oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2025-24-3-114-123oncotomsk-3669Research ArticleОБЗОРЫREVIEWSПути улучшения диагностики и лечения раннего рака толстой кишки: литературная справка и клинический случайWays to improve the diagnosis and treatment of early colorectal cancer: a literature review and a clinical case studyhttps://orcid.org/0009-0007-2108-5209ГауликаВ. О.GaulikàV. O.

Гаулика Владислав Олегович – онколог.

628408, Сургут, ул. Энергетиков, 14

Vladislav O. Gaulikа - MD, Oncologist.

14, Energetikov St., Surgut, 628408

https://orcid.org/0009-0005-4183-6191ПарсаданянА. М.ParsadanyanA. M.

Парсаданян Арарат Микичевич - доктор медицинских наук, профессор, заведующий кафедрой акушерства, гинекологии и онкологии.

628011, Ханты-Мансийск, ул. Мира, 40

Ararat M. Parsadanyan - MD, DSc, Professor, Head of the Department of Obstetrics, Gynecology and Oncology.

40, Mira, Khanty-Mansiysk, 628011

https://orcid.org/0009-0004-5329-1363КостанянК. К.KostanyanK. K.

Костанян Карен Карапетович – онколог.

628408, Сургут, ул. Энергетиков, 14

Karen K. Kostanyan - MD, Oncologist.

14, Energetikov St., Surgut, 628408

Сургутская окружная клиническая больницаРоссияSurgut District Clinical HospitalRussian FederationХанты-Мансийская государственная медицинская академияРоссияKhanty-Mansiysk State Medical AcademyRussian Federation202504082025243114123Copyright © Гаулика В.О., Парсаданян А.М., Костанян К.К., 20252025Гаулика В.О., Парсаданян А.М., Костанян К.К.Gaulikà V.O., Parsadanyan A.M., Kostanyan K.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/3669

Разработка эффективных, высокочувствительных и высокоспецифичных подходов к ранней диагностике рака толстой кишки является основой для своевременного применения различного рода целенаправленных вмешательств, способных эффективно разрешить задачу с сохранением приемлемого качества жизни пациента. Эндоскопические методы диагностики и лечения по-прежнему играют решающую роль в улучшении онкологических исходов и постоянно совершенствуются для повышения выявляемости колоректального рака.

Цель исследования – проанализировать и обобщить современную научную литературу, описывающую пути улучшения ранней диагностики и лечения рака толстой кишки; описать клинический случай из собственной практики, демонстрирующий важность качественной диагностики для подбора стратегии при лечении рака толстой кишки.

Материал и методы

Материал и методы. Для написания обзорной части статьи был произведен поиск публикаций в системе Pubmed, в базах Google Scholar, elibrary.ru по ключевым словам: колоректальный рак, рак толстой кишки, КТ-колонография, колоноскопия. Приоритет был отдан работам, описывающим совершенствование инструментальных методик выявления новообразований толстой кишки. Было изучено более 100 публикаций отечественных и зарубежных авторов за 2016–25 гг., из них 41 была отобрана для настоящего обзора.

Результаты

Результаты. В качестве наиболее перспективного подхода в современной литературе представляется точная оптическая диагностика, с возможностью информативного эндоскопического прогнозирования гистологии полипов в режиме реального времени, в том числе с высокой чувствительностью к выявлению новообразований малых размеров. Подобный подход позволит отказаться от щипцовой биопсии, снизив частоту ошибочных диагнозов (что продемонстрировано в описанном клиническом случае), в том числе по причине неправильного отбора образцов.

Заключение

Заключение. При разработке стратегий улучшения раннего выявления и лечения рака толстой кишки необходимо учитывать, что кадровый, диагностический и терапевтический потенциал в различных регионах России значительно различается. Отечественным исследователям необходимо формировать собственный опыт в проведении комплексных диагностических мероприятий, устранении экономических препятствий для эффективного выявления рака толстой кишки, а также разрабатывать рациональные пути улучшения терапевтических подходов, исходя из возможностей регионального здравоохранения.

The development of effective, highly sensitive and highly specific approaches to early detection of colorectal cancer is the basis for the timely use of various targeted interventions that can effectively solve patients’ problems, minimizing the impact on their quality of life. Endoscopic diagnostic and therapeutic techniques continue to play a critical role in improving cancer outcomes and are continually being reviewed and improved to increase detection rates of colorectal cancer.

The aim of the study was to analyze and summarize the current scientific literature describing promising developments in early diagnosis and treatment of colorectal cancer, as well as to describe a case report demonstrating the importance of high-quality diagnostics for selecting a therapeutic strategy for colorectal cancer.

Material and Methods

Material and Methods. The literature search was conducted in Pubmed, Google Scholar, and Elibrary.ru databases, focusing on articles published between 2016 and 2025, using the key words “colorectal cancer”, “colorectal cancer”, “CT-colonography”, “colonoscopy”. Priority was given to the studies describing the improvement of screening tools for detecting colorectal neoplasia. Of the 100 publications, 41 were selected for this review.

Results

Results. Precise optical diagnosis of colorectal polyps, including the ability to predict polyp histology in real time during colonoscopy, appears to be the most promising approach for detecting even small colorectal lesions. This approach can potentially allow for the abandonment of forceps biopsy reducing the incidence of misdiagnosis (as demonstrated in the described case report).

Conclusion

Conclusion. To develop strategies for improving early detection and treatment of colorectal cancer, it is necessary to take into account the fact that the human, diagnostic and therapeutic potential in different regions of Russia varies significantly. Researchers should prioritize developing their own diagnostic experience, removing economic barriers to effective colorectal cancer detection, and developing rational ways to improve therapeutic approaches within regional health care settings.

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The authors declare that there are no conflicts of interest present.