Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid...

Area of Science:

• Oncology
• Surgical Pathology
• Diagnostic Imaging

Background:

• Papillary thyroid carcinoma (PTC) frequently involves lymph node metastasis (LNM).
• Fine-needle aspiration thyroglobulin (FNA-Tg) is a potential diagnostic tool for LNM.
• The preoperative diagnostic utility of FNA-Tg for lateral neck LNM in PTC requires further clarification.

Purpose of the Study:

• To evaluate the efficacy of FNA cytology and FNA-Tg in detecting neck LNM before surgery in PTC patients.
• To establish a reliable cut-off value for FNA-Tg in diagnosing LNM.
• To assess the performance of FNA-Tg in different regions of the neck.

Main Methods:

• Retrospective cohort study of 228 PTC patients with 299 FNA-Tg measurements.
• Receiver operating characteristic (ROC) curve analysis to determine the optimal FNA-Tg cut-off value.
• Spearman's correlation to analyze relationships between FNA-Tg and other parameters.

Main Results:

• FNA-Tg levels were significantly higher in metastatic LNs (median 414.40 ng/mL) compared to benign LNs (median 6.36 ng/mL).
• An FNA-Tg cut-off of 28.3 ng/mL demonstrated high diagnostic performance (AUC 0.868) for the entire cohort.
• The diagnostic accuracy was superior in the lateral neck group (sensitivity 96.25%, specificity 96.36% with a cut-off of 16.8 ng/mL).

Conclusions:

• FNA-Tg is a valuable preoperative diagnostic tool for LNM in PTC.
• Its utility is particularly pronounced in the assessment of lateral neck lymph nodes.
• FNA-Tg aids in surgical planning and patient management for PTC.