АКТУАЛЬНІ ТЕНДЕНЦІЇ ДІАГНОСТИКИ ТА ЛІКУВАННЯ ФОЛІКУЛЯРНИХ НЕОПЛАЗІЙ ЩИТОПОДІБНОЇ ЗАЛОЗИ

The article explores the problem of diagnosis and treatment of follicular tumors of the thyroid gland, specifically follicular adenomas and carcinomas. Attention is drawn to the complexity of cytological and histological diagnosis of these formations due to the lack of clear morphological signs of malignancy, which complicates the determination of the boundaries between benign and malignant tumors. The aim of the research was to analyze the results of diagnosis and surgical treatment of patients with follicular adenomas and carcinomas. In 2022, new approaches to the classification of follicular tumors were published, particularly the distinction of new categories of low-risk tumors. In diagnosis, the primary method is fine-needle aspiration biopsy (FNAB), but due to difficulties with morphological features, additional methods are employed, such as immunocytochemical markers (TPO and CK17). The study is based on an analysis of data from 749 patients who were examined and treated at the MNPE “Prykarpattia Clinical Oncology Centre” in Ivano-Frankivsk, as well as in the surgical departments of the “Med-Atlant” diagnostic-treatment center (Ivano-Frankivsk) and the “St. Luka’s” diagnostic-treatment center (Ivano-Frankivsk) during the period spanning from 2019 to 2024. From this cohort, 121 patients without comorbidities that could influence diagnostic and treatment outcomes were selected for further analysis. In all cases, the diagnosis was confirmed histologically after surgery. The use of radioiodine therapy for treating patients with follicular carcinomas is also separately considered. The main results of the study include a statistical assessment of the distribution of patients according to the Bethesda system, as well as a characterization of different forms of follicular carcinomas. The study highlights the importance of molecular genetic tests and immunocytochemical markers in increasing the accuracy of diagnosis and predicting treatment outcomes. The implementation of advanced diagnostic tools, including molecular testing, has significantly improved the precision in distinguishing between benign and malignant follicular tumors. The role of these techniques in the early detection and better prognosis of thyroid cancers is particularly critical. Additionally, the study explores various treatment strategies, including surgery and radioiodine therapy, to improve long-term patient outcomes. Moreover, the research underscores the growing need for more refined diagnostic protocols and the continuous improvement of therapeutic methods to address the challenges presented by follicular thyroid tumors. These tumors often present with ambiguous features that make early diagnosis difficult, which is why the development of more reliable diagnostic markers is imperative. The article concludes by stressing the importance of multidisciplinary approaches in managing thyroid diseases, involving endocrinologists, surgeons, pathologists, and oncologists working collaboratively to ensure optimal patient care. The findings of this study not only contribute to the medical community's understanding of follicular thyroid tumors but also lay the groundwork for future research aimed at improving treatment outcomes for patients with these challenging conditions.