Skip to main content

Advertisement

SpringerLink
Log in

Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

    We’re sorry, something doesn't seem to be working properly.

    Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Abstract

In evaluating cervical lymph node (LN) metastasis from papillary thyroid cancer (PTC), ultrasonography (US)-guided fine-needle aspiration biopsy (FNAB) is very important tool. There were limited number of studies about the diagnostic value of thyroglubion measurement in FNAB (FNAB-Tg) in non-thyroidectomized patients. Therefore, in this study, the authors evaluated the role of FNAB-Tg in diagnosing cervical LN metastases in patients with PTC before thyroidectomy. A total 91 suspicious LNs of 68 patients were undergone US-guided FNAB-Tg and cytology. Any FNAB-Tg concentration above 50 ng/ml considered as positive, irrespective of thyroid gland presence. Based on the final pathology, 49 LNs were positive, and the remaining 42 LNs were negative for metastasis. The sensitivity, specificity, and accuracy of FNAB-Tg in thyroidectomized patients were 80.0, 100.0, and 88.9%, respectively. The diagnostic performance of FNAB-Tg was not compromised by the presence of thyroid gland (sensitivity, specificity and accuracy = 95.0, 90.9 and 93.2%, respectively). FNAB-Tg is useful and simple method for the diagnosis of metastatic cervical LNs from PTC. The diagnostic performance of FNAB-Tg was not compromised by the presence of thyroid gland. Therefore, FNAB-Tg could be performed actively for the LN staging of PTC.

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

Similar content being viewed by others

References

  1. F. Pacini, Follow-up of differentiated thyroid cancer. Eur. J. Nucl. Med. Mol. Imaging 29, S492–S496 (2002)

    Article  PubMed  Google Scholar 

  2. S. Leboulleux, E. Girard, M. Rose, J.P. Travagli, N. Sabbah, B. Caillou, D.M. Hartl, N. Lassau, E. Baudin, M. Schlumberger, Ultrasound criteria of malignancy for cervical lymph nodes in patients followed up for differentiated thyroid cancer. J. Clin. Endocrinol. Metab. 92, 3590–3594 (2007)

    Article  PubMed  CAS  Google Scholar 

  3. M. Torlontano, M. Attard, U. Crocetti, S. Tumino, R. Bruno, G. Costante, G. D’Azzò, D. Meringolo, E. Ferretti, R. Sacco, F. Arturi, S. Filetti, 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 (2004)

    Article  PubMed  CAS  Google Scholar 

  4. C. Durante, M. Attard, M. Torlontano, G. Ronga, F. Monzani, G. Costante, M. Ferdeghini, S. Tumino, D. Meringolo, R. Bruno, G. De Toma, U. Crocetti, T. Montesano, A. Dardano, L. Lamartina, A. Maniglia, L. Giacomelli, S. Filetti, Identification and optimal postsurgical follow-up of patients with very low-risk papillary thyroid microcarcinomas. J. Clin. Endocrinol. Metab. 95, 4882–4888 (2010)

    Article  PubMed  CAS  Google Scholar 

  5. L. García-Pascual, M.J. Barahona, M. Balsells, C. del Pozo, J. Anglada-Barceló, J. Casalots-Casado, E. Veloso, J. Torres, Complex thyroid nodules with nondiagnostic fine needle aspiration cytology: histopathologic outcomes and comparison of the cytologic variants (cystic vs. acellular). Endocrine 39, 33–40 (2011)

    Article  PubMed  Google Scholar 

  6. E.K. Alexander, J.P. Heering, C.B. Benson, M.C. Frates, P.M. Doubilet, E.S. Cibas, E. Marqusee, Assessment of nondiagnostic ultrasound-guided fine needle aspirations of thyroid nodules. J. Clin. Endocrinol. Metab. 87, 4924–4927 (2002)

    Article  PubMed  CAS  Google Scholar 

  7. F.F. Maia, P.S. Matos, E.J. Pavin, J. Vassallo, D.E. Zantut-Wittmann, Value of repeat ultrasound-guided fine-needle aspiration in thyroid nodule with a first benign cytologic result: impact of ultrasound to predict malignancy. Endocrine 40, 290–296 (2011)

    Article  PubMed  CAS  Google Scholar 

  8. L. García-Pascual, M. Balsells, M. Fabbi, C.D. Pozo, M.T. Valverde, J. Casalots, J.M. González-González, E. Veloso, J. Anglada-Barceló, Prognostic factors and follow-up of patients with differentiated thyroid carcinoma with false negative or nondiagnostic FNAC before surgery. Comparison with a control group. Endocrine 40, 423–431 (2011)

    Article  PubMed  Google Scholar 

  9. F. Pacini, L. Fugazzola, F. Lippi, C. Ceccarelli, R. Centoni, P. Miccoli, R. Elisei, A. Pinchera, 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 (1992)

    Article  PubMed  CAS  Google Scholar 

  10. H.J. Baskin, Detection of recurrent papillary thyroid carcinoma by thyroglobulin assessment in the needle washout after fine-needle aspiration of suspicious lymph nodes. Thyroid 14, 959–963 (2004)

    Article  PubMed  Google Scholar 

  11. S.J. Jeon, E. Kim, J.S. Park, K.R. Son, J.H. Baek, Y.S. Kim, J. Park do, B.Y. Cho, D.G. Na, Diagnostic benefit of thyroglobulin measurement in fine-needle aspiration for diagnosing metastatic cervical lymph nodes from papillary thyroid cancer: correlations with US features. Korean J. Radiol. 10, 106–111 (2009)

    Article  PubMed  Google Scholar 

  12. T. Uruno, A. Miyauchi, K. Shimizu, C. Tomoda, Y. Takamura, Y. Ito, A. Miya, K. Kobayashi, F. Matsuzuka, N. Amino, K. Kuma, Usefulness of thyroglobulin measurement in fine-needle aspiration biopsy specimens for diagnosing cervical lymph node metastasis in patients with papillary thyroid cancer. World J. Surg. 29, 483–485 (2005)

    Article  PubMed  Google Scholar 

  13. F. Boi, G. Baghino, F. Atzeni, M.L. Lai, G. Faa, S. Mariotti, 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 (2006)

    Article  PubMed  CAS  Google Scholar 

  14. E. Sigstad, A. Heilo, E. Paus, K. Holgersen, K.K. Grøholt, L.H. Jørgensen, T.V. Bogsrud, A. Berner, T. Bjøro, The usefulness of detecting thyroglobulin in fine-needle aspirates from patients with neck lesions using a sensitive thyroglobulin assay. Diagn. Cytopathol. 35, 761–767 (2007)

    Article  PubMed  CAS  Google Scholar 

  15. M.J. Kim, E.K. Kim, B.M. Kim, J.Y. Kwak, E.J. Lee, C.S. Park, W.Y. Cheong, K.H. Nam, Thyroglobulin measurement in fine-needle aspirate washouts: the criteria for neck node dissection for patients with thyroid cancer. Clin. Endocrinol. (Oxf.) 70, 145–151 (2009)

    Article  CAS  Google Scholar 

  16. C. Bournaud, A. Charrié, C. Nozières, K. Chikh, V. Lapras, M.L. Denier, C. Paulin, M. Decaussin-Petrucci, J.L. Peix, J.C. Lifante, C. Cornu, C. Giraud, J. Orgiazzi, F. Borson-Chazot, Thyroglobulin measurement in fine-needle aspirates of lymph nodes in patients with differentiated thyroid cancer: a simple definition of the threshold value, with emphasis on potential pitfalls of the method. Clin. Chem. Lab. Med. 48, 1171–1177 (2010)

    Article  PubMed  CAS  Google Scholar 

  17. G. Costante, S. Filetti, Diagnosis: thyroglobulin in fine-needle aspirates-a clue to metastasis? Nat. Rev. Endocrinol. 5, 249–250 (2009)

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgement

This study was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (MEST) (No. 2011-0018362).

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, 344-2 Shinyong-Dong, Iksan, Jeollabuk-do, 570-711, Republic of Korea

    Dae-Weung Kim & Chang Guhn Kim

  2. Department of Radiology, Wonkwang University School of Medicine, Iksan, Jeollabuk-do, Republic of Korea

    Se Jeong Jeon

Authors
  1. Dae-Weung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Se Jeong Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chang Guhn Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chang Guhn Kim.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kim, DW., Jeon, S.J. & Kim, C.G. Usefulness of thyroglobulin measurement in needle washouts of fine-needle aspiration biopsy for the diagnosis of cervical lymph node metastases from papillary thyroid cancer before thyroidectomy. Endocrine 42, 399–403 (2012). https://doi.org/10.1007/s12020-012-9636-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-012-9636-9

Keywords

Search

Navigation