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J Thyroid Res. 2011;2011:621839. doi: 10.4061/2011/621839. Epub 2011 May 30.

Lymph node thyroglobulin measurement in diagnosis of neck metastases of differentiated thyroid carcinoma.

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1
Department of Nuclear Medicine and Thyroid Unit, Oncology Institute of Southern Switzerland, Street Ospedale 12, 6500 Bellinzona, Switzerland.

Abstract

AIM:

Enlarged cervical lymph nodes (LNs) in patients with thyroid cancer are usually assessed by fine-needle aspiration cytology (FNAC). Thyroglobulin (Tg) is frequently elevated in malignant FNAC needle wash specimens (FNAC-Tg). The objectives of the study were to (1) determine an appropriate diagnostic cut-off for FNAC-Tg levels (2) compare FNAC and FNAC-Tg results in a group of 108 patients affected by differentiated thyroid carcinoma (DTC).

METHODS:

A total of 126 consecutive FNACs were performed on enlarged LNs and the final diagnosis was confirmed by surgical pathology examination or clinical follow-up. The best FNAC-Tg cut-off level was selected by receiver operating curve analysis, and diagnostic performances of FNAC and FNAC-Tg were compared.

RESULTS:

The rate of FNAC samples adequate for cytological examination was 77% in contrast FNAC-Tg available in 100% of aspirates (P < .01). The sensitivity, specificity, and accuracy of FNAC were 71%, 80%, 74%, 100%, 80%, and 94%, respectively. The most appropriate cut-off value for the diagnosis of thyroid cancer metastatic LN was 1.1‚ÄČng/mL (sensitivity 100%, specificity 100%).

CONCLUSIONS:

The diagnostic performance of needle washout FNAC-Tg measurement with a cut-off of 1.1‚ÄČng/mL compared favorably with cytology in detecting DTC node metastases.

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