Nodal status in the papillary thyroid vancer. Comparison of the results of routine histopathological examination, immunohistochemistry and reverse transcription - polymerase chain reaction.

Immunohistochemistry (IE) and polymerase chain reaction (PCR) are tools enabling to find small number of tumor cells in lymph nodes (LNs) or peripheral blood. Perhaps these methods will allow early detection of cell dissemination and refine risk group within papillary thyroid cancer (PTC) that might benefit from more extensive surgical procedures or adjuvant therapy. In our study we detected PTC cells in the cervical LNs by routine histopathological examination RHE), IE and RT-PCR and compared obtained results. We also estimated the impact of RT-PCR and IE results on TNM staging and clinical staging according to UICC in patients with PTC. Each of 216 LNs from 28 patients with PTC were divided into two parts: one for RHE and IE the other one for Tg mRNA RT-PCR. Nodal metastases of PTC, in the regional LNs, were found by RT-PCR only in 1(3.6%) patient more than in RHE. In other 4(14.3%) patients molecular examination increased number of involved LNs. In the other patient it revealed less metastasized LNs. The molecular examination changed nodal status in 5(17.9%) of 28 patients. TNM staging was altered from N0 to N1 in one patient. In the others was changed only the number of involved LNs Our research prooved that Tg mRNA RT-PCR technique was sensitive method for detection of nodal metastases of PTC. The outcomes of RT-PCR are similar to RHE so that examination really does not change the estimation of the disease staging according to UICC classification and main surgical therapy in PTC patients.