Pal'tsev M A, Kogan E A, Tuntsova O I, Severin E S, Silaeva S A, Golenchenko V A
I. M. Sechenov Moscow Medical Academy.
Arkh Patol. 1998 May-Jun;60(3):5-10.
The majority of thyroid tumors are not homogeneous histologically, this creating difficulties in interpretation of different carcinoma variants. The aim of the study was a complex comparative study of morphogenetic changes in carcinoma, adenoma and surrounding thyroid tissue. Surgical material from 48 patients operated because of nodular (multinodular) euthyroid goiter in Moscow Medical Academy in 1990-1997 was used. It was established that all the observations of early thyroid carcinoma diagnosed clinically as a nodular (multinodular) euthyroid goiter were represented by differentiated forms of thyroid carcinoma. Thyroid carcinoma was characterized by higher values of biomolecular markers as compared to adenomas and surrounding tissue. High values of c-myc expression in adenomas and surrounding tissue may indicate possible genetic rearrangements. A peculiar feature of carcinomas was the fact that deletions and replication errors in malignant tumors in this study were found simultaneously in the three genes investigated. As to different histological types of carcinoma, the most frequent deletions of the genes studied were observed in medullary and papillary-follicular carcinoma. High values of heterozygosity loss were found already in adenomas and surrounding tissues, this indicating the presence of the genetic changes already in the benign tumors and surrounding tissue.
大多数甲状腺肿瘤在组织学上并非均匀一致，这给不同癌变体的解读带来了困难。本研究的目的是对癌、腺瘤及周围甲状腺组织的形态发生变化进行综合比较研究。使用了1990 - 1997年在莫斯科医学院因结节性（多结节性）甲状腺功能正常性甲状腺肿而接受手术的48例患者的手术材料。已确定临床上诊断为结节性（多结节性）甲状腺功能正常性甲状腺肿的所有早期甲状腺癌观察病例均为分化型甲状腺癌。与腺瘤和周围组织相比，甲状腺癌的生物分子标志物值更高。腺瘤和周围组织中c - myc表达的高值可能表明可能存在基因重排。癌的一个独特特征是，在本研究中，恶性肿瘤中的缺失和复制错误在三个研究基因中同时被发现。至于不同组织学类型的癌，在所研究的基因中，最常见的缺失见于髓样癌和乳头状 - 滤泡状癌。在腺瘤和周围组织中已经发现了高杂合性缺失值，这表明在良性肿瘤和周围组织中已经存在基因变化。
