Ultrasound-guided fine-needle aspiration biopsy combined with washout fluid thyroglobulin detection in diagnosis of lateral neck lymph nodes metastasis of papillary thyroid carcinoma
10.13929/j.1672-8475.201903005
- VernacularTitle: 超声引导下细针抽吸活检联合洗脱液测定甲状腺球蛋白诊断甲状腺乳头状癌侧颈区淋巴结转移
- Author:
Naxiang LIU
1
Author Information
1. Department of Ultrasound, Fujian Provincial Cancer Hospital, Affiliated Tumor Hospital of Fujian Medical University
- Publication Type:Journal Article
- Keywords:
Biopsy;
Lymphatic metastasis;
Thyroglobulin in washout fluid;
Thyroid cancer, papillary;
Ultrasonography
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(9):527-530
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the value of ultrasound-guided fine-needle aspiration (FNA) biopsy combined with thyroglobulin in fine-needle aspirate fluid (FNA-Tg) measurement in diagnosis of preoperative lateral neck lymph node (LN) metastasis of papillary thyroid carcinoma (PTC). Methods: Totally 111 preoperative PTC patients diagnosed with FNA with suspected metastatic LNs were collected and then underwent neck ultrasonography together with FNA cytclogy. FNA-Tg was measured, then the eluents were obtained by flushing aspiration needle with 1 ml normal saline. FNA-Tg of elution was measured by electrochemiluminescence immunoassay. Taken postoperative pathologic results as the gold standards, ROC curve was drawn, the optimal threshold value for diagnosis of FNA-Tg, the diagnostic efficiency of FNA, FNA-Tg, combined FNA and FNA-Tg for suspected metastatic LNs were evaluated. Results: Among 118 suspicious LNs, 81 (81/118, 68.64%) LNs of metastasis and 37 (37/118, 31.36%) LNs without metastasis were confirmed by postoperative pathology. The average value of FNA-Tg in metastasis LNs was significantly higher than that of LNs without metastasis (P<0.001). The optimal diagnostic value of FNA-Tg in diagnosis of LNs metastasis was 2.65 μg/L, and the AUC was 0.937 (95%CI [0.894, 0.980], P<0.001). The differences of accuracy, sensitivity and negative predictive value were all statistically significant between FNA-Tg and FNA (all P<0.05). The accuracy, sensitivity and negative predictive value of FNA combined with FNA-Tg were higher than that of only FNA (all P<0.05). Twenty-two FNA false-negative nodes were correctly diagnosed with FNA-Tg testing. Conclusion: FNA cytology and FNA-Tg detection are useful ancillary tests that can improve the detection of lateral neck LN metastasis of PTC. Combination of FNA and FNA-Tg can significantly increase the accuracy and sensitivity of preoperative diagnosis of lateral neck LN metastasis of PTC, and may have an important role in surgical planning of PTC patients.
