Thyroid cell proliferation in Graves' disease. Use of MIB-1 monoclonal antibody.

OBJECTIVE

To measure thyroid cell proliferation in patients with Graves' disease (GD) before and during treatment with antithyroid drugs.

STUDY

DESIGN

Patients were assessed by fine needle aspiration biopsy before (n = 20) and after 4 (n = 19) and 12 months of treatment (n = 15) with propylthiouracil or methimazole. Cell proliferation index (CPI) was estimated by immunocytochemistry using MIB-1. CPI was studied in relation to the cytologic parameters of the smears; clinical parameters, such as Wayne's Clinical Index (WCI) and time without treatment; laboratory parameters, such as 131I uptake and dosage of serum free thyroxin and thyroid-stimulating hormone; and thyroid ultrasound.

RESULTS

CPI varied from 0.00% to 25.00% before treatment, 0.00% to 23.00% at 4 months and 0.00% to 14.84% at 12 months. CPI median values were 6.50%, 4.30% and 3.30%, respectively (before and after 4 months and 12 months of treatment). CPI had a positive correlation with WCI and FT4 at 12 months of treatment.

CONCLUSION

Thyroid CPI in GD varies from case to case. However, due to its decreasing pattern during follow-up and its positive correlation with thyrotoxicosis severity, CPI may indicate the functional status of the gland and contribute to a better understanding of GD.