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

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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.

About the authors

Pavel N. Romashchenko

Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation

Email: romashchenko@rambler.ru
ORCID iD: 0000-0002-1405-7660
SPIN-code: 3850-1792

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Nicolay A. Maistrenko

Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation

Email: nik.m.47@mail.ru
SPIN-code: 2571-9603

doctor of medical sciences, professor

Russian Federation, Saint Petersburg

Denis S. Krivolapov

Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation

Email: d.s.krivolapov@yandex.ru
ORCID iD: 0000-0002-9499-2164
SPIN-code: 2195-5001

candidate of medical sciences

Russian Federation, Saint Petersburg

Maria S. Simonova

Military Medical Academy named after S.M. Kirov of the Ministry of Defense of the Russian Federation

Author for correspondence.
Email: mariasimonova62@gmail.com
ORCID iD: 0000-0002-8359-1875
SPIN-code: 6004-1995

clinical resident

Russian Federation, Saint Petersburg

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. 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.).
  3. 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.).
  4. 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
  5. 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
  6. 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.).
  7. 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.).
  8. 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
  9. 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
  10. 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
  11. 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
  12. 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
  13. Cibas ES, Ali SZ. The 2017 bethesda system for reporting thyroid cytopathology. Thyroid. 2017;11(27):1341–1346. doi: 10.1089/thy.2017.0500

Supplementary files

Supplementary Files
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2. Fig. 1. Results of the study of the level of Galectin-3 expression by flow fluocytometry in benign and malignant thyroid tumors

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3. Fig. 2. ROC-analysis of the effectiveness of the study of the level of Galectin-3 expression by flow fluocytometry in the differential diagnosis of benign and malignant thyroid tumors

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4. Fig. 3. Level of NIS expression by groups of radioiodine therapy efficacy

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Copyright (c) 2021 Romashchenko P.N., Maistrenko N.A., Krivolapov D.S., Simonova M.S.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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