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Diagnostic performance of thyroglobulin value in indeterminate range in fine needle aspiration washout fluid from lymph nodes of thyroid cancer

Authors
 Yu-Mee Sohn  ;  Min Jung Kim  ;  Eun-Kyung Kim  ;  Jin Young Kwak 
Citation
 YONSEI MEDICAL JOURNAL, Vol.53(1) : 126-131, 2012 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2012
MeSH
Biopsy, Fine-Needle/methods* ; Biopsy, Fine-Needle/standards ; Biopsy, Fine-Needle/statistics & numerical data ; Body Fluids/metabolism ; Carcinoma, Papillary/diagnostic imaging ; Carcinoma, Papillary/metabolism* ; Carcinoma, Papillary/secondary* ; Humans ; Lymph Nodes/diagnostic imaging ; Lymph Nodes/metabolism ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Retrospective Studies ; Sensitivity and Specificity ; Thyroglobulin/metabolism* ; Thyroid Neoplasms/diagnostic imaging ; Thyroid Neoplasms/metabolism* ; Thyroid Neoplasms/secondary* ; Ultrasonography, Interventional
Keywords
Fine needle aspiration biopsy ; thyroglobulin ; lymph nodes
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.
Files in This Item:
T201200095.pdf Download
DOI
22187242
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Jin Young(곽진영) ORCID logo https://orcid.org/0000-0002-6212-1495
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92053
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