title: The value of combined application of ultrasound-guided fine needle aspiration cytology and thyroglobulin measurement for the diagnosis of cervical lymph node metastases from thyroid cancer.
abstract: OBJECTIVE
  The aim of this study was to explore the diagnostic value of ultrasound-guided (US-guided) fine-needle aspiration cytology (FNAC), thyroglobulin measurement on fine-needle aspiration (FNA-Tg), combined US-guided FNAC, and the ratio between FNA-Tg and serum Tg (FNA-Tg/serum Tg) for patients with cervical lymph node (CLN) metastases from thyroid carcinoma.
  
  
  METHODS
  We selected 148 patients with thyroid cancer with suspicious CLN metastases who met the inclusion criteria. FNAC findings, FNA-Tg levels, and serum Tg levels were evaluated before surgical treatment. The results of FNAC and FNA-Tg from CLNs were analyzed retrospectively.
  
  
  RESULTS
  Ninety-four of 148 cases were metastatic and 54 were benign. The sensitivity, specificity, and accuracy of FNAC were 68.1%, 100.0%, and 79.7%, respectively. The sensitivity, specificity, and accuracy of FNA-Tg/serum Tg were 91.5%, 88.9%, and 90.5%, respectively. The sensitivity, specificity, and accuracy of FNA-Tg [10 ng/mL] were 98.9%, 68.5%, and 87.8%, respectively. The sensitivity, specificity, and accuracy of combined US-guided FNAC and FNA-Tg/serum Tg were 95.7%, 96.3%, and 95.9%, respectively. There was a statistically significant difference between FNAC and combined US-guided FNAC and FNA-Tg/serum Tg for sensitivity, specificity, and accuracy (P < 0.05).
  
  
  CONCLUSIONS
  The method of FNA-Tg/serum Tg is sensitive enough for diagnosing CLN metastases from thyroid cancer. The combined application of US-guided FNAC and FNA-Tg/serum Tg contributes to improving the accuracy of diagnosing CLN metastases in patients with thyroid cancer.
authors.affiliation: Jia-hong Shi, Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Shi
authors.affiliation: Ying-ying Xu, Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Xu
authors.affiliation: Qi-zheng Pan, Department of Anesthesia, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Qi-Zheng
authors.initials: QZ
authors.lastname: Pan
authors.affiliation: Guo-qing Sui, Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Guo-Qing
authors.initials: GQ
authors.lastname: Sui
authors.affiliation: Jian-ping Zhou, Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Zhou
authors.affiliation: Hui Wang, Department of Ultrasonography, China-Japan Union Hospital of Jilin University, Changchun 130033, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Wang
keywords: Cervical lymph node; Fine needle aspiration cytology; Papillary thyroid cancer; Thyroglobulin