Ultrasound-Guided Fine-Needle Aspiration Versus Fine-Needle Capillary Sampling in Evaluation of Lymph Node Metastasis of Thyroid Cancer

Abstract

BackgroundTo compare the sampling adequacy and diagnostic efficiency of ultrasound-guided fine-needle aspiration with 22-, 25-gauge needles and capillary sampling with 22-gauge needle in the biopsy of cervical lymph node.MethodsA total of 130 cervical lymph nodes from 103 patients were consecutively included in the prospective study. Each suspected lymph node was aspirated with a 22-gauge needle, capillary sampled with a 22-gauge needle and aspirated with a 25-gauge needle. The adequacy rates and nondiagnostic rates of obtained specimen were calculated.ResultsOf the 130 suspected lymph nodes, there were 77 lymph nodes<6.0 mm and 53 lymph nodes≥6.0mm in the smallest dimension. Both FNA22G and FNC22G got significantly higher sampling adequacy than FNA25G for the total lymph nodes. For lymph nodes<6.0 mm, the sampling adequacy was significantly higher with FNA22G than with FNA25G for each parameter and the cumulative score (all P<0.05), while no difference were seen between FNA22G and FNC22G, and between FNC22G and FNA25G. There were higher nondiagnostic rates for FNA25G compared with FNA22G and FNC22G in all lymph nodes and in each size subgroups. FNA25G yielded more diagnostically inadequate specimens than FNA22G and FNC22G did in the total lymph nodes (P=0.002), in lymph nodes<6.0 mm (P=0.014), and in those ≥ 6.0 mm (P=0.000).ConclusionsFNA22G and FNC22G obtained more diagnostically adequate specimens than FNA25G in cervical lymph nodes. FNA22G and FNC22G may be more suitable than FNA25G in diagnosing cervical lymph nodes. FNA22G and FNC22G may yield specimens with similar quality.

A Rare Complication of Fine-Needle Aspiration of Neck Structures

“…In terms of diagnostic yield of FNA, some studies reported no difference when comparing head and neck specimens obtained with a 21-gauge needle and a 25-gauge needle [ 17 ], or between 23-gauge needle and a 27-gauge needle [ 18 ]. Another study looking at thyroid FNA showed that biopsies using 25-gauge needles have a higher yield than those using 22-gauge needles [ 19 ]. Ultrasound guidance was utilized in both of our cases.…”

Busca De Marcadores Moleculares Preditivos Do Acometimento De Linfonodos Em Carcinomas Papilíferos De Tireoide

“…Entretanto, mesmo que a PAAF seja considerada o método padrão ouro para a caracterização dos nódulos de tireoide, a técnica é subjetiva, apresentando de 5 a 10% de resultados falsos negativos (San Laureano et al, 2020) e 15 a 30% de resultados indeterminados, fazendo com que na maioria das vezes seja necessária a realização da ressecção do nódulo (Oczko-Wojciechowska et al, 2020;Seneldir et al, 2020;Hejaz et al 2022). Tendo em vista as dificuldades no diagnóstico preciso destes tumores, uma melhor compreensão dos mecanismos moleculares que contribuem para a carcinogênese da tireoide poderá auxiliar na conduta clínica dos pacientes com nódudos citologicamente indeterminados pela PAAF e assim permitir um diagnóstico mais acurado e eficaz (Rodrigues et al, 2019;Xia et al 2021;Chen et al 2022), evitando cirurgias desnecessárias de ressecção, além de auxiliar em novas opções de prognóstico e tratamento dos pacientes (Joo et al 2022).…”