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

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

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 TgAbC 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.

CYTOLOGICAL research; THYROGLOBULIN; LYMPHADENECTOMY; THYROID cancer; ULTRASONIC imaging; CANCER risk factors

European Journal of Endocrinology, 2015, Vol 173, Issue 4, p489

0804-4643

Academic Journal

10.1530/EJE-15-0344