Colorectal carcinoma: radiological diagnosis and staging

Elmas, Nevra; Killi, Refik; Sever, Ahmet

doi:10.1016/s0720-048x(02)00036-0

Cited by 35 publications

(30 citation statements)

References 40 publications

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“…For the diagnosis of CRC the examination of the entire large bowel by means of endoscopic or radiological techniques is obligatory (18). Radiological techniques based on obtaining images by means of CT scan or MRI permit a study of the extension of the illness (18,19). The barium enema (20) and especially the double-contrast enema (21,22) are alternatives to the colonoscopy, reaching levels of sensitivity of over 90%.…”

Section: The Value Of Abdominal Ultrasound In the Diagnosis Of Colon mentioning

confidence: 99%

The value of abdominal ultrasound in the diagnosis of colon cancer

Martı́nez-Ares

Barrenechea

Souto-Ruzo

et al. 2005

Rev. esp. enferm. dig.

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Introduction: colon cancer is one of the main causes of cancer death. Diagnosis requires the examination of the entire large bowel by means of radiological or endoscopic techniques. Many patients suspect of colon cancer are referred for colonoscopy but nevertheless this suspicion is not confirmed after endoscopic examination. The objective of this study is the evaluation of the reliability of abdominal ultrasound in the diagnosis of these tumors.Material and method: we selected patients suspect of colon cancer referred to the endoscopy unit for a colonoscopy. An abdominal ultrasound was carried out on all patients prior to the endoscopy. Considering the endoscopic examination as a gold standard, the sensibility, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ultrasonography were evaluated. Likewise, a series of analytical and clinical parameters were evaluated, in an attempt to establish associated factors of a colon cancer. The statistical analysis was carried out by means of the statistical package SPSS 12.0 for Windows.Results: 145 patients were included in the study (56.6% males) with an average 66.72 years of age (22-89). A cancer was diagnosed in 42 cases (28.9%). In the diagnosis of colon cancer, abdominal ultrasound presents a sensitivity of 79.06%, a specificity of 92.15%, a PPV and a NPV of 80.9% and of 91.2%, respectively. Excluding from the analysis lesions of the rectal ampulla, which cannot be adequately evaluated by means of ultrasound, the figures for sensitivity, specificity, PPV and NPV increase to 91.8, 92.1, 80.9 and 96.9% respectively. The univariate analysis showed that an age over 65 years and the presence of microcytosis are associated to a greater risk of colon cancer while after multivariate analysis only the presence of microcytosis resulted to be an independent predictive factor of cancer.Conclusions: abdominal ultrasound presents high sensitivity, specificity, PPV and NPV in the diagnosis of colon cancer. The combination of an ultrasonography and a rectoscopy permits us to rule out the presence of a colorectal carcinoma. In patients with microcytosis of 65 years and over, if there is strong clinical suspicion, a negative ultrasound may not be sufficient to rule out a colorectal neoplasia.

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Section: The Value Of Abdominal Ultrasound In the Diagnosis Of Colon mentioning

confidence: 99%

The value of abdominal ultrasound in the diagnosis of colon cancer

Martı́nez-Ares

Barrenechea

Souto-Ruzo

et al. 2005

Rev. esp. enferm. dig.

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“…Radiologists screen their images for the occurrence of large lymph nodes (Z10 mm) in order to detect metastatic diseases. 18 Our impression, however, is that larger lymph nodes are often not involved in metastatic disease but show lymphofollicular hyperplasia. [19][20][21][22][23] This might explain the relatively disappointing results of diagnosis based on radiological lymph node status assignment, which is mainly dependent upon lymph node size.…”

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confidence: 99%

The clinical significance of lymph node size in colon cancer

et al. 2012

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To date, the clinical value of lymph node size in colon cancer has been investigated only in a few studies. Only in radiological diagnosis is lymph node size routinely recognized, and nodes Z10 mm in diameter are considered pathologic. However, the few studies regarding this topic suggest that lymph node size is not a reliable indicator of metastatic disease. Moreover, we hypothesized that increasing lymph node size is associated with favorable outcome. By performing a morphometric study, we investigated the clinical significance of lymph node size in colon cancer in terms of metastatic disease and prognosis. A cohort of 237 cases with excellent lymph node harvest (mean lymph node count: 33±17) was used. The size distribution in node-positive and -negative cases was almost identical. In all, 151 out of the 305 metastases detected (49.5%) were found in lymph nodes with diameters r5 mm. Only 25% of lymph nodes 410 mm showed metastases. Minute lymph nodes r1 mm were involved only very rarely (2 of 81 cases). In 67% of the cases, the largest positive lymph node was o10 mm. The prognostic relevance of lymph node size was investigated in a subset of 115 stage I/II cases. The occurrence of Z7 lymph nodes that were 45 mm in diameter was significantly associated with better overall survival. Our data show that lymph node size is not a suitable factor for preoperative lymph node staging. Minute lymph nodes have virtually no role in correct histopathological lymph node staging. Finally, large lymph nodes in stage I/II disease might indicate a favorable outcome.

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“…With specificity above 95%, sensitivities ranged from 65.8% to 81.8% and from 27.1% to 41.3% for CRC and advanced adenomas (AAs) respectively. The fact that asymptomatic CRC and 95% of adenomas do not bleed and do not ulcerate explains the relatively low sensitivities of fecal blood based tests for precursor detections [10]. Besides diagnostic accuracy of screening tests, patient compliance is the other major determinant of the effectiveness of screening program.…”

Section: Introductionmentioning

confidence: 99%

Label-free surface-enhanced Raman spectroscopy for detection of colorectal cancer and precursor lesions using blood plasma

Feng

Wang

Tai

et al. 2015

Biomed. Opt. Express

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Fecal based tests have limited diagnostic values in detecting adenomatous polyps, the precursor lesions to colorectal cancer (CRC). Surface enhanced Raman spectroscopy (SERS) using silver nanoparticles as substrate is a multiplexed analytical technique capable of detecting biomolecules with high sensitivity. This study utilizes SERS to analyze blood plasma for detecting both CRC and adenomatous polyps for the first time. Blood plasma samples are collected from healthy control subjects and patients diagnosed with adenomas and CRC. Using a real-time Raman system, SERS spectra for blood plasma samples are measured in 1 s. The collected SERS spectra are analyzed with partial least squares-discriminant analysis. Classification of normal versus CRC plus adenomatous polyps achieved diagnostic sensitivity of 86.4% and specificity of 80%. The results suggest that blood plasma SERS analysis could be a potential screening test to detect both CRC and adenomas. Gastroenterol. 19(12), 1855-1860 (2013). 7. F. Stracci, M. Zorzi, and G. Grazzini, "Colorectal cancer screening: tests, strategies, and perspectives," Front. ©2015 Optical Society of AmericaPublic Health 2, 210 (2014). 8. A. A. Plumb and S. Halligan, "Colorectal cancer screening," Semin. Roentgenol. 50(2), 101-110 (2015). #242906Received 16 #242906Received 16

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Colorectal carcinoma: radiological diagnosis and staging

Cited by 35 publications

References 40 publications

The value of abdominal ultrasound in the diagnosis of colon cancer

The value of abdominal ultrasound in the diagnosis of colon cancer

The clinical significance of lymph node size in colon cancer

Label-free surface-enhanced Raman spectroscopy for detection of colorectal cancer and precursor lesions using blood plasma

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