No abstract

Background. One of the major challenges of modern medicine is prevention and early detection of diseases, especially malignant tumors, since the stage does influence the prognosis and treatment costs. Thyroid involvement is currently one of the leading endocrine disorders in terms of overall morbidity and prevalence in the world. Thyroid cancer is one of the localizations, which being timely detected and properly treated, has a favorable prognosis, when 20–30-year survival rate exceeds 90 %. Therefore, the search for simple, minimally invasive, but highly informative techniques for optimizing the algorithms for diagnosis, differential diagnosis and monitoring of this disease remains a priority. Purpose – to determine and substantiate the diagnostic value of comprehensive assessment of the thyroid status and full blood count values in patients with thyroid nodules. Materials and methods. The study involved 60 patients with thyroid nodules, which according to ultrasonography (US) of the thyroid were classified as TR-4 category of thyroid nodules, TIRADS scale (4–6 points, suspected malignant thyroid changes). The examination included the following: questionnaire, ultrasound examination with fine-needle aspiration puncture biopsy, cytological examination, counting the thyroid hormone concentration, full blood count. The study was carried out at the premises of State Institution “Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine”. Results. Assessment of thyroid status of patients with thyroid nodules showed a significant correlation between the severity of thyroid malignancy and TSH levels (according to Kruskal – Wallis test, H = 7.30, p < 0.05), FT4 (H = 17.64, p < 0.001) and FT3 (H = 12.41, p < 0.01). Patients of Group I with benign thyroid process showed significant (p < 0.05) decrease in total hemoglobin along with significantly frequent (p < 0.05) microcytic anemia. According to the studies, Group II had a significant (p < 0.05) decrease in total platelet count and plateletcrit, as well as an increased average platelet volume and the percentage of large platelets compared to Group I. The blood values in malignant thyroid process (Group III) are characterized by increased levels of leukocytes and the proportion of eosinophils and basophils in the leukocyte formula compared to Group II (p < 0.05). Conclusions. The outcomes of comprehensive assessment of thyroid status and full blood count values in patients with thyroid nodules can be used in preoperative diagnosis as a differential prognostic tool to assess their malignant potential.

The aim of the research is to increase the effectiveness of preoperative diagnosis of patients with thyroid tumors and to assess the use of cancer-embryonic antigen and immunocytochemical research. Materials and methods: Patients were interviewed about their complaints and lifestyle; performed ultrasound with fine-needle aspiration, determination of the level of cancer-embryonic antigen (CEA), cytological and immunocytochemical researches. Results: The Benign process in the thyroid gland is low serum REA (less than 0.95 ng / ml), poor expression of thyroglobulin (77.8%), negative reaction with TTF-1 (100%) and cytokeratin-19 (55.6%). Differential-prognostic markers of thyroid neoplasms with risk of malignancy include increased serum REA (0.95 ng / ml and above), the presence of a moderate reaction with antibodies to thyroglobulin (80.0%), a positive reaction — to TTF-1 (100.0%) and E-cadherin (90.0%), with moderate or strong expression of cytokeratin-19 (90.0%). Statistically significant markers of malignant thyroid disease were determined: the presence of harmful factors at work (45.5%), smoking (27.3%), elevated serum REA (0.95 ng / ml and above), the presence of strong cytoplasmic expression of thyroglobulin (63.6%), moderate or strong expression of TTF-1 (90.9%) and cytokeratin-19 (81.8%). Conclusions: The most appropriate and practically significant for preoperative diagnosis of thyroid tumors is a set of several diagnostic methods, which are carried out in one hospital – ultrasound with fine-needle aspiration, cytomorphological, and immunocytochemical and REA levels in a primary screening.