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Exploring the application of FNA-Tg for the diagnosis of cervical lymph node metastasis in PTC

  • 0Department of General Surgery, Fuzong Clinical Medical College of Fujian Medical University, 900TH Hospital of the Joint Logistics Support Force, Fuzhou, 350025, Fujian, PR China; Department of General Surgery, 900th Hospital, Joint Logistics Support Force, Chinese People's Liberation Army, Fuzhou, Fujian, 350025, PR China.
European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology +

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November 30, 2024

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November 30, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Fine-needle aspiration washout thyroglobulin (FNA-Tg) is a valuable tool for detecting lateral lymph node metastasis in papillary thyroid cancer. It shows superior efficacy, especially for small lymph nodes, compared to fine-needle aspiration cytology.

Area Of Science

  • Oncology
  • Diagnostic Imaging
  • Biochemistry

Background

  • Fine-needle aspiration washout thyroglobulin (FNA-Tg) aids in detecting lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).
  • Current definitions and diagnostic value of FNA-Tg testing for LLNM in PTC are not clearly established.

Purpose Of The Study

  • To evaluate the diagnostic efficacy of FNA-Tg for LLNM in PTC.
  • To determine optimal thresholds and criteria for FNA-Tg testing in PTC LLNM detection.

Main Methods

  • Prospective data from 215 PTC patients undergoing lateral neck lymph node dissection were analyzed.
  • 249 suspicious lymph nodes were categorized into metastasis (n=176) and non-metastasis (n=73) groups based on pathology.
  • Diagnostic performance of FNA-Tg was compared to fine-needle aspiration cytology (FNAC).

Main Results

  • FNA-Tg demonstrated superior diagnostic efficacy for LLNM in PTC compared to FNAC (AUC=0.950 vs. 0.766).
  • Optimal thresholds were 16.45 μg/L for primary LLNM and 0.15 μg/L for recurrent LLNM.
  • FNA-Tg showed significantly better performance for lymph nodes ≤0.8 cm and when thyroglobulin antibody (TgAb) was negative, with the FNA-Tg/serum thyroglobulin (sTg) ratio being most effective (AUC=0.943).

Conclusions

  • FNA-Tg possesses higher diagnostic value for PTC LLNM.
  • FNA-Tg is particularly effective in diagnosing LLNM in small lymph nodes.
  • Established thresholds and the FNA-Tg/sTg ratio improve diagnostic accuracy, especially in specific patient subgroups.

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