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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

  • 0Thyroid and Breast Surgery, Department of General Surgery, Wanbei Coal and Power Group General Hospital affiliated With Bengbu Medical University, Su Zhou, Anhui Province, China.
World Journal of Surgical Oncology +

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June 5, 2024

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June 5, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Fine-needle aspiration-thyroglobulin (FNA-Tg) with a 3.2 ng/mL cutoff is more accurate than FNAC for detecting lymph node metastasis. Combining FNA-Tg with fine-needle aspiration cytology (FNAC) improves diagnostic efficacy without added patient discomfort.

Area Of Science

  • Oncology
  • Diagnostic Imaging
  • Cytopathology

Background

  • Lymph node (LN) metastasis is a critical factor in cancer staging and treatment.
  • Accurate detection of LN metastasis is essential for effective patient management.
  • Current diagnostic methods have limitations in sensitivity and specificity.

Purpose Of The Study

  • To evaluate the diagnostic efficacy and clinical value of ultrasonography (US), fine-needle aspiration cytology (FNAC), fine-needle aspiration-thyroglobulin (FNA-Tg), and the combination of FNAC + FNA-Tg for lymph node metastasis.
  • To determine the optimal cutoff value of FNA-Tg for evaluating lymph node metastasis.

Main Methods

  • Analysis of diagnostic value of US signs and efficiency of US, FNAC, FNA-Tg, and FNAC + FNA-Tg in LN- and LN+ groups.
  • Repeated LN punctures to measure FNA-Tg levels.
  • Immunohistochemical staining (Tg and LCA) of LNs to confirm Tg presence in para-cancerous tissue.

Main Results

  • FNA-Tg levels were significantly higher in the LN+ group compared to the LN- group (P <= 0.018).
  • US showed high sensitivity (92.42%) but low specificity (55.1%).
  • FNA-Tg demonstrated higher sensitivity (92.42%), specificity (100%), and accuracy (92.42%) than FNAC. The combination of FNAC + FNA-Tg further increased sensitivity.

Conclusions

  • Ultrasonography offers a noninvasive assessment of LNs.
  • FNA-Tg, with a cutoff of 3.2 ng/mL, provides higher accuracy and a lower false-negative rate than single diagnostic methods.
  • FNAC combined with FNA-Tg enhances diagnostic efficacy and clinical value without increasing patient discomfort.