title: Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody.
abstract: 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.
  
  
  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 TgAb+ positive serum TgAb (TgAb+) patients. Serum Tg and FNA-Tg levels were significantly lower in patients with TgAb+ than in those with TgAb-negative (TgAb-). Final pathology confirmed 109 LNs (29.5%) as malignant. Diagnostic performance of FNA-Tg at the same cutoff level was lower in the TgAb+ than TgAb- group. FNA-Tg cutoff levels determined by ROC curve were lower in the TgAb+ group.
  
  
  CONCLUSIONS
  The results suggested that the cutoff value of FNA-Tg should be lowered in suspicious LN before thyroidectomy in thyroid cancer patients with TgAb.
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Kwanhoon
authors.initials: K
authors.lastname: Jo
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Yejee
authors.initials: Y
authors.lastname: Lim
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: So-Lyung
authors.initials: SL
authors.lastname: Jung
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Ja-Seong
authors.initials: JS
authors.lastname: Bae
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Chan-Kwon
authors.initials: CK
authors.lastname: Jung
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Moo-Il
authors.initials: MI
authors.lastname: Kang
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea.
authors.forename: Bong-Yun
authors.initials: BY
authors.lastname: Cha
authors.affiliation: Division of Endocrinology and MetabolismDepartments of Internal MedicineRadiologySurgeryHospital PathologyCollege of Medicine, Seoul St Mary's Hospital, The Catholic University of Korea, #505 Banpo-Dong, Seocho-Gu, Seoul 137-701, Korea ldj6026@catholic.ac.kr.
authors.forename: Dong-Jun
authors.initials: DJ
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D044963:Biopsy, Fine-Needle; D002277:Carcinoma / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D002291:Carcinoma, Papillary; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000378:metabolism* / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009333:Neck; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D012016:Reference Values; D012680:Sensitivity and Specificity; D013954:Thyroglobulin / Q000378:metabolism*; D000077273:Thyroid Cancer, Papillary; D013964:Thyroid Neoplasms / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D013965:Thyroidectomy; D055815:Young Adult
chemical_list: D001323:Autoantibodies; C006606:anti-thyroglobulin; D013954:Thyroglobulin