Morphological features of radioiodine-resistance metastases of thyroid papillary carcinoma
An important problem in the diagnosis, treatment and prediction of papillary thyroid cancer is radioiodine-resistant metastases, early prediction of which is possible on the condition of determining their cytological and histological characteristics. The purpose of this work was to identify the histological and cytological characteristics of metastases of papillary thyroid carcinomas correlated with their iodine-accumulative capacity, on the basis of which it will be possible to predict the radio-resistance of papillary thyroid carcinomas. A cytological examination of punctates of 30 papillary carcinomas and 45 of their metastases identified in the postoperative period and analysis of the histological characteristics of 100 papillary carcinomas of the general population, 47 primary papillary carcinomas and their radio-resistant metastasis and 17 primary papillary carcinomas of patients with radioiodine-uptake metastases were conducted. Statistical analysis was performed via the non-parametric criterion χ2 in the package Statistica 11.0. It has been shown a statistically significant difference between presence of sign of follicular structures in the histological material of primary papillary canсer of patients with radioiodine-resistance metastases and between of primary papillary canсer of patients with radioiodine-uptake metastases and common population of papillary thyroid cancer. It has been shown a statistically significant difference between punctuates of radioiodine-resistance and radioiodine-uptake metastases in presence of such cytological characteristics as different subpopulations of thyrocytes. It has been shown that the cytological characteristics of radioiodine-resistant metastases differ from radioiodine-uptake metastases and primary papillary carcinomas by the presence of different subpopulations of thyrocytes, particular structures and oxyphilic changes. It is shown that such histological characteristics as lack of follicular structures in the material of primary papillary carcinomas correlate with radio-resistance and can be prognostic factors of its appearance.
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