Сумісне використання визначення експресії тиреоглобуліну та тиреоїдної пероксидази в пунктатах у передопераційному прогнозуванні ефективності радіойодтерапії поопераційних метастазів папілярного тиреоїдного раку

Abstract

Aim is the immunocytochemical study of the expression of thyroid peroxidase and thyroglobulin in the puncture material of radioiodine-resistant and radioiodine-sensitive metastatic papillary thyroid carcinoma, to ascertain the possibility of their joint use as markers of pre-operative prediction of the effectiveness of radioiodine-therapy. Material and methods. Immunocytochemical studies using monoclonal antibodies against thyroglobulin andthyroid peroxidase were performed on the material of Fine Needle Aspiration Biopsy of 104 metastases detected after thyroidectomy and radioiodine therapy (79 — radioiodine-resistant, 25 — radioiodineuptake). The statistical analysis was performed using the nonparametric Mana-Whitney method in the Statistica 11 program. Results. A very significant difference was found at a significance level of p<0.001 between percent of thyroid cells expressing thyroidperoxidase and thyroglobulin between radioiodine-resistant and radioiodine-sensitive papillary thyroid metastases. The efficacy of radioiodine therapy is different in patients with different expression of thyroid peroxidase. Intermediate values of the percentage of cells with the expression of thyroid peroxidase although they cause moderate accumulation of radioiodine, but may not be sufficient for successful radioiodinetherapy. The consistent determination ofexpression of thyroglobulin and thyroid peroxidase in the postoperative of the thyroid papillary cancers metastasesa increases the accuracy of prediction of their radioiodine resistance, especially when detecting a questionable percentage of cells with thyroid peroxidase. In the absence of an expression of thyroglobulin in papillary thyroid carcinoma metastases found in the postoperative period, it is impossible to exclude a zero level of thyroglobulin in serum,even in the presence of metastases. Therefore, it is not necessary to have a comprehensive personalized approach to such patients. Conclusions. A new method of preoperative prediction of the effectiveness of radioiodine therapy based on immunocytochemical determination of thyroid peroxidase and thyroglobulin expression in punctates of papillary thyroid cancer metastases detected after thyroidectomy and radioiodine was proposed.