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

被引:43
作者
Bournaud, Claire [2 ]
Charrie, Anne [1 ]
Nozieres, Cecile [2 ]
Chikh, Karim [1 ]
Lapras, Veronique [3 ]
Denier, Marie-Laure [4 ]
Paulin, Christian [5 ]
Decaussin-Petrucci, Myriam [5 ]
Peix, Jean-Louis [6 ]
Lifante, Jean-Christophe [6 ]
Cornu, Catherine [7 ,8 ,9 ]
Giraud, Celine [7 ]
Orgiazzi, Jacques [10 ]
Borson-Chazot, Francoise [2 ]
机构
[1] Ctr Hosp Lyon Sud, Ctr Biol, Hosp Civils Lyon, Dept Biol, F-69495 Pierre Benite, France
[2] Grpment Hosp Est, Nucl Med Serv, Hosp Civils Lyon, Lyon, France
[3] Hop Hotel Dieu, Serv Radiol, Hosp Civils Lyon, F-69288 Lyon, France
[4] Ctr Hosp Lyon Sud, Serv Radiol, Hosp Civils Lyon, F-69495 Pierre Benite, France
[5] Ctr Hosp Lyon Sud, Dept Anat Pathol, Hosp Civils Lyon, F-69495 Pierre Benite, France
[6] Ctr Hosp Lyon Sud, Serv Chirurg Gen, Hosp Civils Lyon, F-69495 Pierre Benite, France
[7] INSERM, CIC201, F-69008 Lyon, France
[8] CHU Lyon, Serv Pharmacol Clin, Lyon, France
[9] Univ Lyon, UMR 5558, Lyon, France
[10] Ctr Hosp Lyon Sud, Serv Endocrinol, Hosp Civils Lyon, F-69495 Pierre Benite, France
关键词
fine-needle aspiration; lymph node; thyroglobulin; thyroid cancer; CARCINOMA; DIAGNOSIS; PAPILLARY; ULTRASOUND; BIOPSY; MANAGEMENT; GUIDELINES; DISSECTION; CRITERIA; WASHOUT;
D O I
10.1515/CCLM.2010.220
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Background: Thyroglobulin measurements in fine-needle aspirate (FNA-Tg) is an accurate method for the diagnosis of lymph node metastasis in differentiated thyroid carcinoma. The goal of this study is to determine the most appropriate diagnostic threshold value for FNA-Tg. Methods: Ultrasound-guided fine-needle aspiration-cytology (FNA-C) and FNA-Tg were performed on suspicious lymph nodes in 114 consecutive patients with thyroid cancer prior to thyroidectomy (n = 13) or during follow-up (n = 93), and in 16 control subjects. Functional sensitivity of the thyroglobulin assay was 0.7 ng/mL. Sensitivity and specificity of FNA-Tg and FNA-C were determined for different cut-off values within a range of 0.69-1.34 nanogram/punction (ng/p) using receiver operating characteristic curve analysis. Results: The FNA-Tg cut-off value of 0.93 ng/p offers the best diagnostic performances: 94.2% sensitivity, 97.8% specificity. FNA-C showed 100% specificity in diagnostic samples, but low sensitivity of 71% due primarily to inadequate samples. Combining FNA-C and FNA-Tg resulted in 98% sensitivity and 100% specificity. Conclusions: A unique threshold of 0.93 ng/p gives high sensitivity and specificity, even in non-thyroidectomized patients. However, since false negative results may be observed in poorly differentiated thyroid cancer, FNA-C should remain combined to FNA-Tg. Clin Chem Lab Med 2010;48:1171-7.
引用
收藏
页码:1171 / 1177
页数:7
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