Ultrasound combined with FNA-Tg in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma
10.12007/j.issn.0258-4646.2024.11.008
- VernacularTitle:超声联合细针穿刺洗脱液甲状腺球蛋白测定在甲状腺乳头状癌颈部淋巴结转移诊断中的应用
- Author:
Ruizhu CHEN
1
;
Huan ZHANG
;
Lichun ZHENG
;
Liyun LIU
;
Xiangliu OUYANG
Author Information
1. 唐山市工人医院超声医学科,河北唐山 063000
- Keywords:
papillary thyroid carcinoma;
lymph node metastasis;
ultrasonography;
thyroglobulin
- From:
Journal of China Medical University
2024;53(11):999-1004,1011
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the diagnostic value of ultrasound,thyroglobulin measurement in fine-needle aspiration biopsy(FNA-Tg),and their combination in the diagnosis of cervical lymph node metastasis in papillary thyroid carcinoma(PTC).Methods The clini-cal data of 130 patients(144 lymph nodes in total)with PTC in Tangshan Gongren Hospital from January 2017 to March 2023 were retro-spectively analyzed.Patients were divided into metastatic and non-metastatic groups according to the pathological findings of the cervical lymph nodes.The ultrasonic characteristics,serum Tg,and eluate Tg levels were compared between the two groups.The diagnostic efficacy of ultrasound,FNA-Tg,and the combination for cervical lymph node metastasis was assessed using the receiver operating characteristic(ROC)curve.Results Among 144 cervical lymph nodes,64 comprised the metastatic group and 80 comprised the non-metastatic group.Compared with the non-metastatic group,the lymph nodes in the metastatic group had indistinct cortical-medullary demarcation,uneven echogenicity,cystic changes,microcalcifications,and abnormal blood flow,and the differences were statistically significant(all P＜0.05);however,there was no statistically significant difference between the two groups in transverse to longitudinal ratios and whether the margins were clear(all P＞0.05).Serum Tg in the metastatic and non-metastatic groups was 19.5(1.9-70.7)ng/mL and 20.4(8.9-38.3)ng/mL,respectively,and the difference between the two groups was not statistically significant(P＞0.05);eluate Tg in the metastatic and non-metastatic groups was 500.0(49.4-500.0)ng/mL and 2.4(0.6-6.5)ng/mL,and the difference between the two groups was statisti-cally significant(P＜0.05),with an optimal FNA-Tg critical value of 11.7 ng/mL.FNA-Tg diagnosed cervical lymph node metastasis with the highest specificity,accuracy,and positive predictive value,whereas the combination of ultrasound and FNA-Tg diagnosed cervical lymph node metastasis with the highest sensitivity and negative predictive value.Conclusion Ultrasound manifestations of PTC cer-vical meta-static lymph nodes include poorly demarcated corticomedullary stroma,uneven echogenicity accompanied by cystic changes,microcalcifications,and abnormal blood flow and have high diagnostic efficacy for PTC metastatic lymph nodes.When PTC cervical lymph node abnormalities are suspected on ultrasound,further FNA-Tg should be performed.The combination of ultrasound with FNA-Tg could improve the diagnostic efficacy of PTC cervical lymph node metastasis.
