EVALUATION OF THE INFORMATIVITY OF ULTRASOUND, CYTOLOGICAL AND RAPID HISTOLOGICAL STUDIES FOR MONOFOCAL CANCERS AND CANCERS COMBINED WITH BACKGROUND PATHOLOGY OF THYROID PARENCHEMA

Karachentsev Yu. I., Dubovik V. M., Gerasimenko L. V., Korchagin Y. P., Gopkalova I. V., Filonenko N. G., Khaziev V. V., Sazonov M. Y., Sokolova S. S.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Aim. The aim of this study was to evaluate of the informativity of ultrasound, cytological and rapid histological studies for monofocal cancers and cancers combined with background pathology of thyroid parenchema. Patients and methods. We studied 214 patients with nodular goiter of the thyroid gland (185 women from 18 to 79 years and 29 men from 17 to 82 years), residents of Kharkiv and Kharkiv region, who were operated on in 2019. A comparative analysis of indicators of the diagnostic efficiency of prognostic systems (ultrasound, cytological and rapid histological studies) was carried out. Results. The data of prospective study of 214 patients operated on the nodal pathology of thyroid gland with the analysis and interpretation of the results of ultrasound, cytological, express-histological and final histological studies are presented. The patients were divided into two groups. Group I consisted of 70 patients whose indications for surgical intervention were monofocal thyroid nodes, and Group II consisted of 144 patients with nodes against the background of different types of goitеr changes of the thyroid gland. A comparative analysis of the diagnostic value of stratification systems was made: ultrasonic ACR TI-RADS (American College of Radiology Thyroid Imaging Reporting and Data System) and cytological TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology), as well as intraoperative rapid histological examination for monofocal cancers and cancers in combination with different types of leg changes. It was shown that for ACR TI-RADS the prognostic value of positive cancer test was 80 % in Group I patients and 74 % in Group II, i.e. the diagnostic value of ACR TI-RADS is 6 % higher for monofocal thyroid cancer. The prognostic value of the cytological test (TBSRTC) for cancer was higher than that of the ultrasound test and was 90.5 % for monofocal cancers (group I) and 76.5 % for cancer with diverse goitеr changes (group II), i.e. the diagnostic value of TBSRTC is 14 % higher for monofocal thyroid cancers. Intraoperative rapid histological study confirmed the highest (100 %) diagnostic value for monofocal thyroid cancers and high (up to 94 %) diagnostic value for cancers combined with various types of goitre changes. Conclusions. The combination of thyroid cancer with background pathology of the thyroid parenchyma reduces the prognostic value of a positive thyroid cancer test for ACR TI-RADS and rapid histological examination by 6 %, for TBSRTC by 14 %, which greatly complicates the prediction of thyroid cancer and requires active of dynamic monitoring even in the case of a benign cytological conclusion.

thyroid cancer, ultrasound, fine needle aspiration puncture biopsy, intraoperative rapid histological examination, ACR TI-RADS, TBSRTC.

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«Bulletin of problems biology and medicine» Issue 4 (158), 2020 year, 143-148 pages, index UDK 616.441-006:6-08

10.29254/2077-4214-2020-4-158-143-148