Distinguish Thyroid Malignant From Benign Alterations Using Chemical Element Contents in Nodular Tissue Determined By Neutron Activation and Inductively Coupled Plasma Atomic Emission Spectrometry

Abstract

Objectives: Thyroid benign (TBN) and malignant (TMN) nodules are a common thyroid lesion. The differentiation of TMN often remains a clinical challenge and further improvements of TMN diagnostic accuracy are warranted. The aim of present study was to evaluate possibilities of using differences in chemical elements (ChEs) contents in nodular tissue for diagnosis of thyroid malignancy. Methods: Contents of nineteen ChEs including aluminum (Al), boron (B), barium (Ba), calcium (Ca), chlorine (Cl), coper (Cu), iron (Fe), I (iodine), potassium (K), lithium (Li), magnesium (Mg), manganese (Mn), sodium (Na), phosphorus (P), sulfur (S), silicon (Si), strontium (Sr), vanadium (V), and zinc (Zn) were prospectively evaluated in nodular tissue of thyroids with TBN (79 patients) and to TMN (41 patients). Measurements were performed using a combination of non-destructive and destructive methods: instrumental neutron activation analysis and inductively coupled plasma atomic emission spectrometry. Results: that in TMN tissue means of Br, I, Na, S, and V mass fractions are approximately 2.9, 15, 1.25, 1.15, and 1.7 times, respectively, lower, while the means of Ca, K, Mg, and P mass fraction are 2.3, 1.4, 1.4, and 2.0 times, respectively, higher those in TBN tissue. Mean contents of Al, B, Ba, Cl, Cu, Fe, Li, Mn, Si, Sr, and Zn found in the TBN and TMN groups of nodular tissue samples were similar. Conclusions: It was proposed to use the I mass fraction as well as I/Ca, I/K, I/Mg, and I/P mass fraction ratios in a needle-biopsy of thyroid nodules as a potential tool to diagnose thyroid malignancy. Further studies on larger number of samples are required to confirm our findings and proposals.