Related Experiment Video
Updated: May 2, 2026
Substernal Thyroid Biopsy Using Endobronchial Ultrasound-guided Transbronchial Needle Aspiration
Published on: November 10, 2014
Thyroglobulin in lymph node fine-needle aspiration washout: a systematic review and meta-analysis of diagnostic
Giorgio Grani1, Angela Fumarola
1Department of Experimental Medicine, Unit of Endocrinology, "Sapienza" Università di Roma, 00161 Rome, Italy.
Context:
The thyroglobulin measurement in the needle washout after fine-needle aspiration (FNA) has been reported to increase the sensitivity of FNA in identifying lymph node (LN) metastases from differentiated thyroid cancer (DTC).
Objective:
The aim of the study was to estimate the diagnostic accuracy of this technique.
Data Sources:
To identify eligible studies, we searched electronic databases for original articles in English from 1975 through 2013.
Study Selection:
Studies that enrolled participants with suspicious neck LNs during thyroid nodule workup or thyroid cancer follow-up were included.
Data Extraction:
Working independently, authors used a standard form to extract data. For quality assessment, QUADAS2 guidelines were applied.
Data Synthesis:
Including all the selected studies (24 studies, 2865 LNs) in the pooled analysis, overall sensitivity was 95.0% (95% confidence interval [CI], 93.7-96.0%), specificity was 94.5% (95% CI, 93.2-95.7%), and diagnostic odds ratio (DOR) was 338.91 (95% CI, 164.82-696.88) with significant heterogeneity (inconsistency [I(2)] = 65.7%; heterogeneity, P < .001). Stratifying different populations and including only patients with thyroid gland (410 LNs), pooled sensitivity was 86.2% (95% CI, 80.9-90.5%), specificity was 90.2% (85.1-94.0%), and DOR was 56.621 (22.535-142.26; I(2) = 37.3%; heterogeneity, P = .121). Including only patients after thyroidectomy (1007 LNs), pooled sensitivity was 96.9% (95% CI, 94.9-98.2%), specificity was 94.1% (91.7-96.0%), and DOR was 407.65 (198.67-836.46; I(2) = 0.0%; heterogeneity, P = .673).
Conclusions:
Thyroglobulin measurement in washout from LN FNA has high accuracy in early detection of nodal metastases from DTC. The technique is simple, but a better standardization of criteria for patient selection, analytical methods, and cutoff levels is required.
