PROGNOSTIC SIGNIFICANCE OF MORPHOLOGICAL AND ENDOSCOPIC CHARACTERISTICS OF LARGE COLORECTAL NEOPLASMS

Authors

DOI:

https://doi.org/10.11603/2414-4533.2025.2.15281

Keywords:

large colorectal tumors, endoscopy, dysplasia, early colorectal cancer, optical imaging, histological assessment, laparoscopy, image-enhancement

Abstract

The aim of the work: to identify morphological and endoscopic predictors of high-grade dysplasia or submucosal invasive growth in large colorectal neoplasms.

Materials and Methods. A prospective single-center cohort study of 146 patients with neoplasms ≥20 mm was conducted on the basis of the gastroenterology and surgical departments of the Odessa Regional Clinical Hospital from 2015 to 2023. Before treatment, all patients underwent colonoscopy using modern digital image enhancement methods, in particular, SONOSCAPE HD-550 with the SFI/VIST multispectral visualization mode. The results were compared with histology. Statistical processing of the obtained data was performed using licensed software IBM SPSS Statistics v.26.0 (IBM Corp., Armonk, NY, USA).

Results. Treatment methods included endoscopic mucosectomy, endoscopic submucosal dissection, and surgical resection. Invasive cancer was detected in 21.9 % of cases. LST-NG type, JNET classes 2B and 3, the presence of depressions, and vascular irregularity were significantly correlated with high-grade dysplasia or invasion (p<0.001). The prognostic accuracy of the combined endoscopic assessment was: sensitivity – 92 %, specificity – 89 %, PPC – 85 %, NPC – 94 %. The results of the study confirm that the combination of morphological assessment of neoplasms with the use of modern digital image enhancement technologies, such as VIST, provides high diagnostic accuracy in the preoperative detection of high-grade dysplasia and early forms of invasive cancer in large colorectal lesions.

Conclusions. Minimally invasive endoscopic techniques (EMR and ESD) provide effective and safe treatment of large precancerous and early malignant lesions of the colon and rectum, contributing to a reduction in the duration of surgical intervention, a decrease in the incidence of complications and a reduction in the period of hospitalization. Despite the high prognostic value of endoscopic evaluation, the final conclusion regarding the nature of the neoplasm should be based on the results of histological examination of the resected material.

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Published

2025-05-28

How to Cite

VOROTYNTSEVA, K. O., GRUBNIK, V. V., & DEGTYARENKO, S. P. (2025). PROGNOSTIC SIGNIFICANCE OF MORPHOLOGICAL AND ENDOSCOPIC CHARACTERISTICS OF LARGE COLORECTAL NEOPLASMS. Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (2), 44–48. https://doi.org/10.11603/2414-4533.2025.2.15281

Issue

No. 2 (2025)

Section

ORIGINAL INVESTIGATIONS

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Copyright (c) 2025 К. О. ВОРОТИНЦЕВА, В. В. ГРУБНІК, С. П. ДЕГТЯРЕНКО

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