Abstract
Radioiodine refractoriness is the main problem in the diagnosis and treatment of papillary thyroid carcinoma. The aim of the study was to investigate the cytological and immunocytochemical changes of thyrocytes in fine-needle aspiration smears of thyroid papillary cancer metastases in the course of the development of secondary radioiodine resistance. A total of 70 postoperative metastases of thyroid papillary cancer (secondary radioiodine refractory metastases, previously responsive to radioiodine, that eventually loses the ability to radioiodine accumulation, radioiodine-avid metastases, primary radioiodine-refractory metastases), immunohistochemical staining of thyroid peroxidase, thyroglobulin, cytokeratin 17 and cytological analysis were performed. Revealing the presence of specific cellular phenotypes and structures in punctuates, a low percentage of thyroid peroxidase and thyroglobulin-positive thyrocytes allows the development of the method of cytological prediction of the radioiodine therapy effectiveness.
Highlights
As a result of the Chernobyl accident, there was a sharp increase in incidence of the thyroid cancer [1, 2]
(2020), «EUREKA: Life Sciences» Number 1 studies of fine needle aspiration (FNA) smears in radioiodine refractory metastases (RIRM) have not yet been conducted and no data have been obtained on the cytological characteristics of RIRM
We have previously shown that cytokeratin No 17 (Ck17) is a cytological marker of the preoperative prognosis of RI resistance when determining its expression in FNA smears of primary papillary thyroid carcinoma (PTC) [11]
Summary
As a result of the Chernobyl accident, there was a sharp increase in incidence of the thyroid cancer [1, 2]. For 20 years of observation, most cases of differentiated thyroid cancer (DTC) have shown the excellent prognosis for more than 95 % of patients thanks to thyroidectomy and radioiodine (RI) – therapy, based on the unique ability of the thyroid cells to accumulate RI [3, 4]. Despite the mainly auspicious prognosis of papillary thyroid carcinoma (PTC) without relapses in most cases even using the standard therapy (thyroidectomy, RI and suppressive therapy), metastases occur during the postoperative period in 2–29 % of cases [3]. A combination of studies appears to support the notion that survival for patients with RI-refractory DTC distant metastases is around 2.5–3.5 years [7, 8]. The cytological (2020), «EUREKA: Life Sciences» Number 1 studies of FNA smears in RIRM have not yet been conducted and no data have been obtained on the cytological characteristics of RIRM
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