Ультразвукові та цитологічні характеристики радіойодчутливості метастазів папілярного раку щитоподібної залози
| Autor: | G.V. Zelinskaya, E.A. Shelkovoy |
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| Rok vydání: | 2019 |
| Předmět: | |
| Zdroj: | Endokrynologia. 24:311-317 |
| ISSN: | 2524-0439 1680-1466 |
| DOI: | 10.31793/1680-1466.2019.24-4.311 |
| Popis: | Aim is ultrasound and cytological studies of metastases detected in the postoperative period depending on their iodine accumulation capacity. Material and methods. Ultrasound, cytological, immunocytochemical studies on a group of papillary thyroid cancer metastases detected in the postoperative period (after thyroidectomy and radioiodine therapy) (30 — radioiodine-sensitive metastases, 65 — radioiodine-refractory metatases) were performed. Ultrasoundcharacteristics such as localization of metastases, whether multiple or isolated, echogenicity, echostructure, and the presence of echo (+) inclusions were evaluated. Cytological and immunocytochemical studies on the FNA smears of these metastatic groups, stained according to Romanovsky were performed. Indirect immunoperoxidase method using monoclonal antibodies to thyroid peroxidase and thyroglobulin was used. Statistical analysis using the U-test and the χ2 method in Statistica.11 package was performed. Results. Investigations of ultrasound and cytological characteristics of postoperative metastasesof papillary thyroid carcinomas did not reveal statistically significance difference between groups of radioiodine-resistant and radioiodinesensitive metastases on such ultrasound characteristics as echogenicity and echostructure and presence of echo (+) inclusions It is shown that when hypoechogenicity metastases are detected in the lateral lymphatic collectors, the probability of radioiodine resistance of metastases is 93±2. The ultrasound sign of cystic degeneration was found 1.8 times more frequent in radioiodine-resistance metastases compared to radioiodine-sensitive metastases. Cytological studies demonstrate the phenotypic heterogeneity of epithelium of radiiodine-resistant metastases compared to radioiodine-sensitive metastases and statistically significance difference in the expression of thyroglobulin and thyroid peroxidase were detected. Conclusions. Ultrasound revealed no statistically significant changes that would allow differential diagnosis between radioiodine-resistant and radioiodine-sensitive metastases of papillary thyroid cancer. Cytologic features of radioiodine-resistant metastases of papillary thyroid cancer have been demonstrated, which allow their preoperative prognosis. A statistically significant reduction in the expression of thyroid peroxidase and thyroglobulin in FNA smears of radioiodine-resistant metastases compared with radioiodine-sensitivemetastases, which is the basis of preoperative prognosis of radioiodine-resistance of postoperative metastases has been demonstrated. The metastatic neck lymph nodes, identified by ultrasound diagnostics, allow for further immunocytochemical and cytological studies, which can improve the diagnosis of metastases of highly differentiated thyroid cancer and provide a choice of further treatment. |
| Databáze: | OpenAIRE |
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