Yonsei Med J.  2012 Jan;53(1):126-131. 10.3349/ymj.2012.53.1.126.

Diagnostic Performance of Thyroglobulin Value in Indeterminate Range in Fine Needle Aspiration Washout Fluid from Lymph Nodes of Thyroid Cancer

Affiliations
  • 1Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.
  • 2Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. mines@yuhs.ac

Abstract

PURPOSE
The purpose was to compare the frequency of metastatic and nonmetastatic lymph nodes diagnosed by fine needle aspiration biopsy cytology (FNAC) and thyroglobulin concentration from fine needle aspiration biopsy washout fluid (FNAB-Tg) in an indeterminate range (0.2-100 ng/mL), and to evaluate the most appropriate threshold value of FNAB-Tg in an indeterminate range.
MATERIALS AND METHODS
We performed ultrasound-guided FNAB and FNAB-Tg in suspicious metastatic cervical lymph nodes of papillary thyroid carcinoma and performed surgery. Ninety-five lymph nodes with indeterminate values of FNAB-Tg ranging from 0.2-100 ng/mL in ninety-two patients were included in this study. The diagnostic performances in multiple Tg levels (0.7, 1.0, 5.0, 10.0, 20.0, 50.0) were evaluated to compare with FNAB cytology using sensitivity, specificity, and accuracy with area under the curve (AUC) analysis.
RESULTS
Forty-two were metastatic lymph nodes and fifty three were nonmetastatic lymph nodes. FNAB-Tg ranged from 0.22 to 90.9 ng/mL in metastatic lymph nodes (mean; 34.3+/-33.3 ng/mL) and 0.20 to 56.7 ng/mL in nonmetastatic lymph nodes (mean; 4.9+/-11.1 ng/mL) (p<0.001). The most excellent diagnostic performance was displayed in 5 ng/mL of FNAB-Tg with AUC of 0.76, sensitivity, specificity, accuracy, 69.0, 83.0, and 76.8, respectively. However, there was no significant difference from 10 ng/mL FNAB.
CONCLUSION
We ascertained that 5 ng/mL yielded the most excellent diagnostic performance among FNAB-Tg levels in the present setting with a large series with the indeterminate range (0.2-100 ng/mL) of FNAB-Tg values. These results need additional confirmation under different laboratory conditions.

Keyword

Fine needle aspiration biopsy; thyroglobulin; lymph nodes

MeSH Terms

Biopsy, Fine-Needle/*methods/standards/statistics & numerical data
Body Fluids/metabolism
Carcinoma, Papillary/*metabolism/*secondary/ultrasonography
Humans
Lymph Nodes/metabolism/pathology/ultrasonography
Lymphatic Metastasis
Retrospective Studies
Sensitivity and Specificity
Thyroglobulin/*metabolism
Thyroid Neoplasms/*metabolism/*secondary/ultrasonography
Ultrasonography, Interventional
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