Comparison of the diagnostic performances of US-guided fine needle aspiration cytology and thyroglobulin measurement for lymph node metastases in patients with differentiated thyroid carcinoma: a meta-analysis

Liu, Rongbin; Zhou, Da‐Lei; Xu, Baoshan; Yang, Xinhua; Liu, Qing; Zhang, Xiao; Tang, Tao; Ye, Zu‐Lu; Li, Yue

doi:10.1007/s00330-020-07400-9

Cited by 17 publications

(21 citation statements)

References 32 publications

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“…This finding is consistent with that of previous studies. A previous report found that FNA‐Tg was more sensitive than FNA in detecting LN metastasis of PTC, and after combining FNA‐Tg with FNA, the sensitivity of the latter increased 15–18 . This was confirmed by our study results, where the combination of FNA and FNA‐Tg further increased the sensitivity (92.0%) and diagnostic accuracy (69.5%) over FNA alone.…”

Section: Discussionsupporting

confidence: 90%

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A Combination of Contrast‐Enhanced Ultrasound and Thyroglobulin Level in Fine‐Needle Aspirates Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Papillary Thyroid Carcinoma

Liu

Tang

Chen

et al. 2021

J of Ultrasound Medicine

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Objective-To evaluate the diagnostic performance of contrast-enhanced ultrasound (CEUS) combined with thyroglobulin (Tg) levels in fine-needle aspirates (FNA) washout fluid (FNA-Tg) in diagnosing cervical lymph node (LN) metastasis in papillary thyroid cancer (PTC) patients.Methods-Data from 190 LNs in 167 patients suspected of metastasis from the US between November 2018 and September 2020 were included. All subjects underwent FNA, CEUS, and FNA-Tg examinations. The final outcomes were confirmed by histopathological or cytological examination or follow-up imaging. Data were analyzed using the Wilcoxon rank-sum or chi-squared test. The diagnostic efficacy of FNA, CEUS, and FNA-Tg in diagnosing LNs was compared.Results-A cutoff value of 6.15 ng/ml (AUC 0.925, 95% confidence interval (CI) 0.885-0.966) successfully identified metastatic LNs. FNA missed 58 LN metastases, of these, 94.8% (55/58) were correctly diagnosed using the combination of CEUS and FNA-Tg. FNA-Tg showed higher sensitivity (90.2%), NPV (86.1%) and accuracy (88.9%) than either FNA (48.2, 57.4 and 69.5%, respectively) or CEUS (82.1, 67.7 and 70.5%, respectively) alone. The combination of CEUS, FNA and FNA-Tg resulted in maximal sensitivity (100%) and NPV (100%) but reduced specificity (51.3%) and overall diagnostic accuracy (80.0%). After adding FNA-Tg to discordant samples between CEUS and FNA, 81.9% of LNs (77/94) were correctly diagnosed.Conclusions-The combination of FNA, FNA-Tg and CEUS was found to be a promising imaging tool in detecting metastatic LNs in PTC patients.

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Section: Discussionsupporting

confidence: 90%

“…However, to date, there are still uncertainties in the optimal cutoff value of FNA‐Tg. In previous studies, different FNA‐Tg cutoff values have been proposed, ranging from 0.2 to 36 ng/ml 16 . In our present study, we found that the optimal threshold for FNA‐Tg was 6.15 ng/ml (sensitivity 90.2%, specificity 87.2%).…”

Section: Discussionsupporting

confidence: 52%

A Combination of Contrast‐Enhanced Ultrasound and Thyroglobulin Level in Fine‐Needle Aspirates Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Papillary Thyroid Carcinoma

Liu

Tang

Chen

et al. 2021

J of Ultrasound Medicine

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“…US is used as a primary diagnostic tool to detect cervical metastatic LNs of PTC, and the evaluation indicators included site, size, boundary, hilum, matting, internal nodal echo patterns, and vascularity pattern (17). US-FNA had been commonly used to diagnose lymphadenopathy due to its safety and high accuracy (18)(19)(20).…”

Section: Discussionmentioning

confidence: 99%

A Risk Stratification Model for Metastatic Lymph Nodes of Papillary Thyroid Cancer: A Retrospective Study Based on Sonographic Features

Xu²,

Zhan³

et al. 2022

Front. Endocrinol.

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BackgroundPapillary thyroid carcinoma (PTC) has a high probability of cervical lymph node (LN) metastasis. The aim of the study was to develop an ultrasound risk stratification model to standardize the diagnosis of metastatic LNs of PTC.MethodsPatients with suspicious thyroid nodules who underwent US examination and US guided fine-needle aspiration for cervical LNs were retrospectively collected. Univariate and multivariate logistic regression analyses were performed to assess the independent risk factor of metastatic LNs. According to the OR value of correlated indicators in logistic regression analysis, a risk stratification model was established.ResultsA total of 653 LNs were included. The independent risk factors of metastatic LNs were long-axis diameter/short-axis ≤ 2 (OR=1.644), absence of hilum (OR=1.894), hyperechogenicity (OR=5.375), calcifications (OR=6.201), cystic change (OR=71.818), and abnormal flow (OR=3.811) (P<0.05 for all). The risk stratification model and malignancy rate were as follows: 0-2 points, malignancy rate of 10.61%, low suspicion; 3-5 points, malignancy rate of 50.49%, intermediate suspicion, ≥6 points, malignancy rate of 84.81%, high suspicion. The area under the receiver operating characteristic curve for the model was 0.827 (95% CI 0.795-0.859).ConclusionsOur established risk stratification model can effectively evaluate metastatic LNs in the patients with suspicious thyroid nodules, and it might provide a new strategy choice for clinical practice.

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“…Later, Liu et al. ( 32 ) demonstrated that FNA-C and FNA-Tg/serum-Tg performed together showed higher specificity when compared with combined FNA-C and FNA-Tg. Furthermore, they found that multilevel FNA-Tg was also helpful in identifying lateral CLN metastasis.…”

Section: The Role Of Tg In Preoperative Patients With Dtcmentioning

confidence: 99%

The Role of Thyroglobulin in Preoperative and Postoperative Evaluation of Patients With Differentiated Thyroid Cancer

Ren

Gong

et al. 2022

Front. Endocrinol.

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Thyroglobulin (Tg) is secreted by thyroid follicular cells and stored in the thyroid follicular lumen as a component of thyroid hormone. It is known that both benign and well-differentiated malignant thyroid tissue can secrete Tg. In recent years, growing lines of evidence have shown that Tg plays an important role in the diagnosis and metastasis of preoperative differentiated thyroid carcinoma (DTC). The levels of Tg, whether in the serum or in a fine-needle aspiration washout fluid, are usually viewed as an excellent indicator in the monitoring of postoperative DTC, including the guidance and evaluation of radioactive iodine ablation. Nevertheless, some factors limit the application of Tg, such as the method used to measure Tg and the presence of Tg antibodies. This review aimed to summarize the role of Tg in the preoperative and postoperative evaluation of patients with DTC, and the factors influencing Tg. This review could provide a reference for a more accurate application of Tg in patients with DTC.

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Comparison of the diagnostic performances of US-guided fine needle aspiration cytology and thyroglobulin measurement for lymph node metastases in patients with differentiated thyroid carcinoma: a meta-analysis

Cited by 17 publications

References 32 publications

A Combination of Contrast‐Enhanced Ultrasound and Thyroglobulin Level in Fine‐Needle Aspirates Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Papillary Thyroid Carcinoma

A Combination of Contrast‐Enhanced Ultrasound and Thyroglobulin Level in Fine‐Needle Aspirates Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Papillary Thyroid Carcinoma

A Risk Stratification Model for Metastatic Lymph Nodes of Papillary Thyroid Cancer: A Retrospective Study Based on Sonographic Features

The Role of Thyroglobulin in Preoperative and Postoperative Evaluation of Patients With Differentiated Thyroid Cancer

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