Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma

Salmaslıoğlu, Artür; Erbil, Yeşim; Çıtlak, Gamze; Ersöz, Feyzullah; Sarı, Serkan; Olmez, Aydemir; Tunacı, Mehtap; Yılmazbayhan, Dilek; Colak, Nese; Özarmağan, Selçuk

doi:10.1007/s00423-010-0723-1

Cited by 51 publications

(46 citation statements)

References 18 publications

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“…The technique accuracy, highly dependent on the experience and ability of the cytopathologist, has been reported to vary from 73% to 94% [17,18,22,25]. Over the last years, following clinical evidence showing that FNAB-Tgp in fine-needle washout improves the accuracy of FNAB-C in the evaluation of CLN metastases of DTC, it has been recommended the routine association of FNAB-Tgp with FNAB-C in the preoperative diagnosis of suspicious CLN [6,7,14-27,33].…”

Section: Discussionmentioning

confidence: 99%

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

Baldini¹,

Sorrenti²,

Gioia³

et al. 2013

BMC Clin Pathol

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BackgroundMeasurement of thyroglobulin (Tg) protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C) has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN) metastasis from well-differentiated thyroid cancer (TC). In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp), Tg mRNA (FNAB-Tgm) and calcitonin (CT) mRNA (FNAB-CTm) in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN.MethodsIn this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC) in 26 CLN, metastatic medullary TC (MTC) in 3 CLN, metastatic anaplastic TC (ATC) in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers.ResultsThe overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters.ConclusionsWe demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

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Section: Discussionmentioning

confidence: 99%

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

Baldini¹,

Sorrenti²,

Gioia³

et al. 2013

BMC Clin Pathol

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“…Accordingly, different FNA-Tg cutoff was proposed in the presence (36 μg/L) or absence (1.7 μg/L) of thyroid [31]. Meanwhile, two different papers found a unique accurate threshold of 0.93 ng/punction [22] and 28.5 μg/L [23]. However, among 114 and 225 consecutive patients, they enrolled 11% and 35% DTC patients before surgery, respectively.…”

Section: Clinical Data From Literaturementioning

confidence: 99%

“…In various studies, the volume of fluid used to wash the FNA needle ranges from 0.5 to 3.0 mL, and 1.0 mL is the amount most widely utilized [17,19,21,23,36,[75][76][77]. Some authors suggest rinsing the needle several times and collecting the full amount of washout fluid in a single tube.…”

Section: Pre-analytical Factors: Collection Preparation E Managementmentioning

confidence: 99%

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Trimboli

D’Aurizio

Tozzoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Different imaging tools, circulating endocrine markers, and fine-needle aspiration (FNA) cytology are of great importance in the diagnosis and follow-up of different thyroid and parathyroid diseases. Sometimes, however, they are conflicting or inconclusive: interestingly, measuring endocrine markers (i.e. thyroglobulin, calcitonin, parathyroid hormone) in fluids from FNA proved to be a very useful complementary diagnostic tool in such cases. The determination of endocrine markers in fluids other than serum/ plasma has been developed in the last years. Although studies have reported overall satisfactory results, a good standardization of procedures has not yet been reached, and further efforts should be made in order to better define preanalytical, analytical, and post-analytical aspects. Here we reviewed critically the literature on the measurement of FNA endocrine markers, focusing on laboratory issues, such as preparation of the sample, choice of solution, and technical features of determination of these markers. Indeed, information for use of FNA-Tg, FNA-CT, and FNA-PTH in clinical practice was also provided.

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“…Cytology findings of the LNs reviewed by experienced pathologists were categorized as non-diagnostic, benign and metastatic papillary thyroid carcinoma (PTC; suspicious malignancy, malignancy) (5,10,19,20,21).…”

Section: Fnac and Final Pathologymentioning

confidence: 99%

Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody

Kim

Lim

et al. 2015

European Journal of Endocrinology

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Objective: Fine needle aspiration cytology (FNAC) and measurement of thyroglobulin (Tg) in needle washout (FNA-Tg) are recommended for the diagnosis of metastatic or recurrent lymph nodes (LNs) in differentiated thyroid cancer (DTC). However, the effect of serum Tg antibody (TgAb) on FNA-Tg levels still remains unclear in the preoperative setting. We analyze the interference of serum TgAb on FNA-Tg levels as proof of concept in the diagnostic advantage of serum TgAb combined with FNA-Tg. Subjects and methods: A total of 370 suspicious cervical LNs from 273 patients with DTC were included. The primary tumor was confirmed as DTC on preoperative pathology in all patients. We performed FNA-Tg measurement and FNAC on suspicious LNs and evaluated the diagnostic performance of FNAC and FNA-Tg according to TgAb status. Final diagnoses were confirmed by histological examination of excised specimens or by follow-up ultrasonography for at least 6 months. Results: Data from 273 subjects with suspicious 370 LNs were evaluated. Fifty-five LNs (14.9%) were from TgAbC positive serum TgAb (TgAbC) patients. Serum Tg and FNA-Tg levels were significantly lower in patients with TgAbC than in those with TgAb-negative (TgAbK). Final pathology confirmed 109 LNs (29.5%) asmalignant. Diagnostic performance of FNA-Tg at the same cutoff level was lower in the TgAbC than TgAbK group. FNA-Tg cutoff levels determined by ROC curve were lower in the TgAbC group. Conclusion: The results suggested that the cutoff value of FNA-Tg should be lowered in suspicious LN before thyroidectomy in thyroid cancer patients with TgAb.

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Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma

Abstract: FNA-Tg measurement can be performed safely for the detection of lymph node metastasis in patients with differentiated thyroid carcinomas.

Cited by 51 publications

References 18 publications

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

Measurement of thyroglobulin, calcitonin, and PTH in FNA washout fluids

Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody

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