Detection of lymph node metastases of papillary thyroid cancer—comparison of the results of histopathology, immunohistochemistry and reverse transcription-polymerase chain reaction—a preliminary report

Pomorski, Lech; Kaczka, Krzysztof; Piaskowski, Sylwester; Wojcik, Izabela; Rieske, Piotr; M, Matejkowska; Kuzdak, Krzysztof

doi:10.1007/s00423-004-0528-1

Cited by 6 publications

(6 citation statements)

References 34 publications

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“…Cytological examination of FNA samples was reported to be an accurate method, with high sensitivity and specificity, for detection of metastatic LNs in general head and neck malignancies. [41] The diagnosis of cervical LNs metastases of DTC is often complex because inflammatory lymphadenopathies and nonthyroidal cancer metastases are frequent in this region. [42] Therefore, there are many FP and FN results.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

et al. 2019

Medicine

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Background:To investigate the diagnostic performance of cytology (fine-needle aspiration cytology [FNAC]), thyroglobulin (fine-needle aspiration thyroglobulin [FNA-Tg]), and combination of them in the washout of fine-needle aspiration for those patients who have suspicious metastatic lymph nodes of differentiated thyroid cancer.Methods:Databases, including PubMed, EMbase, Web of Science and Cochrane Library were searched up to June 2019. The quality assessment of diagnostic accuracy scale-2 was used to conduct quality assessments, and publication bias was evaluated using the Deeks funnel plot. STATA version 14.0 was used to perform the meta-analysis.Results:A total of 2257 patients with 2786 samples of suspicious metastatic lymph nodes of differentiated thyroid cancer were included in the meta-analysis. The results showed that the diagnostic value for detecting lymph node metastasis of differentiated thyroid cancer was as follows: combination of FNAC and FNA-Tg > FNA-Tg > FNAC. All differences of superiority among them are statistically significant. The sensitivity of the combination was 0.968 (95% confidence interval [CI]: 0.942–0.983), the specificity was 0.932 (95% CI: 0.856–0.969), the diagnostic score was 6.036 (95% CI: 4.892–7.181), the diagnostic odds ratio was 418.424 (95% CI: 133.167–1314.729), and the score of summary receiver operating characteristic was 0.99 (95% CI: 0.97–0.99).Conclusions:The combination of FNAC and FNA-Tg is an excellent procedure in diagnosis of lymph nodes metastasis of patients with differentiated thyroid cancer, which should be highly recommended.

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Section: Discussionmentioning

confidence: 99%

Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

et al. 2019

Medicine

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“…As a consequence, routine association of FNAB-Tgp with FNAB-C in the diagnosis of CLN metastasis from papillary and follicular thyroid cancers has been recommended [6,7,15]. Similarly, it has been shown that lymph node detection of Tg mRNA (Tgm) in fine-needle washout implemented the FNAB-C sensitivity for the diagnosis of metastatic CLN from DTC, even if this still needs to be validated on larger case-studies [28]. …”

Section: Introductionmentioning

confidence: 99%

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

Baldini¹,

Sorrenti²,

Gioia³

et al. 2013

BMC Clin Pathol

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BackgroundMeasurement of thyroglobulin (Tg) protein in the washout of the needle used for fine needle aspiration biopsy cytology (FNAB-C) has been shown to increase the sensitivity of FNAB-C in identifying cervical lymph node (CLN) metastasis from well-differentiated thyroid cancer (TC). In this study, we evaluated whether routine measurement of Tg protein (FNAB-Tgp), Tg mRNA (FNAB-Tgm) and calcitonin (CT) mRNA (FNAB-CTm) in the FNAB washout of CLN increases the accuracy of FNAB-C in the diagnosis of suspicious metastatic CLN.MethodsIn this prospective study 35 CLN from 28 patients were examined. Histology showed metastatic papillary TC (PTC) in 26 CLN, metastatic medullary TC (MTC) in 3 CLN, metastatic anaplastic TC (ATC) in 3 CLN and 3 metastatic CLN from extra-thyroidal cancers.ResultsThe overall accuracy of FNAB-C was 84.4%, reaching 95.7% when the analysis was restricted to PTC. Both FNAB-Tgp and FNAB-Tgm compared favorably with FNAB-C and shown diagnostic performances not statistically different from that of FNAB-C. However, FNAB-Tgp and FNAB-Tgm/FNAB-CTm were found useful in cases in which cytology results were inadequate or provided diagnosis inconsistent with patient's clinical parameters.ConclusionsWe demonstrated that FNAB-C, Tg/CT mRNA and Tg protein determination in the fine-needle washout showed similar accuracy in the diagnosis of metastatic CLN from TC. The results of this study suggest that samples for Tg protein and Tg/CT mRNA measurements from CLN suspicious for metastatic TC should be collected, but their measurements should be restricted to cases in which FNAB-C provides uninformative or inconsistent diagnosis with respect to patient's clinical parameters.

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“…In this initial study they reported that Tg detection in fine needle aspirates of non-thyroidal neck masses showed 100% sensitivity in detecting CLN metastasis during the follow-up of patients who were previously treated by total thyroidectomy and 131 I ablation, while FNAC alone showed a sensitivity of 85% [72]. Since then, different studies, measuring Tg protein and/or mRNA, confirmed the utility of Tg determinations in the detection of DTC metastasis in CLN [67][68][69][70][71][73][74][75][76][77][78][79][80][81]. It is worth noting that, differently from serum Tg measurement, Tg detection in the washout of fineneedle aspirates from CLN is not affected by circulating anti-Tg antibodies present in about 20% of patients affected by DTC [82].…”

Section: Molecular Diagnosis In Cervical Lymph Nodesmentioning

confidence: 99%

“…In addition, the same technique may be used to detect calcitonin (CT) protein and/or mRNA for the detection of metastatic medullary thyroid cancer (MTC) [81]. The diagnostic performance of this molecular approach, in terms of sensitivity, specificity, negative and positive predictive value and accuracy was shown to be excellent [67][68][69][70][71][72][73][74][75][76][77][78][79][80][81][82]. Based upon these pieces of evidence, the routine association of Tg protein detection with FNAC in the preoperative diagnosis of suspicious CLN was recommended [17,18].…”

Section: Molecular Diagnosis In Cervical Lymph Nodesmentioning

confidence: 99%

New Molecular Approaches in the Diagnosis and Prognosis of Thyroid Cancer Patients

Baldini¹,

Tuccilli²,

Prinzi³

et al. 2013

Global J. Oncolog.

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Thyroid nodules are very common in the adult population, but only a minority of them harbor a malignant lesion. Therefore, the first aim in their clinical evaluation is to exclude malignancy. To date, the fine-needle aspiration cytology (FNAC) represents the main diagnostic tool for the evaluation of thyroid nodules and cervical lymph nodes (CLN) suspected of metastatic disease. It has to be mentioned, however, that FNAC on thyroid nodules suffers from a major diagnostic limit represented by cellular atypias of indeterminate significance, which require the histological diagnosis. Also the FNAC performed on CLN may be a challenging diagnostic category as CLN could harbor metastases from a multiplicity of extrathyroidal malignancies or be affected by several non-tumoral diseases. In addition, inadequate cellularity obtained from both thyroid nodules or CLN prevents diagnosis in about 20% of specimens.Total thyroidectomy followed by adjuvant therapy with 131 I is the treatment of choice for most patients affected by DTC. Although the prognosis of DTC patients is favorable, about 20% of them face the morbidity of disease recurrence and tumor-related deaths. Thus far, the prognosis of these patients still relies on clinic-pathological variables such as patient's age, tumor size, histology, lymph node or distant metastasis, which are not accurate in predicting the long-term outcome. As a consequence, the identification of new molecular biomarkers strictly related to the risk of DTC relapse is highly needed.In the present review we'll attempt to summarize the recent characterization of new molecular markers able to ameliorate the diagnosis and prognosis of thyroid cancer patients.

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Detection of lymph node metastases of papillary thyroid cancer—comparison of the results of histopathology, immunohistochemistry and reverse transcription-polymerase chain reaction—a preliminary report

Abstract: (1) Thyroglobulin (Tg) RT-PCR is an appropriate method of detection for thyroid cancer cells. (2) In combination with histopathology, it might help to qualify patients' nodal status better.

Cited by 6 publications

References 34 publications

Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

Diagnostic value of cytology, thyroglobulin, and combination of them in fine-needle aspiration of metastatic lymph nodes in patients with differentiated thyroid cancer

Cervical lymph node metastases from thyroid cancer: does thyroglobulin and calcitonin measurement in fine needle aspirates improve the diagnostic value of cytology?

New Molecular Approaches in the Diagnosis and Prognosis of Thyroid Cancer Patients

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