Excellent Diagnostic Performance of FNA-Tg in Detecting Lymph Nodes Metastases from Papillary Thyroid Cancer

Wang, Jiahui; Jiang, Xianfeng; Xiao, Guizhou; Zhou, Wenjie; Hu, Yan

doi:10.2217/fon-2020-0213

Cited by 20 publications

(23 citation statements)

References 38 publications

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“…LNs in the central region are more easily affected by blood contamination by circulating Tg at the time of sampling, or Tg leakage into the LN by lymph vessel draining. 7 , 25 , 26 In the present study, only serum TgAb levels correlated negatively with FNA-Tg in the central LN group. It is quite possible that underestimation of the FNA-Tg concentration occurs, to some degree, in the presence of circulating TgAb in the central LN region but not in the lateral region.…”

Section: Discussionsupporting

confidence: 42%

Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer

et al. 2021

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Background Thyroglobulin measurement in fine-needle aspiration (FNA-Tg) is an additional diagnostic tool of lymph node metastasis (LNM) in papillary thyroid carcinoma (PTC). However, its performance as a preoperative indicator of lateral neck LNM in PTC is unclear. We evaluated the use of FNA cytology and FNA-Tg to detect neck LNM presurgery using a simple methodology, and established a cut-off value for diagnosing LNM in PTC. Methods We performed a retrospective cohort study based on hospital records, including 299 FNA-Tg measurements from 228 patients with PTC. The cut-off value for FNA-Tg was obtained through a receiver operating characteristic (ROC) curve analysis. The relationships between various parameters and FNA-Tg were analyzed using Spearman’s correlation. Results Of 299 lymph nodes (LNs) from 228 patients following surgery, 151 were malignant and 148 were benign. The median FNA-Tg levels were 414.40 ng/mL and 6.36 ng/mL in the metastatic and benign LNs, respectively. An FNA-Tg cut-off value of 28.3 ng/mL had the best diagnostic performance (93.38% sensitivity, 70.27% specificity, area under the ROC curve [AUC] 0.868) in the whole cohort. The diagnostic value performed better in the lateral neck group (level II–V, n = 163) than in the central neck group (level VI, n = 136); in the lateral neck group, the sensitivity and specificity of the FNA-Tg cut-off (16.8 ng/mL) were 96.25% and 96.36%, respectively. Conclusions FNA-Tg is a useful technique for the diagnosis of LNM before surgery, especially in lateral neck dissection. Clinical trial registration number ChiCTR1900028547.

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Section: Discussionsupporting

confidence: 42%

Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer

et al. 2021

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“…16 However, Wang noted that sTgAb did not affect the FNA-Tg measurements when diagnosing CLNM. 20 In this study, we found that sTgAb can slightly influence the FNA-Tg level, but cannot alter the result of the diagnosis of FNA-Tg.…”

Section: Diagnostic Performance Of Different Proceduresmentioning

confidence: 51%

The influence of thyroid status, serum Tg, TSH, and TgAb on FNA‐Tg in cervical metastatic lymph nodes of papillary thyroid carcinoma

Sun

Chen

et al. 2021

Laryngoscope Investig Oto

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Objective: Papillary thyroid carcinoma is treated in China mostly with surgery, including total ablation, lobectomy, and lobe and isthmus resection. Therefore, whether thyroid status affects the FNA-Tg cutoff value in the diagnosis of cervical lymph node metastasis deserves our attention. In addition, we investigated the influence of serum Tg, TSH, and TgAb on the accuracy of using FNA-Tg for diagnosis.Methods: Our retrospective analysis included 189 suspected cervical lymph nodes, and we determined whether the cutoff value of FNA-Tg was affected by thyroid status, sTg, sTSH, and sTgAb.Results: In thyroid present cases, the optimal cutoff value of FNA-Tg was 2.3 ng/ml (sensitivity 96.2%, specificity 100%), and in the thyroid absent cases, the optimal cutoff value of FNA-Tg was 0.7 ng/ml (sensitivity 97.6%, specificity 96.0%). Although serum Tg, TSH, and TgAb were weakly correlated with FNA-Tg values, they did not affect the diagnostic performance of the optimal cutoff value of FNA-Tg according to thyroid status. Conclusions:The optimal cutoff value of FNA-Tg should be selected according to the thyroid status (2.3 ng/ml for thyroid present cases and 0.7 ng/ml for thyroid absent cases) to ensure the efficient diagnosis of cervical metastatic lymph nodes of papillary thyroid carcinoma. It was determined that sTg, sTSH, and sTg-Ab cannot influence the diagnostic performance of FNA-Tg. The combination method of FNA-Tg and FNAC is the most optimal choice for the diagnosis of lymph nodes metastasis.

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“…The superior sensitivity and excellent negative predictive values support its routine use as guidance for lateral neck dissection. Because the level of FNA-Tg in the central compartment was easier to be by affected blood contamination or Tg leakage than that in the lateral compartment 4 , 5 , the additional diagnostic value of FNA-Tg is limited in central neck dissection planning. It is of note that, as compared to the absolute value, no diagnostic advantage was found for the difference or ratio between FNA-Tg and serum Tg.…”

Section: Presentmentioning

confidence: 99%

ASO Author Reflection: Optimizing Lateral Neck Dissection Extent of PTC by FNA-Tg

et al. 2021

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Excellent Diagnostic Performance of FNA-Tg in Detecting Lymph Nodes Metastases from Papillary Thyroid Cancer

Cited by 20 publications

References 38 publications

Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer

Thyroglobulin Measurement Through Fine-Needle Aspiration for Optimizing Neck Node Dissection in Papillary Thyroid Cancer

The influence of thyroid status, serum Tg, TSH, and TgAb on FNA‐Tg in cervical metastatic lymph nodes of papillary thyroid carcinoma

ASO Author Reflection: Optimizing Lateral Neck Dissection Extent of PTC by FNA-Tg

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