There are discriminating approaches towards differentiated thyroid carcinomas due to their different prognoses according to the European, American and Japanese thyroid recommendations. Materials and Methods. We have analyzed data on 331 patients with papillary thyroid cancer, operated on during the period of 1966-2000 years. Mean observation period was 18.8 years, the maximum period of observation was 57 years.Results. Survival rate analysis after surgical treatment showed favourable prognosis for thyroid cancer patients, adjusted for that there was no ultrasonography and FNAB during those years, and patients had generally more progressive tumours. One of the most important factors for the prognosis of a patient is the size of a tumour at the moment of operation and presence of distant metastases. Long-term results of surgical treatment are practically independent of its extent (thyroidectomy or thyroid resection, prophylactic lymphodissection). Mortality and recurrence rates in patients who were not submitted to radioactive iodine treatment do not differ considerably from literature data.

Thyroid papillary cancer, one of the most frequent malignant tumors, aroused growing interest during last years due to continuous increase in number of such patients. This article is devoted to the closest results of surgical stage of treatment of patients with thyroid papillary cancer and to the analysis of complications after thyroid surgery. Material and Methods. This work is based on the analysis of results of treatment of 1156 patients with thyroid papillary cancer, who were operated during the period 2007 and 2012 at the Department of Endocrine Surgery of SPCC FGBI “NMSC named after N.I. Pirogov” of MH of RF. The diagnoses were confirmed by histological method. Results. Hemithyroidectomy was performed only in patients with rather favourable forms of thyroid papillary cancer typical, follicular and sclerosing. Patients with more aggressive forms tall cell and columnar!cell were subjected to thyroidectomy. There is increase of complications with thyroid surgery expansion hypoparathyroidism from 7.6% after thyroidectomy without lymphodissection to 13.3% after thyroidectomy with central and lateral lymphodissection, and paresis of lower laryngeal nerve from 5.1% to 6.5%. Postoperative bleeding that required repeated operative intervention was registered in 3/1156 (0.3%) of patients. There were no lethal complications after thyroid surgery. Among operated 1156 patients cancer recurrence was detected in 29 patients (2.5%).

The goal of the study was to determine diagnostic value of fine needle aspiration biopsy (FNAB) in detection of malignant thyroid tumors based on retrospective analyses of 40696 FNAB of patients with thyroid nodules. Results. Comparison of the results of FNAB with postoperative histological examination data from 3004 patients revealed that the rate of false positive cytopathological results was 1.2% and the rate of false negative results was 1.8%. The sensitivity reached 99.67%. The specificity of FNAB when taking into account follicular lesions dropped to 16.29%, while leaving follicular lesions 94.29%. Cytological results of 49609 FNAB of patients with thyroid nodules according to Bethesda system were arranged as follows: noninformative results 8%, benign nodules 81.9% (colloid nodules 71.6%, autoimmune thyroiditis 10.2%, subacute thyroiditis and others 0.02%), follicular lesions 7.2% (follicular neoplasm 7.1%, follicular lesion of indeterminate value 0.1%), suspicious for malignancy 0.02%, malignant tumor 3%, among the latter papillary carcinoma 93%. Malignant tumors, according to postoperative histological examination, were detected among the group with cytological diagnosis “follicular neoplasm” in 16.3% of cases. After performing FNAB of regional lymph nodes with suspicious ultrasound signs the metastases of papillary carcinoma were revealed in 24.6% of cases. Application of FNAB in clinical practice at our Center to all patients with thyroid nodules of 1 cm in size and larger resulted in increment of thyroid operations for oncological indications from 12.5% in 2004 to 53% in 2012. Conclusion. FNAB under ultrasound control is the most informative differential method for thyroid diseases, permitting to reveal primary and metastatic thyroid lesions. FNAB allow to evade nonobligatory diagnostic operations in many patients.

The results of comparative preoperative cytological and postoperative histological investigation of 3714 patients with thyroid nodules are presented. The causes of discrepancies are discussed and measures of their diminution are proposed. Great value of fine needle biopsy to differ thyroid nodules but follicular neoplasia into benign and malignant are determined. Its sensitivity in our clinics is 98.7% and specificity – 100%. Necessity of the of the second FNA if the first one is non informative is established.

The authors present a comparative analysis of preoperative cytological investigation of 65 bioptates of the thyroid gland obtained by the method of fine-needle aspiration puncture biopsy and smears-prints of the same tumors made during the operation. The analysis was made according to 10 cytological criteria. The degree of correspondence of the cytological and histological investigations was determined in nodular goiter and carcinomas of the thyroid gland. The maximal specificity and sensitivity was noted in capillary carcinoma (95.3% and 100% respectively).