Skip to main content

Advertisement

SpringerLink
Log in

Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma

  • Original Article
  • Published:
Langenbeck's Archives of Surgery Aims and scope Submit manuscript

Abstract

Purpose

We aimed to compare the diagnostic value of fine-needle aspiration cytology (FNAC) and fine-needle aspiration thyroglobulin measurements (FNA-Tg) for detecting cervical lymph node metastases from differentiated thyroid carcinomas.

Methods

This prospective study included 225 patients with neck node metastases or recurrences of papillary thyroid carcinoma. From the 225 patients, 255 lymph nodes were evaluated by FNAC and FNA-Tg. Final diagnoses confirmed by histological examination were compared to preoperative FNAC and FNA-Tg results.

Results

FNAC correctly diagnosed 212 metastatic lymph nodes but failed to diagnose 43 of them. FNA-Tg correctly diagnosed 253 metastatic lymph nodes but failed to diagnose two of them. FNA-Tg levels showed 100% sensitivity, 96% specificity, 99% diagnostic accuracy, a 99% positive predictive value (PPV) and a 100% negative predictive value (NPV) with a threshold level of FNA-Tg with a diagnostic accuracy 28.5 ng/ml. The specificity, diagnostic accuracy, PPV and NPV of FNA-Tg were significantly higher than those of FNAC.

Conclusion

FNA-Tg measurement can be performed safely for the detection of lymph node metastasis in patients with differentiated thyroid carcinomas.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Cooper DS, Doherty GM, Haugen BR, Kloos RT, Lee SL, Mandel SJ, Mazzaferri EL et al (2009) American Thyroid Association (ATA) guidelines taskforce on thyroid nodules and differentiated thyroid cancer. Thyroid 19:1167–1214

    Article  PubMed  Google Scholar 

  2. Mazzaferri EL, Kloos RT (2001) Clinical review 128: current approaches to primary therapy for papillary and follicular thyroid cancer. J Clin Endocrinol Metab 86:1447–1463

    Article  CAS  PubMed  Google Scholar 

  3. Pacini F, Schlumberger M, Dralle H, Elisei R, Smit JW, Wiersinga W (2006) European consensus for the management of patients with differentiated thyroid carcinoma of the follicular epithelium. Eur J Endocrinol 154:787–803

    Article  CAS  PubMed  Google Scholar 

  4. Sakorafas GH, Sampanis D, Safioleas M (2010) Cervical lymph node dissection in papillary thyroid cancer: current trends, persisting controversies, and unclarified uncertainties. Surg Oncol 19:57–70

    Article  Google Scholar 

  5. Pacini F, Fugazzola L, Lippi F, Ceccarelli C, Centoni R, Miccoli P et al (1992) Detection of thyroglobulin in fine needle aspirates of nonthyroidal neck masses: a clue to the diagnosis of metastatic differentiated thyroid cancer. J Clin Endocrinol Metab 74:1401–1404

    Article  CAS  PubMed  Google Scholar 

  6. Frasoldati A, Toschi E, Zini M, Flora M, Caroggio A, Dotti C et al (1999) Role of thyroglobulin measurement in fine-needle aspiration biopsies of cervical lymph nodes in patients with differentiated thyroid cancer. Thyroid 9:105–111

    Article  CAS  PubMed  Google Scholar 

  7. Cunha N, Rodrigues F, Curado F, Ilhéu O, Cruz C, Naidenov P et al (2007) Thyroglobulin detection in fine-needle aspirates of cervical lymph nodes: a technique for the diagnosis of metastatic differentiated thyroid cancer. Eur J Endocrinol 157:101–107

    Article  CAS  PubMed  Google Scholar 

  8. Borel AL, Boizel R, Faure P, Barbe G, Boutonnat J, Sturm N et al (2008) Significance of low levels of thyroglobulin in fine needle aspirates from cervical lymph nodes of patients with a history of differentiated thyroid cancer. Eur J Endocrinol 158:691–698

    Article  CAS  PubMed  Google Scholar 

  9. Snozek CL, Chambers EP, Reading CC, Sebo TJ, Sistrunk JW, Singh RJ et al (2007) Serum thyroglobulin, high-resolution ultrasound, and lymph node thyroglobulin in diagnosis of differentiated thyroid carcinoma nodal metastases. J Clin Endocrinol Metab 92:4278–4281

    Article  CAS  PubMed  Google Scholar 

  10. Boi F, Baghino G, Atzeni F, Lai ML, Faa G, Mariotti S (2006) The diagnostic value for differentiated thyroid carcinoma metastases of thyroglobulin (Tg) measurement in washout fluid from fine-needle aspiration biopsy of neck lymph nodes is maintained in the presence of circulating anti-Tg antibodies. J Clin Endocrinol Metab 91:1364–1369

    Article  CAS  PubMed  Google Scholar 

  11. Baloch ZW, Barroeta JE, Walsh J, Gupta PK, Livolsi VA, Langer JE et al (2008) Utility of thyroglobulin measurement in fine-needle aspiration biopsy specimens of lymph nodes in the diagnosis of recurrent thyroid carcinoma. Cytojournal 31:1–5

    Article  Google Scholar 

  12. Kim MJ, Kim EK, Kim BM, Kwak JY, Lee EJ, Park CS et al (2009) Thyroglobulin measurement in fine-needle aspirate washouts: the criteria for neck node dissection for patients with thyroid cancer. Clin Endocrinol 70:145–151

    Article  CAS  Google Scholar 

  13. Torlontano M, Attard M, Crocetti U, Tumino S, Bruno R, Costante G et al (2004) Follow-up of low risk patients with papillary thyroid cancer: role of neck ultrasonography in detecting lymph node metastases. J Clin Endocrinol Metab 89:3402–3407

    Article  CAS  PubMed  Google Scholar 

  14. Francis Z, Schlumberger M (2008) Serum thyroglobulin determination in thyroid cancer patients. Best Pract Res Clin Endocrinol Metab 22:1039–1046

    Article  CAS  PubMed  Google Scholar 

  15. Zucchelli G, Iervasi A, Ferdeghini M, Iervasi G (2009) Serum thyroglobulin measurement in the follow-up of patients treated for differentiated thyroid cancer. Q J Nucl Med Mol Imaging 53:482–489

    CAS  PubMed  Google Scholar 

  16. Elisei R, Schlumberger M, Driedger A, Reiners C, Kloos RT, Sherman SI et al (2009) Follow-up of low-risk differentiated thyroid cancer patients who underwent radioiodine ablation of postsurgical thyroid remnants after either recombinant human thyrotropin or thyroid hormone withdrawal. J Clin Endocrinol Metab 94:4171–4179

    Article  CAS  PubMed  Google Scholar 

  17. Leboulleux S, Girard E, Rose M, Sabbah N, Caillou B, Hartl DM et al (2007) Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J Clin Endocrinol Metab 92:3590–3594

    Article  CAS  PubMed  Google Scholar 

  18. Kuna SK, Bracic I, Tesic V, Kuna K, Herceg GH, Dodig D (2006) Ultrasonographic differentiation of benign from malignant neck lymphadenopathy in thyroid cancer. J Ultrasound Med 25:1531–1537

    PubMed  Google Scholar 

  19. Frasoldati A, Valcavi R (2004) Challenges in neck ultrasonography: lymphadenopathy and parathyroid glands. Endocr Pract 10:261–268

    PubMed  Google Scholar 

Download references

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Radiology, Istanbul Medical Faculty, Istanbul University, Çapa, Istanbul, Turkey

    Artür Salmaslıoğlu & Mehtap Tunacı

  2. Department of General Surgery, Istanbul Medical Faculty, Istanbul University, Çapa, Istanbul, Turkey

    Yeşim Erbil, Gamze Çıtlak, Feyzullah Ersöz, Serkan Sarı, Aydemir Olmez & Selçuk Özarmağan

  3. Department of Pathology, Istanbul Medical Faculty, Istanbul University, Çapa, Istanbul, Turkey

    Dilek Yılmazbayhan

  4. Department of Endocrinology, Istanbul Medical Faculty, Istanbul University, Çapa, Istanbul, Turkey

    Neşe Çolak

Authors
  1. Artür Salmaslıoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yeşim Erbil
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gamze Çıtlak
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Feyzullah Ersöz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Serkan Sarı
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Aydemir Olmez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Mehtap Tunacı
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dilek Yılmazbayhan
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Neşe Çolak
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Selçuk Özarmağan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yeşim Erbil.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Salmaslıoğlu, A., Erbil, Y., Çıtlak, G. et al. Diagnostic value of thyroglobulin measurement in fine-needle aspiration biopsy for detecting metastatic lymph nodes in patients with papillary thyroid carcinoma. Langenbecks Arch Surg 396, 77–81 (2011). https://doi.org/10.1007/s00423-010-0723-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00423-010-0723-1

Keywords

Search

Navigation