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Related Experiment Video

Updated: Aug 18, 2025

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Optimal method for detecting cervical lymph node metastasis from papillary thyroid cancer.

Jing Xiao1, Shuyu Meng1, Mingbo Zhang1

  • 1Department of Ultrasound, the First Medical Center of Chinese PLA General Hospital, 28 Fuxing Road, Haidian District, Beijing, China.

Endocrine
|December 6, 2022
PubMed
Summary

Combining fine needle aspiration (FNA) with thyroglobulin measurement (FNA-Tg) improves papillary thyroid cancer diagnosis. This combined method shows diagnostic performance comparable to core needle biopsy for detecting lymph node metastases.

Keywords:
Cervical lymph nodeCore needle biopsyFine-needle aspirationPapillary thyroid cancerUltrasonography

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Area of Science:

  • Oncology
  • Diagnostic Imaging
  • Pathology

Background:

  • Papillary thyroid cancer (PTC) frequently involves cervical lymph node metastases (LNM).
  • Accurate detection of LNM is crucial for effective PTC management and staging.
  • Current diagnostic methods for LNM include fine needle aspiration (FNA) and core needle biopsy (CNB).

Purpose of the Study:

  • To compare the diagnostic performance of FNA, FNA with thyroglobulin measurement (FNA-Tg), and CNB in detecting cervical LNM in PTC patients.
  • To determine the optimal diagnostic method for cervical LNM in PTC.
  • To evaluate the added value of thyroglobulin measurement in FNA for LNM detection.

Main Methods:

  • Retrospective review of PTC patients with suspicious cervical lymph nodes who underwent FNA or CNB.
  • Collection of patient demographics, lymph node characteristics, and diagnostic results (FNA, FNA-Tg, CNB, surgical pathology).
  • Statistical analysis of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy, and AUC of receiver operating characteristic curves.

Main Results:

  • FNA-Tg demonstrated a higher AUC at a 55 ng/mL threshold compared to a 1 ng/mL threshold (0.782 vs. 0.636, P=0.005).
  • The combination of FNA and FNA-Tg significantly increased sensitivity compared to FNA alone (91.3% vs. 81.0%, P=0.01).
  • The diagnostic performance of combined FNA-FNA-Tg was comparable to CNB (sensitivity 91.3% vs. 88.0%, P>0.05), with no significant differences in other metrics.

Conclusions:

  • Thyroglobulin measurement in FNA (FNA-Tg) enhances the sensitivity of FNA for detecting LNM in PTC.
  • The combination of FNA and FNA-Tg offers improved diagnostic performance over FNA or FNA-Tg alone.
  • Combined FNA-FNA-Tg demonstrates diagnostic efficacy comparable to CNB for identifying cervical LNM in papillary thyroid cancer.