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Aim. The aim of this study was to evaluate of the informativity of ultrasound, cytological and rapid histological studies for monofocal cancers and cancers combined with background pathology of thyroid parenchema. Patients and methods. We studied 214 patients with nodular goiter of the thyroid gland (185 women from 18 to 79 years and 29 men from 17 to 82 years), residents of Kharkiv and Kharkiv region, who were operated on in 2019. A comparative analysis of indicators of the diagnostic efficiency of prognostic systems (ultrasound, cytological and rapid histological studies) was carried out. Results. The data of prospective study of 214 patients operated on the nodal pathology of thyroid gland with the analysis and interpretation of the results of ultrasound, cytological, express-histological and final histological studies are presented. The patients were divided into two groups. Group I consisted of 70 patients whose indications for surgical intervention were monofocal thyroid nodes, and Group II consisted of 144 patients with nodes against the background of different types of goitеr changes of the thyroid gland. A comparative analysis of the diagnostic value of stratification systems was made: ultrasonic ACR TI-RADS (American College of Radiology Thyroid Imaging Reporting and Data System) and cytological TBSRTC (The Bethesda System for Reporting Thyroid Cytopathology), as well as intraoperative rapid histological examination for monofocal cancers and cancers in combination with different types of leg changes. It was shown that for ACR TI-RADS the prognostic value of positive cancer test was 80 % in Group I patients and 74 % in Group II, i.e. the diagnostic value of ACR TI-RADS is 6 % higher for monofocal thyroid cancer. The prognostic value of the cytological test (TBSRTC) for cancer was higher than that of the ultrasound test and was 90.5 % for monofocal cancers (group I) and 76.5 % for cancer with diverse goitеr changes (group II), i.e. the diagnostic value of TBSRTC is 14 % higher for monofocal thyroid cancers. Intraoperative rapid histological study confirmed the highest (100 %) diagnostic value for monofocal thyroid cancers and high (up to 94 %) diagnostic value for cancers combined with various types of goitre changes. Conclusions. The combination of thyroid cancer with background pathology of the thyroid parenchyma reduces the prognostic value of a positive thyroid cancer test for ACR TI-RADS and rapid histological examination by 6 %, for TBSRTC by 14 %, which greatly complicates the prediction of thyroid cancer and requires active of dynamic monitoring even in the case of a benign cytological conclusion.

Aim. The aim of this study was to evaluate the frequency of combinations of Hashimoto’s thyroiditis (HT) with other underlying pathology of the thyroid parenchyma in various forms of thyroid cancer (TC). Patients and methods. This was a retrospective study of 424 histological preparations of patients with TC who had undergone thyroidectomy over an 12-year period (between 2008 and 2019). Was determined of morphological variant of the TС, which appeared of combinations of HT with and without other pathology of the thyroid parenchyma. All statistical calculations are made using Statistics 6.0 Copyright © StatSoft, Inc. 1984-2001, Serial number 31415926535897. Statistical analysis was performed using chi-square test and Fisher’s exact criterion. Results. It was shown that thyroid cancer, as an independent disease, occurred in 35.8% of ТС (152 cases). However, it was found that Gyurtle- cellular ТС, as an independent disease, on the background of intact thyroid parenchyma was observed significantly less often (РF 2-4 = 0,04; РF 3-4 = 0,021), than follicular ТС and medullary ТС, and papillary ТС – much less common than follicular ТС (Рχ1-2 = 0,003). HT as a background pathology, in a separate form was detected in 58 cases (13.7%) of the ТС, and in combination with other pathology of the thyroid gland in 67 cases (15.8%). Thus, in general, HT is 29.5% (125 cases), the last 147 cases of the thyroid gland were combined with other background pathology of the thyroid gland. The most common background thyroid diseases at which ТС was detected in combination with НТ were colloid goiter and follicular adenoma, as well as their combinations. In total, НТ was found in papillary ТС in 47% of cases, in medullary ТС – in 30%, in Gyurtle- cellular – in 56% and in poorly differentiated ТС – in 40%. It was shown, that in combination with follicular carcinoma, НT is detected significantly less frequently than in all other studied forms of ТC (in pure form – 2.5%, all in all – 5.5%). Conclusions. Such a frequent combination of thyroid cancer with other thyroid diseases can significantly complicate preoperative diagnosis and requires special attention when choosing treatment tactics.