Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya31935Editorial articleПередовая статьяReview ArticleCurrent principles in the screening, diagnosis, and therapy of colorectal cancerСовременные принципы скрининга, диагностики и терапии колоректального ракаKhatkovI EХатьковИ ЕKagramanovaA VКаграмановаА ВZakharzhevskayaN BЗахаржевскаяН БBabikovaE AБабиковаЕ АGenerozovE VГенерозовЭ ВShcherbakovP LЩербаковП ЛParfenovA IПарфеновА И«Московский клинический научно-практический центр» Департамента здравоохранения Москвы«НИИ физико-химической медицины» ФМБА России15022016882VOL 88, NO2 ()ТОМ 88, №2 (2016)909610042020Copyright ©; 2016, Consilium MedicumCopyright ©; 2016, ООО "Консилиум Медикум"2016Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/31935

The data available in the literature on the prevalence of colorectal cancer (CRC), its risk factors and genetic aspects are analyzed. Basic screening tests and their diagnostic value are described. The paper indicates the importance of methods (colonoscopy, occult blood feces analysis, fecal immunochemical test, determination of molecular genetic profile of fecal enterocytes) for the early primary diagnosis of colonic epithelial tumors and techniques (echography, computed tomography, magnetic resonance imaging, positron emission tomography) that are required to specify clinical TNM staging and enable one to choose an optimal treatment policy for CRC patients owing to the estimation of tumor volume and to the diagnosis of reginal and distant metastases. It also shows that new screening methods based on the detection of molecular markers for early (premorphological) tumor stages are promising. The role of primary CRC prevention aimed at molding and maintaining a healthy lifestyle in the population is demonstrated.

Аннотация Проанализированы данные литературы о распространенности колоректального рака (КРР), факторах риска и генетических аспектах его развития. Описаны основные скрининговые тесты и их диагностическая ценность. Показано значение методов ранней первичной диагностики эпителиальных опухолей толстой кишки (колоноскопия, анализ кала на скрытую кровь, иммунохимический анализ кала, определение молекулярно-генетического профиля энтероцитов в кале) и методов, необходимых для уточнения клинического диагноза по системе TNM (эхография, компьютерная томография, магнитно-резонансная томография, позитронная эмиссионная томография), позволяющих выбрать оптимальную тактику лечения больных КРР благодаря оценке объема опухолевого поражения и диагностике регионарного и отдаленного метастазирования. Показана перспективность новых методов скрининга, основанных на выявлении молекулярных маркеров ранних (доморфологических) стадий опухолевого процесса. Показана роль первичной профилактики КРР, направленной на формирование и поддержание здорового образа жизни в популяции.

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