The efficacy and assessment value of the level of thyroglobulin wash-out after fine-needle aspiration cytodiagnosis in the evaluation of lymph node metastasis in papillary thyroid carcinoma.
Humans
Biopsy, Fine-Needle
/ methods
Female
Lymphatic Metastasis
/ diagnosis
Male
Thyroid Neoplasms
/ pathology
Middle Aged
Adult
Thyroglobulin
/ analysis
Prognosis
Cytodiagnosis
/ methods
Carcinoma, Papillary
/ pathology
Lymph Nodes
/ pathology
Aged
Follow-Up Studies
Biomarkers, Tumor
/ analysis
Ultrasonography
/ methods
Young Adult
Thyroid Cancer, Papillary
/ pathology
Journal
World journal of surgical oncology
ISSN: 1477-7819
Titre abrégé: World J Surg Oncol
Pays: England
ID NLM: 101170544
Informations de publication
Date de publication:
05 Jun 2024
05 Jun 2024
Historique:
received:
19
03
2024
accepted:
27
05
2024
medline:
6
6
2024
pubmed:
6
6
2024
entrez:
5
6
2024
Statut:
epublish
Résumé
The purpose of this study was to evaluate the efficacy and clinical value of US, FNAC,FNA-Tg and FNAC + FNA-Tg, as well as the cutoff values of FNA-Tg to evaluate LN metastasis. We analyzed the diagnostic value of different US signs, the efficiency of US, FNAC, FNA-Tg and FNAC + FNA-Tg among the LN- and LN + groups, and the cutoff value of FNA-Tg to evaluate LN metastasis. We punctured LNs multiple times and measured the levels of FNA-Tg. Furthermore, the LNs were marked with immunohistochemical Tg and LCA to distinguish the presence of Tg in the para-cancerous tissue of the LNs. The s-Tg and FNA-Tg of the LN + group were higher than those of the LN- group (P = 0.018, ≤ 0.001). The LN + group had more abnormal US signs than the LN- group. The cutoff value of FNA-Tg was 3.2 ng/mL. US had a high sensitivity (92.42), but the specificity was not satisfactory (55.1). FNA-Tg had a higher sensitivity (92.42 vs. 89.39), specificity (100 vs. 93.88), and accuracy (92.42 vs. 83.27) than FNAC. However, the sensitivity of FNAC + FNA-Tg increased further, while the specificity and accuracy decreased slightly. The presence of Tg in the normal lymphocytes adjacent to the cancer was confirmed. Ultrasonography provides a noninvasive, dynamic, multidimensional assessment of LNs. With a cutoff value of 3.2 ng/mL, FNA-Tg has higher accuracy and a lower false-negative rate than various single diagnoses. However, FNAC combined with FNA-Tg does not cause additional pain to patients and offers a higher diagnostic efficacy and clinical value.
Identifiants
pubmed: 38840197
doi: 10.1186/s12957-024-03430-5
pii: 10.1186/s12957-024-03430-5
doi:
Substances chimiques
Thyroglobulin
9010-34-8
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
149Subventions
Organisme : Suzhou Science and Technology Bureau
ID : SZSKJJZC2020028
Informations de copyright
© 2024. The Author(s).
Références
Hong CM, Jeong JH, Son SH, et al. Serum thyroglobulin elevation after needle aspiration of the lymph nodes: the predictive value for detecting metastasis in papillary thyroid cancer patients - a pilot study. Medicine (Baltimore). 2019;98(31):e16461.
doi: 10.1097/MD.0000000000016461
pubmed: 31374007
Cho SJ, Suh CH, Baek JH, et al. Diagnostic performance of CT in detection of metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis. Eur Radiol. 2019;29(9):4635–47.
doi: 10.1007/s00330-019-06036-8
pubmed: 30806803
Cho SJ, Suh CH, Baek JH, et al. Diagnostic performance of MRI to detect metastatic cervical lymph nodes in patients with thyroid cancer: a systematic review and meta-analysis. Clin Radiol. 2020;75(7):562.e1-562.e10.
doi: 10.1016/j.crad.2020.03.025
pubmed: 32303337
Frasoldati A, Valcavi R. Challenges in neck ultrasonography: lymphadenopathy and parathyroid glands. Endocr Pract. 2004;10(3):261–8.
doi: 10.4158/EP.10.3.261
pubmed: 15310545
Wang Y, Duan Y, Zhou M, et al. The diagnostic value of thyroglobulin in fine-needle aspiration of metastatic lymph nodes in patients with papillary thyroid cancer and its influential factors. Surg Oncol. 2021;39:101666.
doi: 10.1016/j.suronc.2021.101666
pubmed: 34634575
Pacini F, Fugazzola L, Lippi F, et al. Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab. 1992;74(6):1401–4.
pubmed: 1592886
Zhu XH, Zhou JN, Qian YY, et al. Diagnostic values of thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis diagnostic values of FNA-Tg. Endocr J. 2020;67(2):113–23.
doi: 10.1507/endocrj.EJ18-0558
pubmed: 31723088
Chen JV, Morgan TA, Liu C, et al. Cervical lymph node features predictive of suboptimal adequacy during ultrasound-guided fine-needle aspiration in thyroid cancer patients. J Ultrasound Med. 2022;41(1):135–45.
doi: 10.1002/jum.15688
pubmed: 33665844
Khadra H, Mohamed H, Al-Qurayshi Z, et al. Superior detection of metastatic cystic lymphadenopathy in patients with papillary thyroid cancer by utilization of thyroglobulin washout. Head Neck. 2019;41(1):225–9.
doi: 10.1002/hed.25488
pubmed: 30536535
Zhao H, Wang Y, Wang MJ, et al. Influence of presence/absence of thyroid gland on the cutoff value for thyroglobulin in lymph-node aspiration to detect metastatic papillary thyroid carcinoma. BMC Cancer. 2017;17(1):296.
doi: 10.1186/s12885-017-3296-3
pubmed: 28454525
pmcid: 5410021
Kim K, Bae JS, Kim JS. Measurement of thyroglobulin level in lateral neck lymph node fine needle aspiration washout fluid in papillary thyroid cancer. Gland Surg. 2021;10(9):2686–94.
doi: 10.21037/gs-21-366
pubmed: 34733718
pmcid: 8514304
Liu RB, Zhou DL, Xu BH, et al. Comparison of the diagnostic performances of US-guided fine needle aspiration cytology and thyroglobulin measurement for lymph node metastases in patients with differentiated thyroid carcinoma: a meta-analysis. Eur Radiol. 2021;31(5):2903–14.
doi: 10.1007/s00330-020-07400-9
pubmed: 33125564
Moon JH, Kim YI, Lim JA, et al. Thyroglobulin in washout fluid from lymph node fine-needle aspiration biopsy in papillary thyroid cancer: large-scale validation of the cutoff value to determine malignancy and evaluation of discrepant results. J Clin Endocrinol Metab. 2013;98(3):1061–8.
doi: 10.1210/jc.2012-3291
pubmed: 23393171
Sohn YM, Kim MJ, Kim EK, et al. Diagnostic performance of thyroglobulin value in indeterminate range in fine needle aspiration washout fluid from lymph nodes of thyroid cancer. Yonsei Med J. 2012;53(1):126–31.
doi: 10.3349/ymj.2012.53.1.126
pubmed: 22187242
Pak K, Suh S, Hong H, et al. Diagnostic values of thyroglobulin measurement in fine-needle aspiration of lymph nodes in patients with thyroid cancer. Endocrine. 2015;49(1):70–7.
doi: 10.1007/s12020-014-0410-z
pubmed: 25185721