Korean J Radiol.  2009 Apr;10(2):106-111. 10.3348/kjr.2009.10.2.106.

Diagnostic Benefit of Thyroglobulin Measurement in Fine-Needle Aspiration for Diagnosing Metastatic Cervical Lymph Nodes from Papillary Thyroid Cancer: Correlations with US Features

• Jeon SJ
• Kim E
• Park JS
• Son KR
• Baek JH
• Kim YS
• Park DJ
• Cho BY
• Na DG

• KMID: 1088720
• DOI: http://doi.org/10.3348/kjr.2009.10.2.106

Abstract

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.
MATERIALS AND 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.
CONCLUSION
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.

Keyword

Papillary thyroid cancer; Lymph node metastasis; Ultrasound (US); Fine needle aspiration; Thyroglobulin

MeSH Terms

Biopsy, Fine-Needle
Carcinoma, Papillary/*pathology
Humans
Lymph Nodes/*ultrasonography
Lymphatic Metastasis/*diagnosis
Retrospective Studies
Sensitivity and Specificity
Thyroglobulin/*metabolism
Thyroid Neoplasms/*pathology
Ultrasonography, Interventional

Figure

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  Fig. 1 52-year-old man with recurrent papillary thyroid carcinoma.

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