DIFFICULTIES IN THE DIAGNOSTIC OF THYROID NODULAR PATHOLOGY ON THE BACKGROUND OF AUTOIMMUNE THYROIDITIS
Keywords:autoimmune thyroiditis, papillary thyroid carcinoma, fine needle aspiration puncture biopsy
Increased interest in autoimmune thyroiditis (AIT) is due to its proliferative activity and frequent combination with other thyroid pathology. In AIT there is a violation of cell cycle regulation and activation of proliferation, which is one of the mechanisms of cell transformation and leads to difficulties at the diagnostic stage.
Aim. To analyze the results of fine-needle puncture biopsy and determine the effect of autoimmune thyroiditis on the informativeness of cytological examination of thyroid nodules.
Materials and methods. A retrospective analysis of 212 case histories with nodular thyroid pathology, which underwent surgical treatment at the VIZUS clinic in the period from January 2018 to December 2020, was performed. All patients underwent laboratory and instrumental studies in the preoperative period.
According to the results of the pathomorphological exam in the main group included 64 (30.2%) patients who had a combination of nodular thyroid pathology with autoimmune thyroiditis. The comparison group included 148 (69.8%) patients who were diagnosed with nodular thyroid pathology without autoimmune thyroiditis.
The Mann-Whitney test was used for statistical comparison of groups. The results were considered statistically significant at p <0.05.
Results. The main group consisted of 61 (95.3%) women and 3 (4.7%) men. The comparison group included 126 (85.1%) women and 22 (14.9%) men.
According to the study, autoimmune thyroiditis occurs most often as a background disease in papillary carcinoma - in 43 (39.1%) patients.
Cytological examination revealed the fourth category of the Bethesda system more often in patients of the main group 22 (34.4%) and in 25 (16.9%) patients of the comparison group, U = 3908.00; p = 0.0436.
Conclusion. The analysis showed that in patients with background autoimmune thyroiditis, cytological signs of follicular neoplasia are detected more often than without it, which creates certain difficulties in interpreting this study in this category of patients.
Berezkina IS, Saprina TV, Zima AP, et al. Clin Experim Thyroidol 2016;1(12): 38-45.
Sheremet MI. Optymizaciya diagnostyky, hirurgichnoho likuvannya ta prognozuvannya perebigu vuzlovoho endemichnoho zoba na tli avtoimunnoho tyreoidytu z urahuvannyam molekulyzrno-henetychnyh preduktoriv, Ternopil, 2018: 276 p.
Weetman AP, Braverman LE, Cooper D. Werner & Ingbar’s the thyroid: a fundamental and clinical text. 10th edition, Philadelphia, 2013: 526 p.
Boi F, Pani F, Mariotti S. Eur Thyroid J 2017;6(4): 178-186. https://doi.org/10.1159/000468928
Caturegli P, De Remigis A, Rose NR, et al. Autoimmun Rev 2014;13(4-5): 391-397. https://doi.org/10.1016/j.autrev.2014.01.007
Safa A, Zainab H, Eman A, et al. Cytojournal 2018;15: 4. 7. Lee JH, Kim Y, Choi JW, et al. Eur J Endocrinol 2013;168(3): 343-349. https://doi.org/10.1530/EJE-12-0903
Del RP, Montana MC, Cozzani F, et al. Endocrine 2019;66: 538-541. https://doi.org/10.1007/s12020-019-01935-8
De Alcântara-Jones DM, de Alcântara-Nunes TF, Rocha B, et al. Radiologia Brasileira 2015;48(3): 148-153. https://doi.org/10.1590/0100-3984.2014.0072
Bojana J, Karen TL, Jerome MH. J Clin Endocrinol Metab 2013;98(2): 474-482. https://doi.org/10.1210/jc.2012-2978
Noureldine SI, Tufano RP. Curr Opinion Oncol 2015;27(1): 21-25. https://doi.org/10.1097/CCO.0000000000000150
Silva de MN, Stuart J, Guan H. J Endocrine Soc 2019;3(4): 791-800. https://doi.org/10.1210/js.2018-00427
Muravl`ova OV. Svit Meducyny ta Biologii` 2014;4(47): 50-52, available at: https://womab.com.ua/ua/smb-2014-04-2/4647
Ragusa F, Fallahi P, Elia G, et al. Best Pract Res Clin Endocrinol Metab 2019;33(6): 1013-1067. https://doi.org/10.1016/j.beem.2019.101367