Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing metastatic cervical lymph nodes from papillary thyroid cancer: correlations with US features.
OBJECTIVE
Our goals were to determine the added value of fine-needle aspiration biopsy (FNAB)-thyroglobulin (Tg) measurements over FNAB-cytology alone for diagnosing metastatic nodes, and to determine whether the ultrasound features of lymph nodes can be used to identify lymph nodes that may benefit from FNAB-Tg measurement in patients with papillary thyroid cancer.


METHODS
We retrospectively evaluated 76 surgically proven cervical lymph nodes. Twenty-nine patients were awaiting surgery and 18 patients had undergone thyroid surgery for papillary thyroid cancer. Ultrasound-guided FNAB and Tg measurements were performed and the ultrasound features were evaluated.


RESULTS
The accuracies, sensitivities, and specificities of FNAB-cytology, FNAB-Tg, and combined FNAB-Tg/cytology were 90%, 80%, and 100%; 92%, 95%, and 90%; and 93%, 96%, and 90%, respectively. The diagnostic sensitivity of FNAB-Tg for metastatic nodes was significantly higher than that of FNAB-cytology (p = 0.011). Furthermore, combined FNAB-Tg/cytology significantly increased sensitivity (p = 0.002) and accuracy (p = 0.03) as compared with FNAB-cytology.


CONCLUSIONS
Combined FNAB-Tg/cytology is significantly more sensitive and accurate at detecting metastatic nodes than FNAB-cytology alone. FNAB-Tg was better at diagnosing metastases in small lymph nodes.
Jeon
Se Jeong
SJ
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul 110-744, Korea.
Kim
Eunhee
E
Park
Jeong Seon
JS
Son
Kyu Ri
KR
Baek
Jung Hwan
JH
Kim
Yoon Suk
YS
Park
Do Joon
DJ
Cho
Bo Youn
BY
Na
Dong Gyu
DG
D044963:Biopsy, Fine-Needle; D002291:Carcinoma, Papillary / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013954:Thyroglobulin / Q000378:metabolism*; D013964:Thyroid Neoplasms / Q000473:pathology*; D018084:Ultrasonography, Interventional
D013954:Thyroglobulin