Cytological and i mmunocytochemical radioresistance prognostic factors of papil lary thyroid cancer metastases

Abstract

Aim — to find out the correlation of cytological signs of cystic degeneration in punctates of metastases detected in the postoperative period and their ability to accumulate radioiodine. The comparison of the frequency of detection of this feature in the punctures of radioiodine resistant, radioiodine-sensitive metastases and the common group of thyroid papillary carcinoma metastases and the comparison of the obtained data with the frequency of detecting the signs of cystic degeneration in the histological findings of radioiodine-resistant metastases and the general population of papillary thyroid carcinoma. Material and methods. Cytomorphological and immunocytochemical studies using monoclonal anti-thyroid peroxidase antibodies, cytokeratin No.17 were performed on the basis of puncture biopsies of 42 papillary thyroid carcinoma metastases detected prior to thyroidectomy and radioiodine therapy and 50 metastases detected after treatment (35-radioiodine-resistant metastases, 15- radioiodine-uptake metastases). The analysis of pathological findings of 42 papillary carcinoma metastases revealed prior to thyroidectomy and radioiodine therapy and 35 radioiodine resistant metastases was conducted. The statistical processing of the data was done using the non-parametric Kolmogorov – Smirnov method, Mann – Whitney method and the method of correlation analysis. The calculations are made in the package Statistica 11.0. Results. Using correlation analysis, it was established that the relationship between radioiodine resistance and the presence of cystic degeneration is inverse and significant (the fi-coefficient of correlation is –0.5, the tetrachoric correlation coefficient is –0.7). The obtained statistical data, as well as the fact that the signs of cystic degeneration are easily determined in the punctious material allows you to propose the definition of cytological signs of cystic degeneration in punctates of papillary thyroid carcinoma detected in the postoperative period to predict their radioiodine resistance and, accordingly, determine the tactics of their treatment (radioiodine therapy or surgical treatment). Correlation analysis of the presence of signs of cystic degeneration, cytokeratin № 17 expression and thyroid peroxidase in the group of radioiodine resistant papillary carcinoma metastases showed that they act as independent factors for the prediction of insensuality to radioiodine therapy. Conclusion. It has been shown for the first time that radioiodine resistance of papillary thyroid cancer metastases correlates with the presence of cytological signs of cystic degeneration in metastases detected in the postoperative period, which can be used as a new method for preoperative prediction of radioiodine resistance and radioiodine therapy efficiency. The presence of cystic degeneration and expression of cytokeratin No. 17 and thyroid peroxidase in metastases detected in the postoperative period act as independent cytological prognostic factors of the radioiodine resistance of papillary thyroid cancers.