Cytological Diagnosis of the Thyroid Gland in Ukraine During Martial Law Conditions

Abstract

Background. Cytopathological studies of the thyroid gland are important in patient diagnosis. Since the beginning of the Russian invasion, most cytopathological screening procedures (including cancer screening) in Ukraine have been reduced or delayed, threatening medical personnel's ability to provide early cancer detection. The aim was to analyze the results of cytological studies of fine-needle aspiration puncture biopsy (FNA) of thyroid neoplasms according to the Bethesda international classification for 2022-2023. Methods. The study was carried out with the involvement of the database of patients who used the service of cytological studies of FNA of the thyroid gland in the "CSD" Medical Laboratory in the period of 2022-2023. The following were analyzed: 1) cytological findings according to the Bethesda international classification; 2) gender of the patient. Light microscopy (Leica Microsystems, DM2000) was used for cytological research. Results. In the period from 2022 to 2023, an analysis of 4,247 cytological studies of patients with thyroid nodules was carried out. Of them, 3,654 (86 %) concerned women, and 593 (14 %) men. Compared with previous years, where the percentage of cytological studies in women was 87 %, it was established that women are more prone to thyroid diseases. In 2022-2023, the rate of non-diagnostic materials was 18.1 %, which emphasizes the need to improve preanalytical processes. The second class, according to the international classification of Bethesda, accounted for 54.7 % of cases. Despite the decrease in the percentage of diagnosed cases of the thyroid gland during the war, the second class remains the most common class among other classes of cytological diagnosis of the thyroid gland. Such a result indicates the importance of further improvement of diagnostic methods and increasing the effectiveness of treatment of patients with thyroid gland pathology. According to the Bethesda 2023 classification, the AUS category has an average risk of malignancy of 22 %. This class was 13.2 % in the period 2022-2023. There is a trend of growth in the production of this class, compared to previous years (8.2 %). Class 4 was detected in 4.8 % of patients and decreased by almost two times compared to previous years. Grades 5 and 6, which have the highest level of malignancy, were within 4-5 %. Conclusions. During the Russian invasion of Ukraine, the process of cytopathological diagnosis was violated, which led to a decrease in the number of cytological samples, particularly studies of FNA of the thyroid gland, sent to the CSD Medical Laboratory.