Abstract
The routine execution of a fine-needle aspiration puncture biopsy is the most informative method for the preoperative diagnosis of thyroid neoplasms, as well as a promising base for improving molecular diagnostics in an endocrine surgery clinic in conjunction with a pathological laboratory. The aim of our work was a comparative analysis of the expression of cell cycle signaling molecules in various thyroid diseases: toxic goiter, adenomatous goiter, autoimmune thyroiditis and papillary cancer. We investigated the quantitative ratio of expression of apoptosis markers CD-95 (Fas-R) and Ki-67 mitosis detected in thyrocytes by immunocytochemistry and immunohistochemistry using standard protocols. The index Z = Fas / (Ki67 + 1) is proposed.
 The performed cluster analysis of the Z-index calculated on the basis of punctate immunocytochemistry material allowed us to identify a group of patients relatively uniform in value (in this group, after the operation, the diagnosis of papillary cancer was histologically confirmed in all patients). Marker expression values were 2,3–9,0 for Ki67 and 0,9–4,1 for Fas, and the Z-index was in the range 0,6–3,9. It can be useful for the differential diagnosis of thyroid cancer based on punctate material, which is important when deciding on the amount of surgical intervention, as well as in the morphological substantiation of the prognosis of the disease.
 Mathematical analysis showed that if the percentage of fissile nuclei visualized immunohistochemically with the Ki-67 marker is unpromising as a singular diagnostic indicator, then in combination with the apoptosis marker it plays an important role in a comprehensive assessment. These data are also interesting in the context of the pathophysiological pattern of inhibition of the expression of CD95 by tumor cells. This is important to justify the approaches of chemotherapy or immunotherapy of cancer of different tissue belonging.
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