Colonic Wall Thickening Reported in Abdominal CT: Does It Always Imply Malignancy?

Abstract

Aim/Background. Early diagnosis of patients with colon cancer is one of the most important parameters affecting the survival of patients. In this study, we aimed to examine the effect of the age, hemoglobin (Hb), albumin, neutrophil lymphocyte ratio (NLR), thrombocyte lymphocyte ratio (PLR), and mean platelet values (MPV) on the separation of benign and malignant diseases in patients with suspected colon wall thickness (CWT) observed in abdominal computed tomography (CT) examination. Method. The study included 116 patients between the ages of 18 and 95 who had CT examination where the colon wall could be evaluated and who also had colonoscopy. Patients suspected for CWT in CT with difficulties in differential diagnosis were divided into two groups according to colonoscopic-histopathological evaluations. Normal or benign pathological causes were included in the first group, while malignant causes constituted the second group. Whether the two groups differed in terms of CWT, Hb, age, albumin, NLR, PLR, and MPV values was investigated with descriptive statistics. Results. One hundred and sixteen patients (74 males, 42 females) with CT examinations and colonoscopic sampling were included in the study. After colonoscopic and histopathological evaluations, there were 64 cases in the first group and 52 in the second group. According to the results of the univariate analysis and multivariate logistic regression, CWT, Hb, NLR, and MPV were identified to be independent variables for determining colon cancer. Conclusion. A combined evaluation of Hb, NLR, and MPV values in patients with CWT in abdominal CT examination may contribute to the separation of benign and malignant pathologies.

The Use of Clinical Parameters as Adjuncts to Endoscopic Evaluation of Mural Thickening on Conventional Computed Tomography in Diagnosing Malignancy

“…There is no consensus regarding what constitutes MT on CT with some authors suggesting any perceptible thickening to indicate abnormalities [24,25]. Abnormalities are frequently incorrectly reported on CT if the part of the intestinal tract being examined is either collapsed or only partially distended.…”

Endoscopic findings of the gastrointestinal tract and conjunctions with preceding tomography findings

“…However, this accuracy level decreased to 26-53% in patients with the early stages of gastric malignancies. Also, Akbas et al noted that the antropyloric region was challenging to evaluate regarding increased wall thickness associated with gastric malignancies due to its anatomical and physiological characteristics [3]. The peristaltic movements in this region and the physiological thickness of the antral smooth muscle can be confounding.…”

“…One of these findings is the visceral wall thickening, either at the upper or lower gastrointestinal tract. While some incidental reports of wall thickening may represent normal findings, some minor changes could be an early sign of malignancy [3,4].…”

Predictors of Neoplasia in Colonic Wall Thickening Detected via Computerized Tomography

“…Akbas et al retrospectively analyzed the colonoscopic evaluations of CWTs reported in aCT for any reason in their studies [ 17 ]. They have focused on hemoglobin, neutrophil-lymphocyte ratio (NLR), and mean platelet volume (MPV) of patients with CWT and contribute to the separation of benign and malignant pathologies.…”