Approaches to Early Diagnosis of Thyroid Cancer

Kiseleva

et al. 2021

jour

Introduction. The literature review deals with the effects of ionizing radiation and radiation on the body of medical personnel.Materials and methods. 50 actual sources were analyzed. The relevance of the study of the constant, long-term influence of low doses of radiation is shown, in view of the increasing use of sources of ionizing radiation in various fields of scientific and practical human activity, including medicine.Results. Thanks to the analysis of numerous literature data, it was revealed that operating doctors, who are faced in their work with sources of ionizing radiation, often do not have a sufficient level of protection of the thyroid tissue from radiation. It was revealed that the overwhelming majority of studies highlighting thyroid pathology in medical personnel working with X-rays are aimed at identifying the risks of thyroid cancer and does not take into account the pathology of non-tumor genesis. Analyzed the data of scientific publications, allowing to draw a conclusion about the effects of chronic exposure to ionizing radiation, namely X-rays, in low doses on the thyroid tissue from a morphological and functional point of view.Discussion. It was established on the basis of the analysis of experimental data that under the influence of low-dose X-ray radiation, the intercellular contacts of thyrocytes are disconnected, which can lead to a decrease in the synthesis of thyroid hormones and, as a consequence, to the development of hypothyroidism.Conclusion. Based on the analysis of the experimental data, it has been established that under the influence of low-dose X-rays there is a disconnection of intercellular contacts of thyrocytes, which may lead to a decrease in the synthesis of thyroid hormones and, consequently, to the development of hypothyroidism.

Section: ионизирующее излучение в работе медицинского персоналаunclassified

Development of thyroid pathology in medical workers with chronic exposure to low doses of ionizing radiation

Kiseleva

et al. 2021

jour

Integral diagnostic scale in thyroid surgery

Romashchenko,

Maistrenko,

Krivolapov

et al. 2024

Endo Serg

BACKGROUND: An increase in the number of patients with thyroid nodules necessitates a detailed study of diagnostic capabilities that improve the quality of their preoperative verification and the choice of optimal treatment tactics. In this regard, the active improvement and introduction of new high-tech techniques continues, which require justification of the effectiveness of their use in clinical practice.AIM: To develop an integrated diagnostic scale for assessing the risk of malignancy of thyroid nodules, contributing to the choice of the optimal surgical treatment.MATERIALS AND METHODS: To assess the validity of the treatment and diagnostic tactics and select the optimal volume of surgical intervention with the development of an original integral diagnostic scale, a retrospective analysis of the results of the examination and treatment of 244 patients with thyroid nodules, as well as a prospective study, including 65 clinical observations, was carried out.RESULTS: In the course of the study, a systematic approach to the differential diagnosis of thyroid nodules was implemented using the most effective modern methods of laboratory and instrumental examination as part of the development of an original integral scale. It has been proven that the use of an integrated diagnostic scale allows predicting the risk of malignancy of formations: low (3–7%) with 0–5 points, medium (7–35%) — 6–10, increased (35–80%) — 11–15, high (80–96%) — 16–20. It has been established that in patients with an increased and high risk of malignancy, the diagnostic accuracy of the proposed integrated scale in detecting highly differentiated thyroid cancer increases to 90.2% when determining the expression of Galectin-3 above 31.2% in the puncture material, as well as in papillary carcinoma — up to 100% when the BRAF V600E mutation is detected. The treatment and diagnostic algorithm for clinical use has been optimized, allowing individualization of treatment tactics: for patients with an increased and high risk of malignancy, it is advisable to perform thyroidectomy with central lymphadenectomy; with an average risk — hemithyroidectomy; with low risk in the absence of signs of compression of the neck organs — dynamic observation, and if it is present — resection of the thyroid gland. It is shown that the implementation of a modified diagnostic and treatment algorithm, taking into account the use of an integral diagnostic scale, provides good immediate results of treatment.CONCLUSION: The introduction of an improved diagnostic and treatment algorithm, taking into account the use of an integrated scale for a comprehensive laboratory and instrumental assessment of thyroid nodules, makes it possible to increase the efficiency of their preoperative differential diagnosis and to choose an individualized surgical treatment option.

Russian Journal of Oncology

Risk factors for thyroid cancer

Лазарев

Zayarova²,

Петрова³

2022

Thyroid cancer (TC) is the most common tumor among endocrine malignant neoplasms all over the world. Over the past 20 years, there has been not only an increase in the indicators of true morbidity (not associated with active detection) of TC, but also the absence of a decrease in mortality and disability in this pathology. The identification of causal factors is important for clinical and scientific purposes, as it is the main requirement for the development of preventive measures and early diagnosis, forecasting the dynamics of the incidence of TC. The article provides an overview of known risk factors for the development of TC using sources of foreign and domestic literature, where preference is given to the results of large-scale scientific research. The article presents a wide range of causes of the development of TC: ionizing radiation, genetic factors, dietary characteristics, background diseases, and others.