IMMUNOHISTOCHEMICAL FEATURES OF THE THYROID GLAND NODULAR FORMATIONS IN PATIENTS WITH COMORBID PATHOLOGY

In clinical practice, the common term «nodular goiter» refers to a disease that combines nodular formations of the thyroid gland with different morphological structures. It should be noted that this pathology most often occurs in the elderly and senile age in individuals of both sexes, when the patient has developed a complex of comorbid pathology that complicates the underlying disease. Concomitant pathology in patients with thyroid diseases is quite diverse, influencing the underlying disease and mutually aggravating each other, they create difficulties in diagnosis and treatment. The purpose of the study: to establish immunohistochemical features of nodular formations of the thyroid gland in patients with comorbid pathology and their diagnostic and prognostic value. The study included 74 patients who underwent thyroidectomy according to clinical indications. Females predominated, making up 85% of the entire study group of patients. The median age of the study group of patients was 47 years. To study morphological changes, preparations of the removed thyroid gland were used. In total, 74 preparations from patients of the surgical department with a clinical assessment of their comorbid profile were analyzed in the course of the study using immunohistochemical assessment of p-53, Ki-67, and thyroglobulin markers. Among the comorbid pathologies, hypertension, coronary heart disease, heart rhythm disturbances, cholelithiasis, and chronic venous diseases of the lower extremities were identified. It was found that immunohistochemical examination of thyroid preparations in patients with complicated comorbid background is a diagnostically valuable method for determining postoperative treatment tactics. Assessment of the degree of proliferative activity of thyroid tissues allows predicting the risk of recurrence and malignancy of nodular goiter, as well as determining the subsequent, most appropriate type of surgical intervention. The first degree of goiter proliferation is not a risk factor for its relapse after surgery. The second degree of proliferation is a risk factor for goiter recurrence. The third degree of proliferation is a reliable sign of goiter recurrence and possible malignancy of the nodes.

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