A new molecular-genetic panel in the algorithm of diagnosis and treatment in patients with tiroid nodules

Abstract

The increase in the number of patients with thyroid nodules requires the development of the most effective methods of preoperative diagnosis, allowing timely detection and differentiation of follicular neoplasia and highly differentiated cancer. A comprehensive study was carried out, which made it possible to optimize the diagnosis and choice of therapeutic tactics in patients of this category through the use of a new molecular genetic panel. Results of examination and surgical treatment of 60 patients suffering from benign and malignant thyroid gland formations are analyzed, pre-operative diagnosis of which was supplemented by immunocytochemical and molecular genetic methods of studying cellular material obtained during fine-needle aspiration biopsy. The threshold value of the Galektin-3 expression level for the differential diagnosis of follicular neoplasia in the direction of adenomas or well-differentiated thyroid cancer was determined. The significance of the BRAF V600E gene mutation in the detection of papillary thyroid cancer, the features of its clinical course and the determination of rational surgical tactics was proved. The limit value of the sodium-iodide symporter for predicting the resistance of thyroid cancer to radioactive iodine therapy, which determines the need to expand the scope of surgical intervention, has been established. The place of these molecular genetic markers in the algorithm of diagnosis and treatment in patients with thyroid nodules was determined.

Keywords

thyroid gland / thyroid nodules / thyroid cancer / follicular neoplasms / differential diagnosis / thyroid surgery / molecular genetic panel / algorithm of diagnosis and treatment

References

[1] Brynova OV. Diagnosis of thyroid diseases using liquid and traditional cytology. Russian news of clinical cytology. 2018;22(3–4):16–21. (In Russ.).

[2] Брынова О.В. Диагностика заболеваний щитовидной железы с использованием жидкостной и традиционной цитологии // Новости клинической цитологии России. 2018. Т. 22, №. 3–4. С. 16–21.

[3] Maistrenko NA, Romashchenko PN, Krivolapov DS. Modern approaches to the diagnosis and surgical treatment of thyroid disorders. Military medical journal. 2018;339(1):37–46. (In Russ.).

[4] Майстренко Н.А., Ромащенко П.Н., Криволапов Д.С. Современные подходы к диагностике и хирургическому лечению заболеваний щитовидной железы // Военно-медицинский журнал. 2018. Т. 339, № 1. С. 37–46.

[5] Reshetova ON, Ivantsova AA, Mokeev AG. Fine-needle aspiration biopsy and liquid-based cytology of the nodular goiter: diagnostic value and analysis of the results. Bulletin of the Medical University “Reaviz”. 2019;(3):131–136. (In Russ.).

[6] Решетова О.Н., Иванцова А.А., Мокеев А.Г. Тонкоигольная аспирационная биопсия узлового зоба с применением метода жидкостной цитологии: диагностическая значимость, анализ полученных результатов // Вестник медицинского института «РЕАВИЗ». 2019. № 3. С. 131–136.

[7] Sanabria A, Kowalski LP, Shah JP, et al. Growing incidence of thyroid carcinoma in recent years: Factors underlying overdiagnosis. Head Neck. 2017;40(4):855–866. DOI: 10.1002/hed.25029

[8] Sanabria A., Kowalski L.P., Shah J.P., et al. Growing incidence of thyroid carcinoma in recent years: Factors underlying overdiagnosis // Head. Neck. 2017. Vol. 40. No. 4. P. 855–866. DOI: 10.1002/hed.25029

[9] Lukyanov SA, Sergiyko SV, Titov SE, et al. Prospects of molecular genetic panels use in the preoperative differential diagnosis of nodular lesions of the thyroid gland. News of surgery. 2020;28(3):284–289 (In Russ.). DOI: 10.18484/2305-0047.2020.2.284

[10] Лукьянов С.А., Сергийко С.В., Титов С.Е., и др. Перспективы использования молекулярно-генетических панелей в дооперационной дифференциальной диагностике узловых образований щитовидной железы // Новости хирургии. 2020. Т. 28, № 3. С. 284–289. DOI: 10.18484/2305-0047.2020.2.284

[11] Romashchenko PN, Maistrenko NA, Krivolapov DS, et al. Modern diagnostic and minimally invasive technology in thyroid surgery. Bulletin of the Russian Military medical academy. 2019;(S1):101–105. (In Russ.).

[12] Ромащенко П.Н., Майстренко Н.А., Криволапов Д.С., и др. Современные диагностические и малоинвазивные технологии в хирургии щитовидной железы // Вестник Российской военно-медицинской академии. 2019. № S1. C. 101–105.

[13] Romashchenko PN, Maistrenko NA, Krivolapov DS. Modern possibilities of diagnostics and surgical treatment of diseases of the thyroid gland. Izbrannye voprosy klinicheskoj hirurgii. Samara, 2018:189–198. (In Russ.).

[14] Ромащенко П.Н., Майстренко Н.А., Криволапов Д.С. Современные возможности диагностики и хирургического лечения заболеваний щитовидной железы // Избранные вопросы клинической хирургии. Самара, 2018. С. 189–198.

[15] Tavares C, Coelho MJ, Eloy C, et al. NIS expression in thyroid tumors, relation with prognosis clinicopathological and molecular features. Endocr Сonnect. 2018;7(1):78–90. DOI: 10.1530/EC-17-0302

[16] Tavares C., Coelho M.J., Eloy C., et al. NIS expression in thyroid tumors, relation with prognosis clinicopathological and molecular features // Endocr. Сonnect. 2018. Vol. 7. No. 1. P. 78–90. DOI: 10.1530/EC-17-0302

[17] Vuong HG, Altibi AM, Duong UN, et al. Prognostic implication of BRAF and TERT promoter mutation combination in papillary thyroid carcinoma-A meta-analysis. Clin Endocrinol (Oxf). 2017;87:411–417. DOI: 10.1111/cen.13413

[18] Vuong H.G., Altibi A.M., Duong U.N., et al. Prognostic implication of BRAF and TERT promoter mutation combination in papillary thyroid carcinoma — A meta-analysis // Clin. Endocrinol. (Oxf). 2017. Vol. 87. P. 411–417. DOI: 10.1111/cen.13413

[19] Yip L, Sosa JA. Molecular-directed treatment of differentiated thyroid cancer: advances in diagnosis and treatment. JAMA Surg. 2016;151(7):663–670. DOI: 10.1001/jamasurg.2016.0825

[20] Yip L., Sosa J.A. Molecular-directed treatment of differentiated thyroid cancer: advances in diagnosis and treatment // JAMA Surg. 2016. Vol. 151. No. 7. P. 663–670. DOI: 10.1001/jamasurg.2016.0825

[21] Zhang M, Lin O. Molecular testing of thyroid nodules: a review of current available tests for fine-needle aspiration specimens. Arch Pathol Lab Med. 2016;140(12):1338–1344. DOI: 10.5858/arpa.2016-0100-RA

[22] Zhang M., Lin O. Molecular testing of thyroid nodules: a review of current available tests for fine-needle aspiration specimens // Arch. Pathol. Lab. Med. 2016. Vol. 140. No. 12. P. 1338–1344. DOI: 10.5858/arpa.2016-0100-RA

[23] Samohvalova NA, Maystrenko NA, Romashchenko PN. Programmed approach to the treatment of secondary hyperparathyroidism in chronic renal disease. Grekov’s bulletin of surgery. 2013;172(2):43–46. (In Russ.). DOI: 10.24884/0042-4625-2013-172-2-043-046

[24] Самохвалова Н.А., Майстренко Н.А., Ромащенко П.Н. Программный подход к лечению вторичного гиперпаратиреоза при хронической болезни почек. Вестник хирургии им. И.И. Грекова. 2013. Т. 172, № 2. С. 43–46. DOI: 10.24884/0042-4625-2013-172-2-043-046

[25] Cibas ES, Ali SZ. The 2017 bethesda system for reporting thyroid cytopathology. Thyroid. 2017;11(27):1341–1346. DOI: 10.1089/thy.2017.0500

[26] Cibas ES, Ali SZ. The 2017 bethesda system for reporting thyroid cytopathology // Thyroid. 2017. Vol. 11. No. 27. P. 1341–1346. DOI: 10.1089/thy.2017.0500

RIGHTS & PERMISSIONS

Romashchenko P.N., Maistrenko N.A., Krivolapov D.S., Simonova M.S.