Authors
Katanyan G.A.1, Durleshter V.M.1, Izmajlova L.G.1, Zencova O.A.1, Dryaeva L.G.1, Kolesnikov N.N.2, Titov S.E.2
1 Regional Clinical Hospital No. 2, Krasnodar
2 Institute of Molecular and Cellular Biology, Siberian Branch of the Russian Academy of Sciences, Novosibirsk
Abstract
Thyroid Cancer is the most common disease of the endocrine system and tends to increase in all countries of the world. The main method of preoperative diagnosis of thyroid nodes is fine-needle aspiration puncture biopsy (TAPB) under ultrasound control, followed by cytological examination of the obtained drugs. TAPB followed by cytological conclusion requires a lot of experience from the performer and relatively often leads to errors (Stevens et al., 2009). The share of uninformative punctures in different medical institutions is 5-12%. In addition, even with adequate sampling of the material, up to 30% of cases the conclusion is uncertain, because the cytological signs are not enough to separate benign and malignant tumors. The only evidence of highly differentiated follicular cancer is the detection of invasion of the tumor into the vessels and capsule, which is impossible to detect in cytological examination.
Cytological samples of 61 patients obtained during standard fine-needle aspiration puncture biopsy were subjected to molecular genetic analysis at the Institute of molecular and cell biology of the Siberian branch of the Russian Academy of Sciences, Novosibirsk. After analyzing the main methods of diagnosis of thyroid nodules, it can be concluded that the molecular analysis allows not only to identify the malignant process, but also to determine the type of malignant lesions and the degree of biological aggressiveness of the tumor. Molecular analysis can improve the differential diagnosis of cancer, exceeding the accuracy, in some cases, histological examination. It is advisable to use molecular research in obtaining uncertain results of cytological research: class III and IV by Bethesda, as well as conflicting results of cytological, ultrasound and histological studies.
Keywords: nodular goiter, ultrasound examination, puncture biopsy, thyroid cancer, molecular genetic study.
References
1. Guth S, Theune U, Aberle J, et al. Very high prevalence of thyroid nodules detected by high frequency (13 MHz) ultrasound examination. Eur J Clin Invest. 2009;39(8):699–706. Doi: 10.1111/j.1365-2362.2009.02162.x.
2. Beltsevich DG, Vanushko VE, Rumyantsev PO, et al. 2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment. Endocrine Surgery. 2017;11(1):6–27. Doi: 10.14341/serg201716-27.
3. Horvath E, Majlis S, Rossi R, et al. An ultrasonogram reporting system for thyroid nodules stratifying cancer risk for clinical management. J Clin Endocrinol Metab. 2009;94(5):1748–1751. Doi: 10.1210/ jc.2008-1724.
4. Dedov II, Kuznetsov NS, Mel'nichenko GA. Endokrinnaya khirurgiya. Rukovodstvo dlya vrachei. Moscow: GEOTAR-Media; 2014. P. 125–128.
5. Cibas ES, Ali SZ. The Bethesda system for reporting thyroid cytopathology. Am J Clin Pathol. 2009;132(5):658–665. Doi: 10.1309/AJCPPHLWMI3JV4LA.
6. Vorob'ev SA. Morfologicheskaya diagnostika zabolevanii shchitovidnoi zhelezy. St. Petersburg; 2014.
7. Bongiovanni M, Spitale A, Faquin WC, et al. The Bethesda system for reporting thyroid cytopathology: a meta-analysis. Acta Cytol. 2012;56(4):333–339. Doi: 10.1159/000339959.
8. Nikiforova MN, Nikiforov YE. Molecular diagnostics and predictors in thyroid. Thyroid. 2009;19(12):1351–1361. Doi: 10.1089/thy.2009.0240.
9. Gómez Sáez JM. Diagnostic and prognostic markers in differentiated thyroid cancer. Curr Genomics. 2011;12(8):597–608. Doi: 10.2174/138920211798120826.
10. Jansson MD, Lund AH. MicroRNA and cancer. Mol Oncol. 2012;6(6):590–610. Doi: 10.1016/j.molonc.2012.09.006.
11. Iorio MV, Croce CM. MicroRNA dysёregulation in cancer: diagnostics, monitoring and therapeutics. A comprehensive review. EMBO Mol Med. 2012;4(3):143–159. Doi: 10.1002/emmm.201100209.
12. Novosti klinicheskoi tsitologii Rossii. Moscow; 2017.
