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Original paper
Submitted: 2021-05-03
Accepted: 2021-07-16
Published online: 2021-08-16
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Thyroglobulin measurements in washouts of fine-needle aspiration biopsy in monitoring the patients with differentiated thyroid carcinoma - analysis of non-compliance results.

Elwira Bakuła-Zalewska1, Agnieszka Żyłka2, Joanna Długosińska2, Emilia Musiał2, Jacek Gałczyński2, Marek Dedecjus2
DOI: 10.5603/EP.a2021.0077
·
Pubmed: 34647603
Affiliations
  1. Department of Pathology, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
  2. Department of Endocrine Oncology and Nuclear Medicine, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland

open access

Ahead of print
Original Paper
Submitted: 2021-05-03
Accepted: 2021-07-16
Published online: 2021-08-16

Abstract

Introduction: Approximately 35% patients with papillary thyroid carcinoma (PTC) and 13% with follicular thyroid carcinoma (FTC), present with cervical lymph nodes (LNs) metastases at the time of diagnosis. In addition, 15-20% of patients treated with total thyroidectomy develop, after an interval of five years, metastases to the neck LNs on ultrasound examination. Fine-needle aspiration biopsy (FNAB) represents the gold standard technique for the detection of cervical LNs metastases. However, the aspiration of small and cystic LNs metastases occasionally yields a sparse and suboptimal specimen. The aim of the study was to evaluate the diagnostic performance of the technique of thyroglobulin (Tg) measurement of the washout FNAB (FNAB-Tg) and the clinical outcome of discrepant results between FNAB-Tg and final histopathologic diagnosis. Material and Methods: Two hundred FNAB-Tg samples from 200 patients (158 women; 42 men; age 51.37 ± 16.77 [53]) diagnosed with DTC were examined for the assessment of the diagnostic utility of FNAB-Tg from suspicious LNs. FNAB-Tg ranged from 1.96 to 5000 ng/mL in metastatic LNs (mean; 1510 ± 1486 ng/mL [958.5]) and from 0.04 to 635.9 ng/mL in nonmetastatic LNs (mean; 57.86 ± 319.19 ng/mL [1.96], p < 0.001. Results: The most accurate diagnostic performance was displayed for concentration of 33.28 ng/mL in FNAB-Tg with AUC of 0.91 and high sensitivity and specifity (0.92 and 0.93). FNAB-Tg in conjunction to the cythopatologic examination of suspicious LNs in differentiated thyroid carcinoma (DTC) patients increases the diagnostic accuracy of FNAB (sensitivity 0.99; specificity 0.99; AUC 1.00). Conclusions: FNAB-Tg may be particularly useful in detecting of cystic metastases earlier characterized as indeterminate upon cythopatologic examination, and in differential diagnosis of various LNs metastasizing malignancies. FNAB-Tg measurement has high specificity and sensitivity in the detection of LNs metastases of DTC.

Abstract

Introduction: Approximately 35% patients with papillary thyroid carcinoma (PTC) and 13% with follicular thyroid carcinoma (FTC), present with cervical lymph nodes (LNs) metastases at the time of diagnosis. In addition, 15-20% of patients treated with total thyroidectomy develop, after an interval of five years, metastases to the neck LNs on ultrasound examination. Fine-needle aspiration biopsy (FNAB) represents the gold standard technique for the detection of cervical LNs metastases. However, the aspiration of small and cystic LNs metastases occasionally yields a sparse and suboptimal specimen. The aim of the study was to evaluate the diagnostic performance of the technique of thyroglobulin (Tg) measurement of the washout FNAB (FNAB-Tg) and the clinical outcome of discrepant results between FNAB-Tg and final histopathologic diagnosis. Material and Methods: Two hundred FNAB-Tg samples from 200 patients (158 women; 42 men; age 51.37 ± 16.77 [53]) diagnosed with DTC were examined for the assessment of the diagnostic utility of FNAB-Tg from suspicious LNs. FNAB-Tg ranged from 1.96 to 5000 ng/mL in metastatic LNs (mean; 1510 ± 1486 ng/mL [958.5]) and from 0.04 to 635.9 ng/mL in nonmetastatic LNs (mean; 57.86 ± 319.19 ng/mL [1.96], p < 0.001. Results: The most accurate diagnostic performance was displayed for concentration of 33.28 ng/mL in FNAB-Tg with AUC of 0.91 and high sensitivity and specifity (0.92 and 0.93). FNAB-Tg in conjunction to the cythopatologic examination of suspicious LNs in differentiated thyroid carcinoma (DTC) patients increases the diagnostic accuracy of FNAB (sensitivity 0.99; specificity 0.99; AUC 1.00). Conclusions: FNAB-Tg may be particularly useful in detecting of cystic metastases earlier characterized as indeterminate upon cythopatologic examination, and in differential diagnosis of various LNs metastasizing malignancies. FNAB-Tg measurement has high specificity and sensitivity in the detection of LNs metastases of DTC.

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Keywords

thyroid carcinoma, thyroglobulin, fine-needle aspiration biopsy, lymph node metastasis, washout of the needle

About this article
Title

Thyroglobulin measurements in washouts of fine-needle aspiration biopsy in monitoring the patients with differentiated thyroid carcinoma - analysis of non-compliance results.

Journal

Endokrynologia Polska

Issue

Ahead of print

Article type

Original paper

Published online

2021-08-16

DOI

10.5603/EP.a2021.0077

Pubmed

34647603

Keywords

thyroid carcinoma
thyroglobulin
fine-needle aspiration biopsy
lymph node metastasis
washout of the needle

Authors

Elwira Bakuła-Zalewska
Agnieszka Żyłka
Joanna Długosińska
Emilia Musiał
Jacek Gałczyński
Marek Dedecjus

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