title: Diagnostic values of thyroglobulin measurement in fine-needle aspiration of lymph nodes in patients with thyroid cancer.
abstract: We aimed to evaluate the diagnostic performance of measuring the concentration of thyroglobulin (Tg) in the washout fluid of the needle aspiration (FNA-Tg). We performed a systematic search of MEDLINE (inception to October 2013) and EMBASE (inception to October 2013) for English publications using keywords "thyroid", "aspiration", "washout", and "thyroglobulin". All searches were limited to human studies. We included studies of FNA-Tg measurement in the washout fluid rinsed with 1 ml of normal saline. Eight studies including 843 lymph nodes (LNs) were eligible for this study. The pooled sensitivity and specificity of preoperative studies are 0.89 [95 % CI 0.82-0.95], 0.60 [0.49-0.70], and those of postoperative studies are 1.0 [0.83-1.0], 1.0 [0.92-1.0]. To determine best cutoffs from each preoperative and postoperative study, the distance between the point (0, 1) and each observed cutoff values (1-specificity, sensitivity) was calculated, and the distance is minimal when the cutoff value of 32.04 for preoperative studies and of 0.9 for postoperative one are selected. FNA-Tg can be used for both preoperative and postoperative evaluation of LN metastasis. Although the cutoff values for the FNA-Tg has not been standardized, preoperative values of 32.04 ng/ml and postoperative values of 0.9 ng/ml are recommended for identifying neck LN metastasis.
authors.affiliation: Department of Nuclear Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea, ilikechopin@daum.net.
authors.forename: Kyoungjune
authors.initials: K
authors.lastname: Pak
authors.forename: Sunghwan
authors.initials: S
authors.lastname: Suh
authors.forename: Hyunsook
authors.initials: H
authors.lastname: Hong
authors.forename: Gi Jeong
authors.initials: GJ
authors.lastname: Cheon
authors.forename: Seo Kyung
authors.initials: SK
authors.lastname: Hahn
authors.forename: Keon Wook
authors.initials: KW
authors.lastname: Kang
authors.forename: E Edmund
authors.initials: EE
authors.lastname: Kim
authors.forename: Dong Soo
authors.initials: DS
authors.lastname: Lee
authors.forename: June-Key
authors.initials: JK
authors.lastname: Chung
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D044963:Biopsy, Fine-Needle / Q000592:standards*; D006801:Humans; D008198:Lymph Nodes / Q000737:chemistry / Q000473:pathology*; D059035:Perioperative Period; D012680:Sensitivity and Specificity; D013954:Thyroglobulin / Q000032:analysis*; D013964:Thyroid Neoplasms / Q000175:diagnosis*
chemical_list: D014408:Biomarkers, Tumor; D013954:Thyroglobulin