Open AccessAN ALGORITHM FOR MORPHOLOGICAL DIAGNOSIS OF NODULAR GROWTHS IN THE THYROID GLAND (clinical experience)
Author(s) -
Д В Зима,
О Ф Безруков,
E. P. Golubinskaya,
EVGENIA YU. ZYABLITSKAYA,
Tatiana P. Makalish,
РOLINA E. MAXIMOVA,
ELENA A. NEPRITIMOVA
Publication year - 2021
Publication title -
vestnik sovremennoj kliničeskoj mediciny
Language(s) - English
Resource type - Journals
eISSN - 2079-553X
pISSN - 2071-0240
DOI - 10.20969/vskm.2021.14(4).73-77
Subject(s) - immunohistochemistry , pathology , thyroid , biopsy , medicine , fine needle aspiration , aspiration biopsy , surgical pathology , thyroid cancer , anatomical pathology , radiology
Background.To date, there are two opposing views among surgeons regarding surgical intervention in the early stages of thyroid cancer. Since after the introduction of fineneedle aspiration biopsy with cytological examination of biopsy sample into clinical practice the number of patients with early stages of papillary cancer who undergo surgical interventions has increased. Among all methods of diagnosis of thyroid neoplasms the leading role is currently given to fineneedle aspiration biopsy. Aim. The aim of the study was to demonstrate the results of our clinical experience of applying the algorithm of morphological diagnostics of thyroid nodular masses with regard to regional peculiarities and the proposed adjuvant immunohistochemical method. Material and methods. Thin aspiration biopsy material of the thyroid gland was used to make a cell block, semithin sections from which were stained by immunohistochemical methods for the expression of proliferation (Ki67) and apoptosis (Fas) markers. Positive stained cells were assessed and counted under a microscope at 100× magnification, and the ratio of these values was calculated. Results and discussion.Having analyzed the results of staining for the expression of apoptosis and proliferation markers and compared them with the results of pathomorphological examination of the material from which the clot was obtained, we developed a diagnostic algorithm for verification of «doubtful» changes, e.g.: papillary structures, cytoplasmic plasmacytoid, presence of intranuclear furrows, piling of nuclei and their enlargement, immunocytochemical or immunohistochemical reaction with Ki67, and FasR markers to determine the malignant potential (Zindex) is being performed. Conclusion. Isolated assessment of immunocytochemical reactions with Fas or Ki67 markers on fineneedle aspiration biopsy material is not diagnostically significant. However, it can be used in combination with cytological characteristics of a smear for prognostic assessment of malignant potential of a neoplasm.