ANAMNESTIC, LABORATORY, INSTRUMENTAL AND MORPHOLOGIC PROPERTIES OF ASYMPTOMATIC THYROID CARCINOMAS: RETROSPECTIVE MULTIFACTOR ANALYSYS

R. ZAMANOV

Scientific Surgical Center named after ac. M.A.Topchubashov. Baku, AZERBAIJAN

Introduction.In post-operative morphologic analysis of 6,0-29,0% of surgical operations performed for non-oncologic pathologies of thyroid gland, there was detected “thyroid carcinoma”. This necessitates preparation of adequate informative diagnostic criteria in preoperative period.

Purpose: to systemize anamnestic, clinical, laboratory, instrumental, cytological, cytochemical and histologic criteriaandimprove algorithm of diagnostic procedures by means of retrospective multifactor

analysis of asymptomatic thyroid carcinoma detected after surgical operations of non-oncologic

pathologies.

Materials and methods. The population consists of 245 patients with postoperatively detected asymptomatic thyroid carcinoma in 2000-2009. Retrospective analysis was carried out based on the following factors: age, sex; duration of disease (chronologic factor), inherited thyroid pathology, place of residence (region), nature of enlargement of the organ (diffuse, nodular, duffise-nodular); number, localization, ultrasound parameters of nodes and cysts, “indicators of thyroid panel” (Т₃, Т₄, anti-thyroid peroxidase, TSH), nuclear polymorphism in thyroid epithelium, nucleocytoplasmic ratio,, cytoplasmicvacuolization, thromboleukocytal masses in peripheral blood, oxygen saturation of erythrocytes, free and peroxide lipids in peripheral blood cells and peroxide lipids, stroma fibrosis in fine-needle biopsy materials, proliferation intensity (mitosis) of epithelium in the interfollicular masses and follicles. The analysis was carried out by the calculation of correlation factor (r) in the П=0,95 (п≤0,05) reliability level and Pirson criterion (c²) by non-parametric and alternative statistical methods.

Results. The majority of analysis parameters do not have diagnostic significance. The following signs separately has basic diagnostic significance: tendency to inherited throid pathology, “cold” node with indistinct limits (area of enlargement), slight increase of or extreme normal level of TSH, more than 3.0 score content of free and peroxide lipids in peripheral blood, higher than 4,0‰ mitosis index in thyroid epithelium, high intensity of desmoplastic fibrosis in fine-needle biopsy material, dysplasia of interfollicularepithelium, polymorphism and dysplasia of follicular epithelium.

Conclusion. There is no (completely specific) separate parameter of absolute diagnostic significance with preoperative period of asymptomatic thyroid cancer.

Date: 2014-12-28; view: 791