Molecular-genetic testing in preoperative diagnosis and choice of surgical tactics in patients with thyroid neoplasms

Abstract

The high frequency of the detection of follicular thyroid tumors requires the development of the most effective new methods for their differential diagnosis to early verification of well-differentiated cancer, reduce the number of unjustified surgical interventions, select their rational volume, and improve the treatment results. The use of molecular genetic research methods in preoperative diagnostics and the choice of surgical tactics in patients with the thyroid neoplasms was substantiated. To optimize the algorithm of diagnosis and treatment, a retrospective analysis of the results of examination and surgical treatment of 100 patients with the thyroid neoplasms was carried out, the diagnosis of which was supplemented by the determination of molecular genetic markers in the cellular material of the puncture fine-needle biopsy using a flow fluor-cytometry and polymerase chain reaction. The diagnostic significance of the preoperative determination of the tumor marker Galectin-3, the V600E mutation of the BRAF gene in the puncture material in the detection of thyroid cancer and the choice of the rational surgical tactics was assessed. The prognostic value of the sodium iodide symporter in the development of a thyroid cancer resistance to postoperative radioactive iodine therapy has been established, which makes it possible to substantiate the need to expand the scope of the surgical intervention. The use of an optimized diagnostic and treatment algorithm, considering a new molecular genetic research methods in this category of the patients, contributes to the choice of individualized surgical tactics, depending on the nature of the pathological process.