References:
1.
Залуцкий И.В. Алгоритмы диагностики и лечения злокачественных новообразований // Алгоритмы диа-
гностики и лечения злокачественных новообразований. Минск. 2007. Гл. 11. С.129–138.
2.
Кохнюк В.Т. Колоректальный рак в Республике Беларусь: заболеваемость, смертность, диагностика // III
съезд онкологов и радиологов СНГ: Материалы съезда. Минск, 25–28 мая 2004г. Ч.1. С.231.
3.
Напалков Н.П. Демографический процесс и злокачественные новообразования // III съезд онкологов и ра-
диологов СНГ: материалы съезда. Минск, 25–28 мая 2004г. Ч.1. С.15–30.
4.
Поляков С.М. Злокачественные новообразования в Беларуси 1997
-
2006 // Минск. 2007. С.43–58.
5.
Bardi G., Fenger C., Johansson B. [et al.] Tumor karyotype predicts clinical outcome in colorectal cancer pa-
tients / // Journal Clinical Oncology. 2004. Vol.22. N.13. P.2623
-
2634.
6.
Benavides M., Garcia
-
Alfonso P., Cobo M. [et al.] Weekly Irinotecan (CPT
-
11) in 5
-
FU Heavily Pretreated and
Poor
-
Performance
-
Status Patients with Advanced Colorectal Cancer // Medical Oncology. 2004. Vol.21. N.3.
P.255
-
262.
7.
Szynglarewicz B. Prognostic significans of clinical and pathomorphological factors in colorectal cancer: a uni —
and multivariante analysis // Poland. Merkuriusz Lek. 2004. Vol.17. P.586–589.
8.
Tamura M., Oda M., Tsunezuka Y. [et al.] Vascular endothelial growth factor expression in metastatic pulmonary
tumor from colorectal carcinoma: utility as a prognostic factor // Thoracic. Cardiovascular. Surgery. 2004.
Vol.128. N.4. P.517
-
522.
9.
Vanhoefer U. Novel molecular approaches in the therapy of advanced colorectal carcinoma // Onkologie. 2003.
Vol.26. Suppl 7. P.70
-
74.
10.
Veronese M.L. Monoclonal antibodies in the treatment of colorectal cancer // European Journal. Cancer. 2004.
Vol. 40. N.9. P.1292
-
1301.
11.
White C.A. Antidiv
-
targeted immunotherapy for treatment of malignancy //Annual Review. Medicine. 2001.
Vol.52. P.125
-
145, 175.
