Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 14, 2022; 10(2): 492-501
Published online Jan 14, 2022. doi: 10.12998/wjcc.v10.i2.492
Value of thyroglobulin combined with ultrasound-guided fine-needle aspiration cytology for diagnosis of lymph node metastasis of thyroid carcinoma
Liu-Yang Zhang, Yong Chen, Ya-Zhou Ao
Liu-Yang Zhang, Yong Chen, Ya-Zhou Ao, Department of Thyroid Surgery, Affiliated Hospital of Chengde Medical University, Chengde 067000, Hebei Province, China
Author contributions: Zhang LY and Chen Y designed the research study; Zhang LY and Ao YZ performed the research, analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Supported by The Research and Development Project of Science and Technology of Chengde City, No. 201706A046.
Institutional review board statement: The study was reviewed and approved by the Affiliated Hospital of Chengde Medical College Institutional Review Board.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yong Chen, BM BCh, Chief Physician, Department of Thyroid Surgery, Affiliated Hospital of Chengde Medical University, No. 36 Nanyingzi Street, Shuangqiao District, Chengde 067000, Hebei Province, China. chenyong2021@yeah.net
Received: September 16, 2021
Peer-review started: September 16, 2021
First decision: October 18, 2021
Revised: October 19, 2021
Accepted: December 3, 2021
Article in press: December 3, 2021
Published online: January 14, 2022
Abstract
BACKGROUND

Surgery for thyroid carcinoma offers a good prognosis; however, cervical lymph node metastasis may occur in the early stage. An effective diagnostic method can accurately guide clinical surgical planning and the scope of lymph node dissection, ultimately improving patient prognosis.

AIM

To explore the diagnostic value of fine-needle aspiration of thyroglobulin (FNA-Tg) combined with ultrasound (US)-guided fine-needle aspiration cytology for cervical lymph node metastasis in thyroid carcinoma.

METHODS

We enrolled 209 pathologically confirmed thyroid carcinoma patients who visited our hospital between Jan 2017 and Dec 2020. Patients were tentatively diagnosed with cervical lymph node enlargement using preoperative US. They underwent US-guided fine-needle aspiration cytology and FNA-Tg. The value of single and combined application of the two methods for the diagnosis of cervical lymph node metastasis was calculated. The factors affecting FNA-Tg for diagnosis were analyzed using univariate and multivariate methods.

RESULTS

FNA-Tg values were significantly higher among patients with positive cervical lymph node metastasis. The sensitivity and specificity of US-guided fine-needle aspiration cytology, FNA-Tg, and US-guided fine-needle aspiration cytology + FNA-Tg were 85.48% and 90.59%, 83.06% and 87.06%, and 96.77% and 91.76%, respectively. The area under the receiver operating characteristic curve for US-guided fine-needle aspiration cytology, FNA-Tg, and the two combined, was 0.880, 0.851, and 0.943, respectively. A long diameter/short diameter ratio < 2, an insufficient number of acquired cells, a low serum thyroglobulin level, and an absence of typical metastatic US features increased the risk of cervical lymph node metastasis in thyroid carcinoma patients misdiagnosed using FNA-Tg.

CONCLUSION

The diagnostic value of FNA-Tg for detecting cervical lymph node metastasis is not high; however, combined with US-guided fine-needle aspiration cytology, it is significantly improved.

Keywords: Thyroid carcinoma, Ultrasonic guidance, Fine-needle aspiration cytology, Lymph node puncture, Thyroglobulin, Diagnosis

Core Tip: Fine-needle aspiration of thyroglobulin (FNA-Tg) has relatively high diagnostic value in lymph node metastasis and recurrence of differentiated thyroid carcinoma. FNA-Tg combined with ultrasonic-guided fine-needle aspiration cytology has a certain meaning in the thyroid carcinoma with lymph node metastasis.