The article is devoted to the relevance of the application of the Bethesda classification system of interpretation of FNA in practice. In this study was investigated 104 cytological specimens of the thyroid gland from patients with var ious diseases of the thyroid gland. Revision of the cytological results was carried out by four highly qualified cytopathologists, working on the basis of three leading medical centers in the Russian Federation. Also, the respons es of each cytopathologist by diagnostic categories Bethesda Classification were compared. Statistical analysis showed that by the revision of the biopsy specimens there were no statistically significant differences between the ini tial cytologic findings and the results of independent cytopathologists. In analyzing the data, it was found that the fundamental error of cytological diagnosis were papillary carcinoma, medullary carcinoma, as well as “follicular neoplasm”. Comparing the results of histological examination with the responses of the cytopathologists was found that the major fault was the definition of papillary carcinoma and “follicular neoplasm”. The results suggest that Bethesda Classification allows to achieve the best results in the interpretation of the results of FNA, which leads to a more elaborate tactics of treatment of the patient.

Purpose: to evaluate the clinical utility of antithyroglobulin antibodies (TgAb) as a tumor marker in patients with differentiated thyroid cancer (DTC) after thyroidectomy and radioiodine ablation. Patients and methods. From 345 consecutive DTC patients after thyroidectomy and radioiodine ablation we select ed 148 patients with elevated TgAb level (with distant metastasis n = 93, without distant metastasis n = 55). Serum TgAb concentration was measured before radioiodine ablation and then every time before 131I treatment (RIT) or diagnostic 131I whole body scanning (WBS). Results were compared with serum thyroglobulin (Tg) concentration, neck echography, lung and bone roentgenography and 131I WBS findings. Results. TgAb level was elevated in 21% DTC patients before 131I ablation. The other 22% with initially normal TgAb displayed their rising during followup. In absence of distant metastasis TgAb declined after 1 st–2 nd cycle of RIT (an average 8.9 months after 131I ablation). Persistance or rising of TgAb in the longer term was associated with detectable thyroid remnant, residual tumor or metastatic lymph nodes. In case of negative TgAb status after sugery an increase of TgAb during first 3–6 months after ablation indicated mostly a response to the rise of Tg antigen secondary to 131I ablation. A rise TgAb in the longer term (after 3rd–5th cycles of RIT) indicated to residual or recurrent disease in 86% cases. In patients with distant metastasis there were no correlation between change in TgAb concentration and clinical sta tus, including the rate of regression of metastatic disease. But in case of low or undetectable Tg and permanent high TgAb level only TgAb indicated the presence of disease. Conclusion: persistence or rising TgAb in longer term after 131I ablation can serve as surrogate tumor marker of per sistent or recurrent disease. It is critical to measure TgAb concentration, especially in patients with low or unde tectable Tg, because in these cases TgAb appears to be the only serum DTC tumor marker.

High prevalence of family cases of autoimmune thyroid diseases (AITD) causes requirement of researching this group of patients. The objective of this study is to estimate genotypes and alleles frequencies of CD40 C(1)T poly morphism (rs1883832) in Graves` disease and Hashimoto`s disease families at least two firstdegree affected relatives. 70 patients with AITD took part in the study (35 families) and 76 control subjects. Results suggested that carrying of CT and TT genotypes of CD40 C(1)T polymorphism is associated with the low risk of developing of Graves` disease family cases without any regards to degree relationship. No association between CD40 C(1)T polymorphism and Hashimoto`s disease was identified. Carrying of allele C is associated with the high risk of developing of Graves` dis ease family cases odds ratio OR = 2,669, 95% CI, 1,6124,39, but not Hashimoto`s disease family cases.

AIM: to examine the association of polymorphisms Pro12Ala and C1431T PPARγwith the development of thyroid eye disease (TEO). Materials and methods. A total of 88 people: 52 patients with TEO, 36 – healthy individuals. Identified polymorphisms Pro12Ala and C1431T PPARγby PCR. Results. In more common TEO homozygous genotypes Pro/Pro and Ala/Ala (χ 2 = 6,035, p = 0.049) and allele Ala (χ 2 = 15,062, p <0,001) polymorphism Pro12Ala; geno types C/C and T/T (χ 2 = 28,34, p <0,001), the allele C (χ 2 = 15,06, p <0,001) polymorphism C1431T PPARγ, than in the control. The relative risk of TEO in the Ala/Ala genotype of 1.73 (95% CI, 1.45–2.08), with C/T genotype of 0.61 (95% CI, 0.39–0.96). The odds ratio for C/T genotype in patients with TEO 0.33 (95% CI, 0.13–0.82).

The aim of the study was to examine the system of tumor necrosis factor α(TNFα), depending on the functional and morphological outcome of Graves’ disease (GD). It has been shown that activation of TNFαis associated with a “soft” and “benign” clinical course of GD and appearance of morphological markers of autoimmune thyroiditis (Hurthlecells transformation of thyroid epithelium).