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Abstract
The early preoperative prediction of the behavior of papillary thyroid carcinoma (PTC) based on the detection of specific cytological features of fine-needle aspiration (FNA) smears of primary PTC, which correlate with the frequency of their postoperative metastases and radioiodine resistance is an urgent problem. The aim of this work was to study the correlation between the expression of thyroid peroxidase (TPO), as well as the presence of special cellular subpopulations in the FNA smears of primary PTC and the frequency of their postoperative metastases. Material and methods. Cytological and immunocytochemical studies using monoclonal antibodies to TPO «TPO‑47» («DakoCytomation», Denmark) were performed on the FNA smears of primary PTC and their metastases obtained from 125 patients treated with radioiodine therapy after surgery in clinic of SI «V.P. Komisarenko Institute of Endocrinology
and Metabolism of the National Academy of Medical Sciences of Ukraine». Results. An inverse correlation (p<0.05) between the content of TPO-positive epitheliocytes in the FNA smears of primary PTC and the frequency of their postoperative metastasis was shown. No PTC metastases were detected in the postoperative period when the content of TPO-positive epitheliocytes was from 50.0 to 92.0%. Radioiodine resistant metastases (RIRM) were recorded only in the absence of TPO, or at 25.0% positive epitheliocytes at the smears of primary PTS. Individual comparison of the content of TPO-positive thyrocytes in the FNA smears of primary PTCs and their synchronous metastases showed that their percentage in most cases does not match. The difference between the frequency of postoperative metastases in groups of patients with the presence and absence of special S-epitheliocytes FNA smears of primary PTC (p=0.0272 according to test χ2) was statistically confirmed. Conclusions. Determination of TPO expression and the presence of S-epitheliocytes in the FNA smears of primary PTC can be used to predict their postoperative metastases and radioiodine resistance. A high percentage of TPO-positive epitheliocytes in FNA smears of PTC (>50.0%) allows to predict their favorable behavior without the development of postoperative metastases. It is shown that when the content of
TPO-positive cells does not exceed 25.0% of thyroid cells of the PTC, postoperative metastases and the appearance of RIRM are not excluded. The difference between the frequency of postoperative metastases depending on the presence of special S-epitheliocytes in the FNA smears of the primary PTC is proved.
References
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