Surgical treatment of the thyroid nodes of uncertain cytological structure

Keywords: thyroidal nodes; fine-needle аspiration puncture biopsy; surgical treatment.

Abstract

Objective. To determine the clinical factors of the enhanced risk of malignancy in patients, having categories of cytological conclusions III (AUS/FLUS) and IV (FN/SFN).

Маterials and methods. There were 11 621 patients examined with cytological investigation of thyroidal nodes under ultrasonographic control. Cytological conclusions of category ІІІ (AUS/FLUS) have characterized 621 nodes, while conclusions of category IV (FN/SFN) - 1215 nodes. There were operated 150 patients, owing cytological conclusions of category III, 436 patients - with cytological conclusions of category IV, and 11 patients, having categories of cytological conclusions III and IV.

Results. Papillary and follicular carcinomas were revealed in 36% patients, suffering thyroidal nodes of the Bethesda III category, what is trustworthily more frequently (р < 0.01), than in the patients, suffering thyroidal nodes of the Bethesda category IV (25.1%).

There were revealed such factors of risk for malignant properties in patients, suffering thyroidal nodes with the Bethesda category III, as: the node size 2 сm and less, its hypoechogeneicity, uneven borders, irregular form, and presence of hyperechogenic foci (р < 0.01). Cystic degeneration of a node constitutes the sign of its benign origin (р < 0.01).

Conclusion. High risk of malignant changes (36%) in thyroidal nodes, in accordance to cytological conclusion of the Bethesda category III revealed, trusts the need for enhanced oncological suspicion and conduction of surgical treatment. Тhe additional factors of malignant changes must be taking into account as well, such as the node size 2 сm and less, its hypoechogeneicity, uneven borders, irregular form, and presence of hyperechogenic foci.

Author Biographies

Yu. M. Таrashchenko, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Yuriy M. Tarashchenko, FD,
Department of Surgery Endocrin Glands
V.P.Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-66
E-mail: yutar0380@gmail.com ORCID:
https://orcid.org/0000-0003-4787-359X

А. E. Коvalenko, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Andrey Ye. Kovalenko, MD, professor
Department of Surgery Endocrin Glands
V.P. Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-88
E-mail: ae@kovalenko.co.ua ORCID:
http://orcid.org/0000-0003-0326-6421

M. V. Оstafiychuk, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Marian V. Ostafiychuk, Melnyk Yanchii Zelinskaya Naida
Department of Surgery Endocrin Glands
V.P. Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-66
E-mail: skorpionmaryan@gmail.com
ORCID: https://orcid.org/0000-0002-0446-051X

I. R. Yanchiі, Коmisarenko Institute of Endocrinology and Metabolism of Substances, Kyiv

Ivan R. Yanchii, FD,
Department of Surgery Endocrin Glands
V.P. Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-66
E-mail: ivan.yanchiy@gmail.com
ORCID: https://orcid.org/0000-0003-0600-5833

M. D. Melnyk, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Mykola D. Melnyk,
Department of Surgery Endocrin Glands
V.P.Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-66
E-mail: melnik2015@gmail.com
ORCID: https://orcid.org/0000-0001-8991-3352

G. V. Zelinskaya, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Anna V. Zelinskaya,
Department of Functional Diagnostic
V.P.Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-96
E-mail: ann.zelinskaya@ukr.net
ORCID https://orcid.org/0000-0002-4320-6901

Yu. M. Naida, Коmisarenko Іnstitute of Endocrinology and Metabolism of Substances, Kyiv

Iurii M. Naida,
Department of Functional Diagnostic
V.P. Komisarenko Institute of Endocrinology and Metabolism
Address: Vyshgorodska Str., 69, 04114 Kyiv, Ukraine,
tel.: +38 (044) 254-12-12
E-mail: y.nayda@ukr.net ORCID
https://orcid.org/0000-0001-6020-568X

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Published
2019-05-05
How to Cite
ТаrashchenkoY. M., КоvalenkoА. E., ОstafiychukM. V., YanchiіI. R., Melnyk, M. D., Zelinskaya, G. V., & Naida, Y. M. (2019). Surgical treatment of the thyroid nodes of uncertain cytological structure. Klinicheskaia Khirurgiia, 86(5), 59-63. https://doi.org/10.26779/2522-1396.2019.05.59
Section
General Problems of Surgery