Thyroglobulin in the Washout Fluid of Lymph-Node Biopsy: What Is Its Role in the Follow-Up of Differentiated Thyroid Carcinoma?

Torres, Maria Roseneide dos Santos; Neto, Sebastião Horácio Nóbrega; Rosas, Rosalina Jenner; Martins, Aline Lemos Barros; Ramos, André Luis Correia; Cruz, Thomaz

doi:10.1089/thy.2013.0244

Cited by 61 publications

(55 citation statements)

References 58 publications

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“…The Tg-FNAB cutoff point for the diagnosis of malignancy has not been unanimously established in the literature (12,13). We used the value of 10 ng/mL, which is consistent with the majority of published reports (11,14,(20)(21)(22).…”

Section: Assaysmentioning

confidence: 78%

“…The use of Tg-FNAB is well recognized as a valuable instrument in the examination of suspicious LN metastases (3,4,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). However, there are limited data regarding factors that may interfere with the diagnostic sensitivity of Tg-FNAB, such as the presence of TgAb in washout fluid samples.…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, the use of Tg-FNAB alone has several limitations, and despite being well established as an important tool in the investigation of suspicious LN metastases, Tg-FNAB presents variable results between metastatic and non-metastatic LNs (3,4,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). This subject has been the topic of recent reviews and meta-analysis studies (12,13).…”

Section: Thyroglobulin and Anti-thyroglobulin Antibodies In Needle Wamentioning

confidence: 99%

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Clinical impact of thyroglobulin (Tg) and Tg autoantibody (TgAb) measurements in needle washouts of neck lymph node biopsies in the management of patients with papillary thyroid carcinoma

Martins-Costa

Maciel

Kasamatsu

et al. 2017

Arch. Endocrinol. Metab.

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Objectives:The presence of thyroglobulin (Tg) in needle washouts of fine needle aspiration biopsy (Tg-FNAB) in neck lymph nodes (LNs) suspected of metastasis has become a cornerstone in the followup of patients with papillary thyroid carcinoma (PTC). However, there are limited data regarding the measurement of anti-Tg antibodies in these washouts (TgAb-FNAB), and it is not clear whether these antibodies interfere with the assessment of Tg-FNAB or whether there are other factors that would more consistently justify the finding of low Tg-FNAB in metastatic LNs. Materials and methods: We investigated 232 FNAB samples obtained from suspicious neck LNs of 144 PTC patients. These samples were divided according to the patient's serum TgAb status: sTgAb-(n = 203 samples) and sTgAb+ (n = 29). The TgAb-FNAB levels were measured using two different assays. Tg-FNAB was also measured using two assays when low levels (< 10 ng/mL) were identified in the first assay of the metastatic LNs from the sTgAb+ samples. Results: The TgAb-FNAB results were negative in both assays in all samples. Low levels of Tg-FNAB were identified in 11/16 of the metastatic LNs of the sTgAb+ patients and 16/63 of the sTgAb-patients (p < 0.05) using assay 1. The measurement of the Tg-FNAB levels using assay 2 indicated additional metastases in 5 LNs of the sTgAb+ patients. Conclusions: Factors other than the presence of TgAb-FNAB may contribute to the higher number of metastatic LNs with undetectable Tg-FNAB in the sTgAb+ group. In addition, the measurement of Tg-FNAB using different assays was useful to enhance the diagnosis of metastatic LNs, particularly when cytological and Tg-FNAB results are discordant.

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Section: Assaysmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Thyroglobulin and Anti-thyroglobulin Antibodies In Needle Wamentioning

confidence: 99%

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Clinical impact of thyroglobulin (Tg) and Tg autoantibody (TgAb) measurements in needle washouts of neck lymph node biopsies in the management of patients with papillary thyroid carcinoma

Martins-Costa

Maciel

Kasamatsu

et al. 2017

Arch. Endocrinol. Metab.

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“…Послеоперационное ультразвуковое исследование [70,190,[195][196][197][198][199][200][201][202] Рекомендация 40. После оперативного лечения УЗИ шеи проводят через 6-12 мес в зависимости от группы риска и динамики концентрации ТГ.…”

Section: определение тиреоглобулина и антител к тиреоглобулинуunclassified

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

et al. 2017

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В представленных клинических рекомендациях обсуждаются современные подходы к диагностике и лечению дифференцированного рака щитовидной железы у взрослых. Изменения в настоящей редакции Клинических рекомендаций касаются показаний к пункционной биопсии, скринингового определения концентрации кальцитонина, унификации заключений цитологического исследования, новых подходах к послеоперационной динамической стратификации риска рецидива, показаний к супрессивной и заместительной терапии, таргетной терапии йоднегативных форм дифференцированного рака щитовидной железы.

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“…A thyroglobulin level above 10 ng/mL has been reported to suggest lymph node metastasis. On the other hand, its disadvantages are its being a non-standardized technique, the non-clarity of which level exactly shows malignancy, and continuing arguments on the accuracy of results in patients not having undergone thyroidectomy (16).…”

Section: Fnabmentioning

confidence: 99%

The Management of Thyroid Nodules

Ulusoy¹

2016

Turk Arch Otorhinolaryngol

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ReviewThyroid nodules are extremely common and are detected in 3%-7% of the general population by palpation and in 70% of the population by ultrasonography (USG). Approximately 5%-15% of these nodules are malignant. Therefore, in nodule examination, our primary aim is to detect malignant nodules. Besides the medical history and the findings of the physical examination, USG and fine-needle aspiration biopsy (FNAB) are the most commonly used methods to examine these nodules. Ultrasound-guided FNAB and on-site assessment of FNA specimens are suggested to decrease false negative and non-diagnostic test results. FNAB results in the "atypia of undetermined significance" group is challenging in the follow-up or treatment of the nodule. In this group, to differentiate the malignant nodules, other developing methods, such as analyzing molecular genetic markers, protein markers, and elastography, are generally studied. However, these methods are not used in a routine nodule examination because of cost-benefit analysis. Keywords

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Thyroglobulin in the Washout Fluid of Lymph-Node Biopsy: What Is Its Role in the Follow-Up of Differentiated Thyroid Carcinoma?

Abstract: FNAB-Tg improves the diagnostic performance of FNAB-C in LN metastases, even when the latter is unable to diagnose the metastases. For that reason, FNAB-Tg should be included in the monitoring of DTC.

Cited by 61 publications

References 58 publications

Clinical impact of thyroglobulin (Tg) and Tg autoantibody (TgAb) measurements in needle washouts of neck lymph node biopsies in the management of patients with papillary thyroid carcinoma

Clinical impact of thyroglobulin (Tg) and Tg autoantibody (TgAb) measurements in needle washouts of neck lymph node biopsies in the management of patients with papillary thyroid carcinoma

2016 Russian clinical practice guidelines for differentiated thyroid cancer diagnosis and treatment

The Management of Thyroid Nodules

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