METHOD FOR ASSESSING THE RISK OF METASTATIC LESION OF THE LATERAL PELVIC LYMPH NODES IN PATIENTS WITH RECTAL CANCER

摘要

FIELD: medicine, oncology in particular. ;SUBSTANCE: invention relates to the field of medicine, namely to oncological coloproctology, and can be used to assess the risk of metastatic lesion of the lateral pelvic lymph nodes in patients with rectal cancer. Radiation diagnostics of the pelvic organs and histological examination of the tumor sample are performed. Based on the results of these studies, diagnostic signs are determined, which are measured in points. Distance from the anal margin to the lower edge of the tumor (k1): at a distance of up to 6.0 cm inclusive, 1 point is assigned, more than 6 cm to 12 cm inclusive, 2 points are assigned, more than 12 cm to 18 cm inclusive, 3 points are assigned. The presence or absence of extramural vascular invasion (k2): in the absence of invasion, 0 points are assigned, in the presence of invasion, 1 point. The size of the largest lateral lymph node on the short axis (k3): if the lymph node is not determined, 0 points assigned, if the node size is up to 6 mm inclusive, 1 point, more than 6 mm and up to 10 mm inclusive, 2 points, more than 10 mm and up to 20 mm inclusive, 3 points are assigned, more than 20 mm, 4 points. The depth of germination of the tumor into the intestinal wall (k4): at the depth of germination corresponding to stage T1, 1 point is assigned, stage T2, 2 points, stage T3, 3 points, stage T4, 4 points. Histological structure of the tumor (k5): in the case of highly differentiated adenocarcinoma without mucus formation, 0 points are assigned, moderately differentiated adenocarcinoma without mucus formation, 1 point, low differentiated adenocarcinoma without mucus formation, 2 points, mucin–producing adenocarcinoma, 3 points, in cricoid cell cancer, 4 points. The value of D is calculated by the formula ;where e is Euler’s number. In the case of the obtained value of D ≥ 0.23, it is concluded that there is a high risk of metastatic lesion of the lateral pelvic lymph nodes. At a value of D<0.23, it is concluded that there is a low risk of metastatic lesion of the lateral pelvic lymph nodes. ;EFFECT: method provides prediction of metastatic lesion of the lateral pelvic lymph nodes in patients with rectal cancer due to diagnostic signs. ;1 cl, 1 tbl, 3 ex