Lowered cutoff of lymph node fine-needle aspiration thyroglobulin in thyroid cancer patients with serum anti-thyroglobulin antibody.

Abstract

OBJECTIVE:

Fine needle aspiration cytology (FNAC) and measurement of thyroglobulin (Tg) in needle washout (FNA-Tg) are recommended for the diagnosis of metastatic or recurrent lymph nodes (LNs) in differentiated thyroid cancer (DTC). However, the effect of serum Tg antibody (TgAb) on FNA-Tg levels still remains unclear in the preoperative setting. We analyze the interference of serum TgAb on FNA-Tg levels as proof of concept in the diagnostic advantage of serum TgAb combined with FNA-Tg.

SUBJECTS AND METHODS:

A total of 370 suspicious cervical LNs from 273 patients with DTC were included. The primary tumor was confirmed as DTC on preoperative pathology in all patients. We performed FNA-Tg measurement and FNAC on suspicious LNs and evaluated the diagnostic performance of FNAC and FNA-Tg according to TgAb status. Final diagnoses were confirmed by histological examination of excised specimens or by follow-up ultrasonography for at least 6 months.

RESULTS:

Data from 273 subjects with suspicious 370 LNs were evaluated. Fifty-five LNs (14.9%) were from TgAb+ positive serum TgAb (TgAb+) patients. Serum Tg and FNA-Tg levels were significantly lower in patients with TgAb+ than in those with TgAb-negative (TgAb-). Final pathology confirmed 109 LNs (29.5%) as malignant. Diagnostic performance of FNA-Tg at the same cutoff level was lower in the TgAb+ than TgAb- group. FNA-Tg cutoff levels determined by ROC curve were lower in the TgAb+ group.

CONCLUSION:

The results suggested that the cutoff value of FNA-Tg should be lowered in suspicious LN before thyroidectomy in thyroid cancer patients with TgAb.

• Authors: Kwanhoon Jo, Min-Hee Kim, Yejee Lim, So-Lyung Jung, Ja-Seong Bae, Chan-Kwon Jung, Moo-Il Kang, Bong-Yun Cha, Dong-Jun Lim
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 173 Issue 4 Pg. 489-97 (Oct 2015) ISSN: 1479-683X [Electronic] England
• PMID: 26208979 (Publication Type: Journal Article)
• Copyright: © 2015 European Society of Endocrinology.

Chemical References

• Autoantibodies
• anti-thyroglobulin
• Thyroglobulin

Topics

• Adult
• Aged
• Aged, 80 and over
• Autoantibodies (blood)
• Biopsy, Fine-Needle
• Carcinoma (diagnosis, metabolism, pathology)
• Carcinoma, Papillary
• Female
• Humans
• Lymph Nodes (metabolism, pathology)
• Lymphatic Metastasis
• Male
• Middle Aged
• Neck
• Neoplasm Recurrence, Local (diagnosis, metabolism, pathology)
• Reference Values
• Sensitivity and Specificity
• Thyroglobulin (metabolism)
• Thyroid Cancer, Papillary
• Thyroid Neoplasms (diagnosis, metabolism, pathology)
• Thyroidectomy
• Young Adult