Clinical value of high frequency ultrasound guided fine needle aspirates(FNA) and FNA-thyroglobulin detection for diagnosing cervical metastatic lymph nodes in patients underwent thyroidectomy for papillary thyroid carcinoma
10.3760/cma.j.issn.1004-4477.2014.08.010
- VernacularTitle:高频超声引导下细针抽吸活检结合细针抽吸洗脱液甲状腺球蛋白检测对甲状腺乳头状癌术后颈部淋巴结转移的诊断价值
- Author:
Lilong XU
;
Shiyan LI
;
Haishan XU
;
Bowen ZHAO
;
Li GAO
;
Murui ZHANG
;
Mengwei WENG
- Publication Type:Journal Article
- Keywords:
Ultrasonography;
Thyroid neoplasms;
Biopsy,fine-needle;
Lymphatic metastasis;
Thyroglobulin
- From:
Chinese Journal of Ultrasonography
2014;23(8):679-682
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the diagnositc value of high frequency ultrasound guided fine needle aspirates (FNA) and thyroglobulin (Tg) in fine-needle aspirate fluid (FNA-Tg) measurement for detecting metastatic lymph nodes in patients underwent thyroidectomy for papillary thyroid carcinoma (PTC).Methods Sixty-five patients with 79 suspected metastatic lymph nodes were retrospective analysis in this study.FNA for suspected lymph nodes was performed guided by high frequency ultrasound and FNATg was measured.The histopathologic diagnosis for all of the suspected lymph nodes was obtained after lymphadenectomy.Results By histopathologic diagnosis,62 lymph nodes were positive metastasis,while 17 were negative metastasis.Fifty-four lymph nodes were diagnosed as positive metastasis and 25 as negative metastasis by FNA.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FNA for assessing cervical metastatic lymph nodes from PTC were 89.87% (71/79),87.10% (54/62),100% (17/17),100% (54/54) and 68.00% (17/25),respectively.Sixty-five lymph nodes were diagnosed as positive metastasis and 14 as negative metastasis by FNA-Tg.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of FNA-Tg were 96.20% (76/79),100% (62/62),82.35% (14/17),95.38% (62/65) and 100% (14/14),respectively.There was no significant difference between FNA and FNA-Tg for evaluating cervical metastatic lymph nodes from PTC (x2 =1.454,P =0.228).Eight positive metastatic lymph nodes which were missed by FNA were corrected diagnosed by FNA-Tg measurement.Conclusions Both FNA and FNA-Tg are effective methods for assessing cervical metastatic lymph nodes from PTC postoperatively,and these two methods could be combined for early and accurate evaluating the lymph nodes state.