Thyroglobulin measurement in fine‐needle aspirate washouts: the criteria for neck node dissection for patients with thyroid cancer

Abstract

FNA-Tg measurement as well as FNAC should be performed either before or after surgery to evaluate neck node metastases or recurrences in patients with differentiated thyroid carcinomas. We recommend that the threshold values for FNA-Tg levels should be > 10 ng/ml if the serum-Tg level or the mean+2SD in node-negative patients is not available for reference.

Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody

“…They showed a diagnosis based on FNA-Tg in metastatic LNs might have a lower sensitivity and NPV in the TgAb-positive patients (19,26). Consistent with their results, our study also showed a lower diagnostic accuracy of FNA-Tg, whether combined with FNAC or not, in the TgAb-positive patients (Table 5).…”

“…In addition, FNA-Tg/sTg ratio was also used as a cut-off value to diminish the influence of sTg in preoperative patients (19,23) (Table 4) FNAC alone showed the lowest sensitivity (88.4%) but the highest specificity (99.6%). With FNA-Tg 0.7 added to FNAC, sensitivity was the highest (99.1%) but PPV was the lowest (63.9%).…”

“…Cytology findings of the LNs reviewed by experienced pathologists were categorized as non-diagnostic, benign and metastatic papillary thyroid carcinoma (PTC; suspicious malignancy, malignancy) (5,10,19,20,21).…”

Thyroglobulin measurements in washout of fine needle aspirates in cervical lymph nodes for detection of papillary thyroid cancer metastases

“…Cutoffs used in previous studies have varied widely, without a consensus about the most appropriate level (6,19,20). However, a recent study with 168 patients that analyzed 4 different levels of cutoffs (1, 10, 100 ng/mL and FNAB-Tg mean ± SD) indicated that the best level for diagnosis of DTC persistence/recurrence was < 10 ng/mL (16). Here, considering this cutoff, the sensitivity and specificity of FNAB-Tg was 100% and all cases were distinguishable as positive or negative based on FNAB-Tg.…”

“…Considering a cutoff value of 10 ng/mL, based on previous reports (7,16), all metastatic LN (n = 5) had higher FNAB-Tg values (median of 3,419.0 ng/mL, range 11.1-25,538.0). In all patients without LN disease (n = 38), confirmed by negative cytology and at least 1-year follow-up, the FNAB-Tg was below 10 ng/mL with a median of 3.7 ng/mL (0.8-7.4) ( Table 2).…”